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 9780128127223, 4224224224, 4664664664, 5445445445, 0128127228

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Essentials of Chinese Materia Medica and Medical Formulas

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Essentials of Chinese Materia Medica and Medical Formulas New Century Traditional Chinese Medicine

Shengyan Xi Yuewen Gong

Academic Press is an imprint of Elsevier 125 London Wall, London EC2Y 5AS, United Kingdom 525 B Street, Suite 1800, San Diego, CA 92101-4495, United States 50 Hampshire Street, 5th Floor, Cambridge, MA 02139, United States The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, United Kingdom Copyright © 2017 Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library ISBN: 978-0-12-812722-3 For information on all Academic Press publications visit our website at https://www.elsevier.com/books-and-journals

Publisher: Mica Haley Acquisition Editor: Kristine Jones Editorial Project Manager: Joslyn Chaiprasert-Paguio Production Project Manager: Lucía Pérez Designer: Christian Bilbow Typeset by Thomson Digital

Contents Contributors xi Introduction to Compiler-in-Chief xiii Foreword xvii Preface xix Acknowledgments xxi Compendium xxiii

 3. Herbs That Drain Downward

Part I Chinese Materia Medica Introduction to Chinese Materia Medica Habitat and Collection of Chinese Medicinals Chinese Medicinal Processing Properties and Actions of Chinese Medicinals Efficacy and Indications of Chinese Medicinals Application of Chinese Medicinals

Section 4  Herbs That Clear Heat and Cool the Blood 80 Outline 80 Specific Application Knowledge of Herbs 80 Section 5  Herbs That Clear Heat From Deficiency 85 Outline 85 Specific Application Knowledge of Herbs 85

1 1 2 4 8 8

  1. Herbs That Release the Exterior Section 1  Herbs That Dispel Wind-Cold 14 Outline 14 Specific Application Knowledge of Herbs 14 Section 2  Herbs That Dispel Wind-Heat 24 Outline 24 Specific Application Knowledge of Herbs 25

 2. Herbs That Clear Heat Section 1  Herbs That Clear Heat and Drain Fire 36 Outline 36 Specific Application Knowledge of Herbs 36 Section 2  Herbs That Clear Heat and Dry Dampness 45 Outline 45 Specific Application Knowledge of Herbs 45 Section 3  Herbs That Clear Heat and Resolve Toxins 52 Outline 52 Specific Application Knowledge of Herbs 52

Section 1  Herbs That Promote Defecation by Purgation 90 Outline 90 Specific Application Knowledge of Herbs 90 Section 2  Herbs That Promote Defecation by Moistening Purgation 93 Outline 93 Specific Application Knowledge of Herbs 93 Section 3  Herbs That Expel Water by Drastic Purgation 95 Outline 95 Specific Application Knowledge of Herbs 95

 4. Herbs That Expel Wind and Damp Section 1  Herbs That Expel Wind-Cold-Damp 104 Outline 104 Specific Application Knowledge of Herbs 104 Section 2  Herbs That Expel Wind-Damp-Heat 116 Outline 116 Specific Application Knowledge of Herbs 116 Section 3  Herbs That Expel Wind-Damp and Strengthen the Sinew and Bone 123 Outline 123 Specific Application Knowledge of Herbs 123

 5. Herbs That Transform Dampness Specific Application Knowledge of Herbs

130

v

vi Contents

  6. Herbs That Promote Urination and Percolate Dampness Section 1  Herbs That Promote Urination to Relieve Edema 138 Outline 138 Specific Application Knowledge of Herbs 138 Section 2  Herbs That Promote Urination and Relieve Strangury 145 Outline 145 Specific Application Knowledge of Herbs 145 Section 3  Herbs That Clear Damp-Heat and Relieve Jaundice 152 Outline 152 Specific Application Knowledge of Herbs 152

 7. Herbs That Warm the Interior Specific Application Knowledge of Herbs

160

  8. Herbs That Rectify Qi Specific Application Knowledge of Herbs

170

 9. Herbs That Promote Digestion Specific Application Knowledge of Herbs

188

10. Herbs That Expel Parasites Specific Application Knowledge of Herbs

198

Outline 228 Specific Application Knowledge of Herbs 229 Section 2  Herbs That Invigorate Blood and Regulate Menstruation 236 Outline 236 Specific Application Knowledge of Herbs 236 Section 3  Herbs That Invigorate Blood and Cure Injury 246 Outline 246 Specific Application Knowledge of Herbs 246 Section 4  Herbs That Break up Blood Stasis and Resolve Masses 251 Outline 251 Specific Application Knowledge of Herbs 252

13. Herbs That Dissolve Phlegm, Relieve Cough, and Calm Panting Section 1  Herbs That Warm and Dissolve Cold-phlegm 258 Outline 258 Specific Application Knowledge of Herbs 258 Section 2  Herbs That Clear and Dissolve Hot Phlegm 266 Outline 266 Specific Application Knowledge of Herbs 266 Section 3  Herbs That Relieve Cough and Calm Panting 281 Outline 281 Specific Application Knowledge of Herbs 281

11. Herbs That Stanch Bleeding Section 1  Herbs That Cool the Blood and Stanch Bleeding 206 Outline 206 Specific Application Knowledge of Herbs 207 Section 2  Herbs That Dissolve Stasis and Stanch Bleeding 212 Outline 212 Specific Application Knowledge of Herbs 213 Section 3  Herbs That Astringe and Stanch Bleeding 218 Outline 218 Specific Application Knowledge of Herbs 218 Section 4  Herbs That Warm the Channels and Stanch Bleeding 224 Outline 224 Specific Application Knowledge of Herbs 224

12. Herbs That Invigorate Blood and Dissolve Stasis Section 1  Herbs That Invigorate Blood and Relieve Pain

228

14. Herbs That Calm the Mind Section 1  Herbs That Strongly Calm the Mind With Minerals and Shells 294 Outline 294 Specific Application Knowledge of Herbs 294 Section 2  Herbs That Nourish the Heart and Mildly Calm the Mind 298 Outline 298 Specific Application Knowledge of Herbs 298

15. Herbs That Calm the Liver and Extinguish Wind Section 1  Herbs That Calm the Liver and Subdue Hyperactive Yang 306 Outline 306 Specific Application Knowledge of Herbs 306 Section 2  Herbs That Extinguish Wind and Arrest Convulsion 312 Outline 312 Specific Application Knowledge of Herbs 313

Contents

16. Herbs That Open the Orifices Specific Application Knowledge of Herbs

22. Formulas That Release the Exterior 322

17. Herbs That Supplement Deficiency Section 1  Herbs That Supplement Qi 329 Outline 329 Specific Application Knowledge of Herbs 329 Section 2  Herbs That Supplement Yang 343 Outline 343 Specific Application Knowledge of Herbs 343 Section 3  Herbs That Supplement the Blood 360 Outline 360 Specific Application Knowledge of Herbs 360 Section 4  Herbs That Supplement Yin 366 Outline 366 Specific Application Knowledge of Herbs 367

18. Herbs That Astringe Section 1  Herbs That Consolidate the Exterior and Arrest Sweating 382 Outline 382 Specific Application Knowledge of Herbs 382 Section 2  Herbs That Astringe the Lung and Intestines 384 Outline 384 Specific Application Knowledge of Herbs 385 Section 3  Herbs That Consolidate Essence, Reduce Urination, and Arrest Vaginal Discharge 389 Outline 389 Specific Application Knowledge of Herbs 390

19. Herbs That Induce Vomit Specific Application Knowledge of Herbs

398

20. Herbs That Counteract Toxins, Kill Parasites, and Relieve Itching Specific Application Knowledge of Herbs

401

21. Herbs That Draw Out Toxins, Remove Putridity, and Engender Flesh Specific Application Knowledge of Herbs

411

Part II Chinese Medical Formulas Introduction to Chinese Medical Formulas Formula and Therapeutic Methods Formula Classification and Preparation Formula Decocting and Administration Methods Principles of Composing Formula

vii

417 417 418 418 419

Section 1  Formulas That Release the Exterior With Acrid-warm Medicinals 422 Outline 422 Specific Application Knowledge of Formulas 422 Section 2  Formulas That Release the Exterior With Acrid-cool Medicinals 429 Outline 429 Specific Application Knowledge of Formulas 430 Section 3  Formulas That Reinforce Healthy Qi and Release the Exterior 438 Outline 438 Specific Application Knowledge of Formulas 439

23. Formulas That Treat the Interior Excess Syndrome With Purgation Section 1  Formulas That Treat the Interior Excess Syndrome With Cold Purgation 448 Outline 448 Specific Application Knowledge of Formulas 448 Section 2  Formulas That Treat the Interior Excess Syndrome With Warm Purgation 451 Outline 451 Specific Application Knowledge of Formulas 452 Section 3  Formulas That Treat the Interior Excess Syndrome With Moistening Purgation 454 Outline 454 Specific Application Knowledge of Formulas 454 Section 4  Formulas That Expel Water by Purgation 457 Outline 457 Specific Application Knowledge of Formulas 458 Section 5  Formulas That Purge Pathogen and Supplement Healthy Qi 461 Outline 461 Specific Application Knowledge of Formulas 461

24. Formulas That Harmonize Section 1  Formulas That Harmonize Shaoyang 466 Outline 466 Specific Application Knowledge of Formulas 466 Section 2  Formulas That Regulate and Harmonize the Liver and Spleen 471 Outline 471 Specific Application Knowledge of Formulas 472 Section 3  Formulas That Regulate and Harmonize the Intestine and Stomach 476 Outline 476 Specific Application Knowledge of Formulas 477

viii Contents

25. Formulas That Clear the Heat Section 1  Formulas That Clear Heat in Qi Aspect 482 Outline 482 Specific Application Knowledge of Formulas 482 Section 2  Formulas That Clear Heat in Nutrient Aspect and Cool the Blood 486 Outline 486 Specific Application Knowledge of Formulas 486 Section 3  Formulas That Clear Heat and Resolve Toxins 490 Outline 490 Specific Application Knowledge of Formulas 490 Section 4  Formulas That Clear Heat in Both Qi and Blood Aspects 497 Outline 497 Specific Application Knowledge of Formulas 497 Section 5  Formulas That Clear Zang-Fu Heat 500 Outline 500 Specific Application Knowledge of Formulas 500 Section 6  Formulas That Clear Deficiency-Heat 511 Outline 511 Specific Application Knowledge of Formulas 511

26. Formulas That Dispel Summer Heat Section 1  Formulas That Clear Summer Heat and Release the Exterior 518 Outline 518 Specific Application Knowledge of Formulas 518 Section 2  Formulas That Clear Summer Heat and Drain Dampness 520 Outline 520 Specific Application Knowledge of Formulas 520 Section 3  Formulas That Dispel Summer Heat and Clear Heat 522 Outline 522 Specific Application Knowledge of Formulas 522 Section 4  Formulas That Clear Summer Heat and Boost Qi 524 Outline 524 Specific Application Knowledge of Formulas 524

27. Formulas That Warm the Interior Section 1  Formulas That Warm the Center and Dispel Cold 528 Outline 528 Specific Application Knowledge of Formulas 528 Section 2  Formulas That Restore Yang to Rescue From Counterflow (Desertion) 534 Outline 534 Specific Application Knowledge of Formulas 534

Section 3  Formulas That Warm the Channels and Dissipate Cold 539 Outline 539 Specific Application Knowledge of Formulas 539

28. Formulas That Release Pathogens From Both the Exterior and Interior Section 1  Formulas That Release the Exterior and Clear the Interior 544 Outline 544 Specific Application Knowledge of Formulas 544 Section 2  Formulas That Release the Exterior and Warm the Interior 547 Outline 547 Specific Application Knowledge of Formulas 548 Section 3  Formulas That Release the Exterior and Attack the Interior 549 Outline 549 Specific Application Knowledge of Formulas 550

29. Formulas That Supplement and Boost Section 1  Formulas That Supplement Qi 556 Outline 556 Specific Application Knowledge of Formulas 557 Section 2  Formulas That Supplement the Blood 567 Outline 567 Specific Application Knowledge of Formulas 568 Section 3  Formulas That Supplement Both Qi and Blood 574 Outline 574 Specific Application Knowledge of Formulas 574 Section 4  Formulas That Supplement Yin 582 Outline 582 Specific Application Knowledge of Formulas 582 Section 5  Formulas That Supplement Yang 598 Outline 598 Specific Application Knowledge of Formulas 598 Section 6  Formulas That Supplement Both Yin and Yang 606 Outline 606 Specific Application Knowledge of Formulas 606 Section 7  Formulas That Concurrently Supplement Qi, Blood, Yin and Yang 611 Outline 611 Specific Application Knowledge of Formulas 611

30. Formulas That Consolidate and Astringe Section 1  Formulas That Consolidate the Exterior and Arrest Sweating 616 Outline 616 Specific Application Knowledge of Formulas 616

Contents

Section 2  Formulas That Astringe the Lung and Relieve Cough 618 Outline 618 Specific Application Knowledge of Formulas 618 Section 3  Formulas That Astringe the Intestines From Desertion 620 Outline 620 Specific Application Knowledge of Formulas 620 Section 4  Formulas That Arrest Enuresis and Emission With Astringents 623 Outline 623 Specific Application Knowledge of Formulas 624 Section 5  Formulas That Stop Profuse Uterine Bleeding and Arrest Vaginal Discharge 628 Outline 628 Specific Application Knowledge of Formulas 628

31. Formulas That Calm the Mind Section 1  Formulas That Calm the Mind With Heavy Sedatives 634 Outline 634 Specific Application Knowledge of Formulas 634 Section 2  Formulas That Nourish the Heart and Calm the Mind 638 Outline 638 Specific Application Knowledge of Formulas 638 Section 3  Formulas That Restore Interaction Between the Heart and the Kidney 643 Outline 643 Specific Application Knowledge of Formulas 644

32. Formulas That Open the Orifices Section 1  Formulas That Open the Orifices (Resuscitate) With Cool Medicinals 648 Outline 648 Specific Application Knowledge of Formulas 648 Section 2  Formulas That Open the Orifices (Resuscitate) With Warm Medicinals 654 Outline 654 Specific Application Knowledge of Formulas 654

33. Formulas That Rectify Qi Section 1  Formulas That Move Qi 660 Outline 660 Specific Application Knowledge of Formulas 660 Section 2  Formulas That Direct Qi Downward 674 Outline 674 Specific Application Knowledge of Formulas 674

ix

34. Formulas That Rectify Blood Section 1  Formulas That Invigorate Blood and Dispel Stasis 682 Outline 682 Specific Application Knowledge of Formulas 682 Section 2  Formulas That Stanch Bleeding 702 Outline 702 Specific Application Knowledge of Formulas 702

35. Formulas That Expel and Calm the Wind Section 1  Formulas That Scatter and Dissipate External Wind 712 Outline 712 Specific Application Knowledge of Formulas 712 Section 2  Formulas That Calm and Extinguish Internal Wind 722 Outline 722 Specific Application Knowledge of Formulas 722

36. Formulas That Treat Dryness Syndrome Section 1  Formulas That Relieve External Dryness by Light Diffusion 732 Outline 732 Specific Application Knowledge of Formulas 733 Section 2  Formulas That Nourish and Moisten Internal Dryness 736 Outline 736 Specific Application Knowledge of Formulas 736

37. Formulas That Dispel Dampness Section 1  Formulas That Remove Dampness and Harmonize the Stomach 742 Outline 742 Specific Application Knowledge of Formulas 742 Section 2  Formulas That Clear Heat and Dispel Dampness 747 Outline 747 Specific Application Knowledge of Formulas 748 Section 3  Formulas That Promote Urination and Percolate Dampness 761 Outline 761 Specific Application Knowledge of Formulas 762 Section 4  Formulas That Warm and Dissolve Water-Dampness 768 Outline 768 Specific Application Knowledge of Formulas 769 Section 5  Formulas That Dispel Wind and Overcome Dampness 775 Outline 775 Specific Application Knowledge of Formulas 775

x Contents

38. Formulas That Dispel Phlegm

42. Formulas That Treat Abscess and Ulcer

Section 1  Formulas That Dry Dampness and Dissolve Phlegm 782 Outline 782 Specific Application Knowledge of Formulas 782 Section 2  Formulas That Clear Heat and Dissolve Phlegm 790 Outline 790 Specific Application Knowledge of Formulas 790 Section 3  Formulas That Moisten Dryness and Dissolve Phlegm 796 Outline 796 Specific Application Knowledge of Formulas 796 Section 4  Formulas That Warm and Dissolve Cold-phlegm 799 Outline 799 Specific Application Knowledge of Formulas 799 Section 5  Formulas That Expel or Calm the Wind and Dissolve Phlegm 802 Outline 802 Specific Application Knowledge of Formulas 802

39. Formulas That Remove Food Stagnation and Accumulation Section 1  Formulas That Promote Digestion and Guide Out [Food] Stagnation 810 Outline 810 Specific Application Knowledge of Formulas 810 Section 2  Formulas That Resolve Masses and Remove Accumulation 818 Outline 818 Specific Application Knowledge of Formulas 818

40. Formulas That Expel Parasites Specific Application Knowledge of Formulas

825

41. Formulas That Induce Vomit Specific Application Knowledge of Formulas

834

Section 1  Formulas That Dissipate Masses and Resolve Abscess 838 Outline 838 Specific Application Knowledge of Formulas 839 Section 2  Formulas That Strengthen Vital Qi and Drain Pus 850 Outline 850 Specific Application Knowledge of Formulas 851 Section 3  Formulas That Supplement Deficiency and Close Sore 853 Outline 853 Specific Application Knowledge of Formulas 854

43. Attached Formulas That are Used Externally Specific Application Knowledge of Formulas

860

Appendix 1  Introduction to Medicinal Selection for Common Diseases and Syndromes 875 Appendix 2  Introduction to Well-Known Literatures About Chinese Medicinal and Formula 903 Appendix 3  Introduction to Intricate TCM Terminologies of Diseases and Syndromes 925 References 929 Pharmaceutical-Pinyin Names Reference of Chinese Materia Medica English-Pinyin Cross Reference of Chinese Materia Medica Names English-Pinyin Cross Reference of Chinese Medical Formula Names Pinyin-English Cross Reference of Chinese Materia Medica Names Pinyin-English Cross Reference of Chinese Medical Formula Names Subject Index

931 943 955 965 977 987

Contributors Compiler-in-Chief Shengyan Xi Medical College of the Xiamen University, Xiamen, China

Yuewen Gong College of Pharmacy of the University of Manitoba, Winnipeg, MB, Canada

Associate Compiler-in-Chief Xueqiang Jiang Dongfeng Hospital of the Hubei University of Medicine, Shiyan, China

Hui Zhao School of Traditional Chinese Medicine of the Capital Medical University, Beijing, China

Lifeng Yue Dongzhimen Hospital of the Beijing University of Chinese Medicine, Beijing, China

Yanzhu Hong Medical College of the Xiamen University, Xiamen, China

Xuezeng Hao Dongzhimen Hospital of the Beijing University of Chinese Medicine, Beijing, China

Yifei Li School of Medicine of the Tongji University, Shanghai, China

Compiler (listed in the order of letter of their given names) Biqian Fu Medical College of the Xiamen University, Xiamen, China Dejian Wen Medical School of the Hubei University for Nationalities, Enshi, China Dylan Kirk Ontario College of Traditional Chinese Medicine, Toronto, ON, Canada Honglian Yang Shaanxi University of Chinese Medicine, Xi’an, China Hua Chai Beijing Shijingshan District Hospital of Traditional Chinese Medicine, Beijing, China

Meng Liu China-Japan Friendship Hospital, Beijing, China Mengmeng Shi Yantai Hospital of Traditional Chinese Medicine, Yantai, China Peng Zhou Tianjin University of Traditional Chinese Medicine, Tianjin, China Soo Min Teoh Penang Chinese Medical Research Institute, Penang, Malaysia Shu Kai Chen California Acupuncture Board, Sacramento, CA, United States Tong Wu Beijing Ditan Hospital of the Capital Medical University, Beijing, China

Jiayue Wang Beijing University of Chinese Medicine, Beijing, China

Tzu Yu Tseng California Acupuncture Board, Sacramento, CA, United States

Jingxia Wang Beijing University of Chinese Medicine, Beijing, China

Xiangyang Zhai Medical College of the Xiamen University, Xiamen, China

Junyi Huang Wangzuozhen Community Health Service Center, Beijing, China

Xiaobo Dong Dongfang Hospital of the Beijing University of Chinese Medicine, Beijing, China

Lei Wen Medical College of the Xiamen University, Xiamen, China

Xiaoni Dou Beijing Shijingshan Hospital, Beijing, China

Longsheng Deng Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China

Xinmin Li Henan University of Traditional Chinese Medicine, Zhengzhou, China

xi

xii Contributors

Ya’nan Wang Medical College of the Xiamen University, Xiamen, China

Yu Cao Shanxi University of Traditional Chinese Medicine, Taiyuan, China

Ying Peng Medical College of the Xiamen University, Xiamen, China

Yue Yan China-Japan Friendship Hospital, Beijing, China

Chief Examiner and Reviewer Xuemin Gao Beijing University of Chinese Medicine, Beijing, China

Yanhui Wang Medical College of the Xiamen University, Xiamen, China

Introduction to Compiler-in-Chief

Dr. Shengyan Xi Dr. Xi is a Doctor of Medical Science and holds the following positions: Associate Professor of TCM, Master Advisor of the TCM internal medicine of Medical College of Xiamen University (China), Associate Chief Physician of the TCM Outpatient Department of Xiamen University (China), visiting scholar of the University of Manitoba (Canada), and evaluation expert of National Natural Science Foundation of China (NNSFC). He is engaged in research for basic theory and clinical practice of Chinese Materia Medica (CMM) and Chinese Medical Formulas, and mainly teaches these subjects. He is affiliated with the following groups: council member of the first Board of Specialty Committee of Cancer Palliative Treatment of World Federation of Chinese Medicine Societies, member of China Association of Chinese Medicine (CACM), Chinese Association of Integrative Medicine (CAIM), and Chinese Medical Association (CMA), academic deputy of Translation Branch of CACM, standing academic deputy of CMM Basic Theory Branch of CACM, academic deputy of Formula-CMM Dose-Effect Research Branch of CACM, youth academic deputy of Basic Theory Specialized Committee of CAIM, and youth academic deputy of Experimental Medicine Specialized Committee of CAIM. Dr. Xi received his Medical Doctorate specializing in Clinical Chinese Materia Medica from the Beijing University of Chinese Medicine (China) in 2009, graduated from Chinese Medicine Fundamentals specialty of the Hubei University of Chinese Medicine (China) in 2006, and was granted the Medical Master’s Degree and Traditional Chinese Medicine specialty of the Hubei University for Nationalities (China) in 2003 and was granted the Bachelor of Medicine in TCM. He had obtained academical guidance from the renowned CMM expert Professor Gao Xue-min. In clinical practice, he had the privilege of obtaining guidance from renowned veteran doctors of TCM in China, such as Professor Yan Zhenghua and Professor Wang Yu-ying. Currently, Dr. Xi is mainly involved in the diagnosis and treatment of common internal and gynecological diseases through TCM, especially the zang-fu organ diseases of the lung, spleen, and liver, precancerosis and common tumors based on syndrome differentiation. Dr. Xi is also engaged in the treatment of a variety of postchemotherapy tumors with Chinese medicinals and also the formulas to relieve the medicinal side effects caused by chemotherapy and prolong the patient’s life postchemotherapy.  

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xiv Introduction to Compiler-in-Chief

His recent works and academic outputs include being the chief compiler of Essentials of Chinese Materia Medica and Medical Formulas and Essentials for Clinical Practice With Traditional Chinese Medicine (English edition). He is also the vice-chief compiler of Omniscience for Health Preserving and Care With 400 Kinds of CMM and the ethnomedicine serial of State Administration of Traditional Chinese Medicine (SATCM) of the People’s Republic of China Materia Medica of the Tujia Region, a compiling board member of Picture Mirror for Medicinal Substances and Decoction Pieces of China Pharmacopoeia, Numerous Herbs and Fine Formulas for Common Tumor, and the international standard library of Chinese medicine Chinese Materia Medica (English edition). He assisted his advisor Professor Zhao Jing-hua to complete the project “Arrangement Research of Tujia Medicine Clinic” of SATCM which won the Hubei important technology achievement prize in 2010 and the first grade prize of science and technology progress of Enshi Tujia and Miao Autonomous Prefecture (Hubei, China) in 2011. Dr. Xi has published more than 80 professional papers on Chinese kernel and authoritative periodicals and English SCI periodicals, and over 10 academic books. At present, Dr. Xi is in charge of one project from the National Natural Science Foundation of China and one from the Natural Science Foundation of Fujian Province (China), and participates in three other projects. In March 2011, as a keynote speaker, he gave four consecutive lectures on “How to recognize and select traditional Chinese medicines correctly for preventing and curing diseases” on China Fujian TV Station’s “Health Road Eight Column” which was well received by the audience. Email: [email protected]

Dr. Yuewen Gong Dr. Gong is a Doctor of Medical Science and Doctor of Philosophy. He holds the following positions: Professor and Associate Dean (Research) of the College of Pharmacy, Faculty of Health Sciences of the University of Manitoba (Canada). He is a member of the Section of Hepatology of the Department of Internal Medicine of the College of Medicine, Faculty of Health Sciences of the University of Manitoba, visiting Professor of the Faculty of Medicine of the University of British Columbia (Canada), Guest Professor of the Xiangya Medical College of the Central South University (China), Guest Professor of the Wenzhou Medical University (China), and Guest Professor of the Institute of Clinical Medical Sciences of the ChinaJapan Friendship Hospital (China). He is the Executive Council Member of the Specialty Committee of Kidney Disease of Internal Medicine and the Committee Member of the Committee for Approval of English Translation of Terms in Chinese Medicine of the World Federation of Chinese Medicine Societies. He is also the vice president of the Canadian Institute of Chinese Medicinal Research (CICMR) and licensed acupuncturist of the College and Association of Acupuncturists of Alberta (CAAA). His research interests are to understand mechanism of liver and kidney diseases and develop effective therapeutics for these diseases. His clinical practice is to treat patients with TCM in the Beijing Acupuncture Pain Clinic. He is also an instructor in the HuaXia Acupuncture and Herb College of Canada. He is a member of the following professional associations: American Physiological Society (APS), Canadian Association for the Study of the Liver (CASL), Canadian Society of Pharmaceutical Sciences (CSPS), Canadian Society for Molecular Biosciences (CSMB), Canadian Institute of Chinese Medicinal Research (CICMR), and College and Association of Acupuncturists of Alberta (CAAA).

Introduction to Compiler-in-Chief

xv

Dr. Gong obtained the Bachelor of Medicine in TCM from the Beijing University of Chinese Medicine in 1982, the Master of Science in Medicine from the Peking Union Medical College in 1986, and the Doctor of Philosophy in Molecular Endocrinology in the Department of Physiology of the Faculty of Medicine at the University of Manitoba in 1993. After graduation he completed postdoctoral trainings at the Mayo Clinic and the University of Manitoba. From July 1997, Dr. Gong has been an Assistant Professor, Associate Professor, and Professor at the University of Manitoba. The focus of Dr. Gong’s research program is to understand cellular differentiation and transdifferentiation, mechanism of liver fibrosis and cancer, mechanism of diabetic nephropathy and kidney diseases, and develop TCM treatments for these conditions. The research in Dr. Gong’s laboratory has been supported by local funding agencies, industry, Canadian Liver Foundation, Health Canada, Canadian Institute of Health Research (CIHR), Natural Science and Engineering Research Council of Canada (NSERC). He has participated in several projects funded by the National Natural Science Foundation of China, and the International Collaboration Project of the Ministry of Science and Technology of China. Dr. Gong has published more than 170 peer review papers and abstracts. His researches have been cited by others more than 2400 times. His H-index is 28 according to Google Scholar statistic. He was a keynote speaker in several international conferences, such as 2011 Shanghai International Integrative Medicine Congress. He is an Associate Editor of the Evidence-Based Complementary and Alternative Medicine (eCAM), and a member of Board of Editor of the World Journal of Gastroenterology. During his research career, he has received numerous awards including the postdoctoral fellowships from Medical Research Council of Canada and Canadian Liver Foundation respectively, New Investigator Award from the CIHR, and Canada-China Scientific Exchange Award from the CIHR. Email: [email protected]

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Foreword The Cambridge Advanced Learner’s Dictionary and Thesaurus defines paradigm shift as “a time when the usual and accepted way of doing or thinking about something changes completely.” With that definition in mind, the question arises: is the delivery of Medicine in the midst of a paradigm shift and if so, how will Medicine be practiced once the shift has settled? The answer to the first question requires a clear understanding of how conventional “Western Medicine” (WM) is presently practiced. Patients appear with signs or symptoms of illness, health care providers apply various investigative tools to identify the source and nature of the illness and when available, the most effective medical and/or surgical therapy, preferably identified by the results of prospective, randomized controlled-clinical trials, is initiated. In many instances, this paradigm works well and patients return to a normal state of health or at least baseline. Unfortunately, in many other instances, the approach fails. Patient illnesses are either not diagnosed or misdiagnosed, there is no treatment or the treatment offered is inappropriate, responses are suboptimal, or the drugs/procedures are prohibitively expensive. Moreover, the underlying mechanism or pathophysiology responsible for the development of the illness is often not addressed, thereby inviting subsequent recurrences or relapses. These limitations of WM have not gone unnoticed by the principal stakeholder: the patient. As a result increasing numbers of patients and to a lesser extent, their physicians, are searching for alternatives to the WM paradigm. Where that search is gravitating toward is Traditional Chinese Medicine (TCM) which includes such treatments as Chinese Herbal Medicine, acupuncture, dietary therapy, and various methods of massage and exercise. Indeed, recent estimates suggest one of every five persons in the United States between the ages of 35 and 49 years used at least one alternative therapy in 1997, a growth of 47.3% since 1990. This growth has been particularly pronounced with the use of herbal medicines, which grew by 380% over the same time period. Similar figures have been described in other countries where WM prevails. In an effort to stay abreast of this largely patient-driven initiative, more visionary medical schools have introduced lectures and formal courses in TCM for their trainees. By 1999, two thirds of American medical schools had integrated complementary and alternative medicine (CAM) methods into their curricula. In some countries, such as Germany, the integration of CAM has been required by law since 2003. In addition, the National Institutes of Health has established a National Center for Complementary and Alternative Medicine (NCCAM) which in 2008, allotted 121 million dollars for CAM research. Thus, from a patient, physician, trainee, and research perspective, the search for a new paradigm appears to be well underway. The second question posed was what might the new paradigm look like when the shift settles? Will it be an either/or proposition where stakeholders decide between WM and TCM or will it be a blended, integrated model wherein both WM and TCM are both considered essential components of patient care. If the latter, one must ask whether WM trained health care providers are likely to “buy in” to share care with TCM. Here, well-established biases will need to be addressed and resolved. For example, advocates of WM will have to come to appreciate that some TCM treatments, such as acupuncture do not lend themselves to placebo-controlled trials. Also arguing against the acceptance of TCM are the well acknowledged limitations and concerns raised regarding the experimentation, statistical methods, and “publication bias” responsible for the inordinately high efficacy rates described in the Chinese Medical literature where the results of most TCM studies have been published. On the other hand, consideration of the benefits that TCM brings to the table must also be considered. Here, there are many. First and foremost is the emphasis TCM gives to holistic care. Simply stated, TCM considers an illness as a consequence or manifestation of a disequilibrium within the body and correcting that disequilibrium will not only result in an improvement in the illness but also prevention of recurrences. TCM usage is also more flexible in that treatments are individualized to accommodate a patient’s internal environment rather than regulated by strict guidelines or rules set out by authoritative bodies or associations. An additional benefit is the extent of patient involvement in their care which tends to be greater than what is required for most WM-care maps. Also to be considered is the relatively limited role the medico–pharmaceutical–industrial complex plays in the development, application, and maintenance of TCM which translates into lower costs and more inclusive medicine, particularly for patients with rare disorders that might otherwise remain neglected.

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xviii Foreword

Finally, as demonstrated by the growing number of reports in the WM literature, TCMs are effective, both as principal as well as complementary therapy. In summary, a paradigm shift in our provision of health care is already well underway. As the cohort of WM physicians who are resistant to change becomes diminished with time and more trainees who have been afforded a broader perspective of the strengths and limitations of TCM emerge onto the health scene; an Integrative Medicine paradigm is most likely to emerge. It will be the acute need for a reference text, such as the present Essentials of Chinese Materia Medica and Medical Formulas to guide therapy. Fortunately, Dr. Shengyan Xi and Dr. Yuewen Gong, two world-renowned authorities on TCM, have been prescient in providing this very thorough, highly educational, easy to read, and instructive reference text for the present and future health care providers.

Dr. Gerald Y. Minuk, MD, FRCPC Professor of Medicine, Pharmacology and Therapeutics, Health Sciences Centre, John Buhler Research Centre, University of Manitoba, Winnipeg, MB, Canada February 1, 2016

Preface Nobel Prize in Physiology or Medicine 2015 was awarded to a Chinese pharmaceutical female scientist, Youyou Tu by Swedish King Carl XVI Gustaf on December 10, 2015 in Stockholm, for her important contribution to the world: first finding that artemisinin, extracted from a traditional herbal medicine—Herba Artemisiae Annuae (qing hao), can effectively inhibit malaria which has saved multimillion people’s life, traditional Chinese medicine (TCM) receives more and more attention by Swedish scientists and other western countries’ scientists. This award lets scientists around the world recognize that TCM is a treasure house, where they can find ideas and methods for many difficult problems of human health diseases. Moreover, they also recognize that only with comprehensive understanding of TCM there are possibilities to have a breakthrough in many circumstances where western medicine has hard time to treat them. Just as the 1993 Nobel Prize winner Richard J. Roberts once said “traditional Chinese medicine and pharmacy is not only the treasure of China, but also the wealth of all human being.” As of 2015, TCM has been spread to more than 170 countries and regions. According to the data of WHO, TCM has been accepted with legislation by 29 countries, such as Thailand, Canada, Australia, Austria, Singapore, Vietnam, and South Africa, and brought into medical insurance by 18 countries. Nonetheless, TCM is still in gray district in the overwhelming majority countries, and no legitimacy status and lack of legal protection. Besides the influence of technical barrier and economic profit, culture difference is the chief hindrance of TCM developing abroad. In the foreigner’s eyes, TCM is hard to explain and not be understood. It is better to understand because anyone who is accepting a foreign culture this will be based on the understanding of his local culture. If the learners lack of recognition of cultural identity, just discuss the herbs like western medicine, TCM developing abroad will be forever on the way. Let foreigners who don’t believe in TCM accept the TCM diagnosis and use Chinese herbal medicine that must start from the cultural transmission. There is a well-known theory in cross-cultural communication called “iceberg effect.” TCM is like an iceberg. The floating part above the sea level is known to treat and prevent certain diseases, but the hidden part under the sea is the authentic treasure of TCM with peculiar value and philosophy thinking. In order to remove the iceberg effect from the foreigner’s eyes and let TCM internationalization further developed, it would be just like Youyou Tu said in the Nobel lecture “Artemisinin is a gift to the world given by TCM,” we must appeal to more people to experience the charm of Chinese culture and discover the treasures hidden in TCM. President Jinping Xi said “Traditional Chinese medicine has condensed profound philosophy wisdom and several thousand’s health preserving idea and practice experience of the Chinese nation, is the gems of Chinese ancient science and also the key to open the treasurehouse of Chinese civilization.” Today, the iceberg is fast broken and pathway is dredged clear. We should draw assistance from the “east wind” of Youyou Tu awarded Nobel Prize 2015, burnish the visiting card of Chinese culture, and promote traditional Chinese medicine to meet the world with a brand-new image. Based on the previously mentioned, we believe the value of Chinese materia medica will become more and more protruding in the world from this moment. At present, we still deeply feel that western countries need to know more about TCM, and TCM still doesn’t have its status. Therefore, we want to provide a large English book about introduction of Chinese materia medica and Chinese medical formulas to the world. We know that the history of modern normal TCM books in Chinese organized, compiled, and authorized by the Ministry of Education and Ministry of Health of the People’s Republic of China, encompasses more than 60 years. Throughout use, these books have been revised and reprinted numerous times. At present, there are still some various categories and different hierarchical teaching materials that are yet to be published, but will play an important role in establishing the standard of TCM theoretical teaching. With increased globalization pace of TCM, more and more individuals around the world are focusing on TCM in their own countries. Additionally, a great number of individuals are traveling to China to study this ancient Chinese system of medicine. Today, high-level international students of TCM or clinical traditional Chinese physicians should also master essential modern medical knowledge, diagnosis, and treatment techniques besides possessing a

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thorough understanding of TCM theory. Therefore, in order to carry out TCM teaching during the stages of clinical practice for international students, some specialized basis books or reading materials must exist to provide guidance for them. In order to suit the innovation of international education of TCM, to meet the requirements of the clinical clerkship in foreign countries, and to enhance the study of Chinese medicine both in China and overseas, we have composed a collaboration between professors and chief physicians of various TCM universities, colleges, and hospitals, and compiled the new century traditional Chinese medicine English book for international TCM-interested learners: Essentials of Chinese Materia Medica and Medical Formulas. It is based on current compiled Chinese–English bilingual materials, guided by the TCM authoritatively writings in China, and consolidated with determinate modern medical knowledge. We wish to achieve the purpose of having relevancy in the clinical setting. In the Xiamen University Medical College, international TCM education dates back to a few decades ago. Up to now, several thousand foreign students coming from more than 30 countries and regions around the world have studied TCM or were trained with acupuncture in this university. Currently, there are nearly 200 foreign students studying TCM in the Xiamen University Medical College and Xiamen University Malaysia Campus. Many TCM curriculums are taught in full English. Meanwhile, many TCM teachers of the Xiamen University have often been sent to America, Canada, Germany, Indonesia, Thailand, Malaysia, and Singapore to teach TCM curriculums and carry out medical treatment activities. In this manner, the Xiamen University has accumulated rich experience in international TCM education and understood special requirements of international students in studying TCM. Many years of practice in this field and the needs of the TCM teaching (especially the establishment of TCM Confucius College in other countries and the TCM undergraduate course of the Xiamen University Malaysia Campus, Kuala Lumpur, Malaysia) have helped and urged for us to compile this book together with the same professional experts from other universities and their affiliate hospitals in China and other countries. Contents of the Essentials of Chinese Materia Medica and Medical Formulas mainly include introduction to Chinese materia medica and medical formula, specific knowledge about sources, properties (medicinal nature), actions, and applications of more than 780 kinds of commonly used Chinese materia medica, as well as efficacies and applications of more than 820 kinds of commonly used Chinese medical formulas. Essentials of Chinese Materia Medica and Medical Formulas is an English language TCM book that can be used for international TCM students, who begin their basic curriculums or clinical practice, or international TCM physicians for advanced study or training purposes. It is also aimed at other international readers with a keen interest in TCM for self-study. It may also function as a clinical reference for TCM-experienced practitioners who intend to practice abroad or participate in academic congress or exchange schemes. It’s worth noting for the user that the Chinese herbal medicines and medical formulas in this book should be used, as far as possible, under the guidance of a traditional Chinese physician in order to ensure that the medication is safe for the patient as much as possible. Due to our limitations and certain constraints, any correction to errors and valuable suggestions on the contents will be appreciated greatly. We will pay more attention to them and improve the book in the next edition.

Dr. Shengyan Xi The Xiamen University, Xiamen, China November 1, 2016

Acknowledgments During the compilation of the Essentials of Chinese Materia Medica and Medical Formulas, we have received strong support from many institutions, such as the Medical College of the Xiamen University (China), the University of Manitoba (Canada), the Beijing University of Chinese Medicine (China), the Tongji University (China), the Beijing University of Chinese Medicine Dongzhimen Hospital (China), the Hubei University of Medicine Dongfeng Hospital (China), the Tianjin University of Chinese Medicine (China), the Capital Medical University (China), the California Acupuncture Board (USA), the Penang Chinese Medical Research Institute (Malaysia), the Beijing University of Chinese Medicine Dongfang Hospital (China), the Capital Medical University, Beijing Ditan Hospital (China), and the Ontario College of Traditional Chinese Medicine (Canada), etc. Establishing the new full English curriculum Essentials of Chinese Materia Medica and Medical Formulas, as one of the Education and Scientific Research Projects for Middle and Young Teachers in Fujian Province (China) (No. JZ160271), has been especially supported with funds from the Education Department of Fujian Province (China). While working on this book, we have also been supported by the National Natural Science Foundation of China (NNSFC) (No. 81202659), which has given us great confidence to compile this book. We are indebted to the esteemed TCM expert Professor Xueming Gao from Beijing University of Chinese Medicine, the famous scholar of Chinese materia medica in China and academic leader of “Chinese Materia Medica,” which is the medical key subject of the China State Administration of Traditional Chinese Medicine. Professor Gao provided lots of his own apprehension and the valuable experience with some Chinese materia medica and medical formulas mentioned in this book. We also offer gratitude to the respected traditional Chinese physician Professor Yanhui Wang who is the vice president of the Medical College of Xiamen University, has assisted in examining and reviewing this book’s manuscript and ensuring that academic standards were met. In addition we thank the esteemed Dr. Gerald Y. Minuk, Dr. Garry Shen, and Dr. Sudharsana R. Ande, from the University of Manitoba (Canada), who provided lots of valuable suggestions for this book’s writing to ensure English proficiency. Special thanks to Dr. Gerald Y. Minuk for his great efforts in writing this book’s foreword. Moreover, thanks to the PhD Peng Ye from Art College of the Xiamen University for drawing the cover picture, and thanks to Dr. Manna Zhang, Dr. David Songtag, Dr. Yangxinzi (Cindy) Xu, Dr. Jiaqi Yang, Dr. Qian Li, and Dr. Pollock Galia from the University of Manitoba, Jiangqin Xu from College of Foreign Languages and Cultures of the Xiamen University, Ms. Shuqiong Huang from the Medial College of the Xiamen University, the postgraduates and undergraduates of the TCM Department of Medical College of the Xiamen University, Ying Peng, Biqian Fu, Mengmeng Shi, Xiangyang Zhai, Yao Cheng, Ya’nan Wang, Weiwei Wang, and Hill Lachlan Glenn (Australia) for completing the many extra tasks for compilation. Special thanks need to be sent to my graduate student Ying Peng for her 3 years’ efforts in preparing this book’s compiling materials. Thanks to Dr. Deqin Zhang, Dr. Peng Zhou, Professor Tianxiang Li and Technician Guohui Li from Tianjin University of Chinese Medicine, and Dr. Yue Yan from the China-Japan Friendship Hospital (China) for providing with literatures. Thanks to Professor Dejian Wen and Technician Yang Xiang from Hubei University for Nationalities, Dr. Jingxia Wang from Beijing University of Chinese Medicine, Dr. Shuai Yao and Linxia Zhu from Yan Lai Fu Chinese Medicine Center for offering the help in taking photos of Chinese medicinals. The international TCM students of Medical College of the Xiamen University, from Australia, Brazil, Malaysia, Thailand, Singapore, and the other countries, have given us lots of pertinent suggestions for the compilation off this book. We would like to express our profound thanks to them. Without the contributions of all these people, this book would not be possible to get everything finished in time. Dr. Shengyan Xi, Dr. Yuewen Gong University of Manitoba, Winnipeg, MB, Canada March 30, 2016

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Compendium The Essentials of Chinese Materia Medica and Medical Formulas is compiled by TCM experts and professional physicians from several universities or colleges namely the Xiamen University (China), the University of Manitoba (Canada), the Capital Medical University (China), the Beijing University of Chinese Medicine (China), the Ontario College of Traditional Chinese Medicine (Canada), the Penang Chinese Medical Research Institute (Malaysia), and many hospitals including the Beijing University of Chinese Medicine Dongzhimen Hospital (China), the China-Japan Friendship Hospital (China), and others. This is for the use of international students learning basic curriculums of traditional Chinese medicine in China, Malaysia, and other countries. TCM curriculums are geared toward the use of TCM to carry out specific medical practices. Clinical basic curriculums bridge and connect TCM basic theories with clinical practice. All kinds of published teaching materials and monographs about Chinese materia medica, Chinese herbal medicine, material medica, pharmaceutical botany, Chinese medical formulas, and Chinese patent medicine have provided valuable information for compiled reference. In order to satisfy conventional standards of cultivating talented international TCM practitioners in the modern era and also the requirements of higher education of TCM while embodying reformed achievements on international education of TCM, in conformity with the compiling principle of inheritance and innovation, our compiler committee has incorporated the successful experiences of other TCM clinical basic teaching materials and monographs and pooled wisdom from it, and enhanced it by strengthening the cooperation between the institutions of higher learning and hospitals. This book is divided into three parts: “Chinese materia medica,” “Chinese medical formulas,” and “appendix.” The first part includes 21 chapters that are arranged as follows: herbs that release the exterior; herbs that clear heat; herbs that drain downward; herbs that expel wind and damp; herbs that transform dampness; herbs that promote urination and percolate dampness; herbs that warm the interior; herbs that rectify qi; herbs that promote digestion; herbs that expel parasites; herbs that stanch bleeding; herbs that invigorate blood and dissolve stasis; herbs that dissolve phlegm, relieve cough, and calm panting; herbs that calm the mind; herbs that calm the liver and extinguish wind; herbs that open the orifices; herbs that supplement deficiency; herbs that astringe; herbs that induce vomit; herbs that counteract toxins, kill parasites, and relieve itching; and herbs that draw out toxins, remove putridity, and engender flesh. It introduces 515 primary Chinese materia medica, 274 attached Chinese materia medica, and some differentiation between similar efficacy medicinals. Each Chinese materia medica is introduced from “source and collection,” “property and channel entry,” “efficacy and action,” “clinical application and usage,” and “caution for use.” The second part includes 22 chapters that are arranged as follows: formulas that release the exterior, formulas that treat the interior excess syndrome with purgation, formulas that harmonize, formulas that clear the heat, formulas that dispel summer heat, formulas that warm the interior, formulas that release pathogens from both the exterior and interior, formulas that supplement and boost, formulas that consolidate and astringe, formulas that calm the mind, formulas that open the orifices, formulas that rectify qi, formulas that rectify blood, formulas that expel and calm the wind, formulas that treat dryness syndrome, formulas that dispel dampness, formulas that dispel phlegm, formulas that remove food stagnation and accumulation, formulas that expel parasites, formulas that induce vomit, formulas that treat abscess and ulcer, and attached formulas that are used externally. It introduces 258 primary Chinese medical formulas, 572-attached formulas, and some differentiation between similar efficacy formulas. Each primary formula is introduced from “name of formula,” “source, composition, and usage,” “efficacy and indication,” “modified clinical application,” “caution for use,” and “efficacy analysis for primary formulas.” The contents of “clinical application” or “indication” embody the principles of TCM syndrome differentiation to use medicinals and formulas. The contents of “attached herbs’ introduction” or “attached formulas’ introduction” may provide more choices for TCM doctors or medical students. The contents of “efficacy analysis for primary formulas” help TCM doctors or medical students to better understand the principle of forming a formula. The content of “differentiation between

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similar efficacy herbs” or “differentiation between similar efficacy formulas” can help the learners to use medicinals or formulas more correctly. Appendix 1 can help the learners to deepen the thinking of medication based on syndrome differentiation. Appendix 2 is for easy reference and allow learners to understand the source background of herb and formula. Appendix 3 can assist the learners to better study some profound contents. The indexes include “Pharmaceutical-Pinyin names reference of Chinese materia medica,” “English-Pinyin cross reference of Chinese materia medica names,” “English-Pinyin cross reference of Chinese medical formula names,” “PinyinEnglish cross reference of Chinese materia medica names,” and “Pinyin-English cross reference of Chinese medical formula names,” which can help students, readers, or TCM doctors to study easily and effectively. When using this book, lots of announcements should be paid attention to. First, some valuable Chinese medicinals mentioned in this book are prohibited to apply by laws. The succedaneous medicinals may be a good choice. For example, Cornu Rhinocerotis (xi jiao) is usually substituted by Cornu Bubali (shui niu jiao), Os Tigris (hu gu) and Os Pardi (bao gu) are often substituted by Os Felinus (mao gu). To maintain the original formula name and composition, the authors don’t make a change or indicate the succedaneum, but in clinical application, please make a change. Second, the indicated dosage of lots of Chinese materia medica may be beyond the scope of China pharmacopoeia or different from other medical and pharmacal books stipulated by laws although the authors try their best to bring into correspondence with them. All Chinese materia medica and medical formulas are best used under the guidance of traditional Chinese doctors. Especially, the poisonous Chinese materia medica or medical formulas should be used strictly following the traditional Chinese doctor’s advice in order to avoid poisoning. Compiler Committee for Essentials of Chinese Materia Medica and Medical Formulas March 20, 2016

Part I

Chinese Materia Medica INTRODUCTION TO CHINESE MATERIA MEDICA Chinese medicine refers to medicine that has been collected, processed, prepared, and applied in clinics under the guidance of traditional Chinese medicine (TCM) theory. It is a major component of Chinese traditional drugs, and also is a vital part of Chinese heritage. The invention and application of Chinese medicine has a long history, a unique theory system and application form, which thoroughly reflects the umpteen characteristics of Chinese history, culture, and natural resources. Chinese medicine mainly comes from natural medicinal ingredients and their processed products, including plant medicine, animal medicine, mineral drugs, and parts of chemical biological preparation. As most of Chinese medicinals and the commonly used ones are herbal medicines, Chinese medicine is often called “materia medica” (ben cao) or “herbs” (cao yao). There is a wide range of species of Chinese medicines. Over 8000 kinds of medicines are recorded in the ancient books. Currently, more than 12,000 kinds of Chinese medicines are recorded and applied. For thousands of years, Chinese medicine has been applied in the prevention and treatment of disease. Furthermore, Chinese medicine has made a tremendous contribution to the prosperity of the Chinese Nation reproduction, and has greatly boosted the development of the world medicine. Chinese materia medica (the study of clinical Chinese medicinals) (zhong yao xue) refers to a discipline that specializes in basic theory of Chinese medicine and its source, place of production, collection, medicinal processing, properties and actions, and clinical application rules.

Habitat and Collection of Chinese Medicinals Proper managements of habitat, collection, and storage of Chinese medicinals have a direct influence on the medicinal quality and therapeutic effect.

Habitat In ancient times, traditional Chinese medical doctors often liked to use certain genuine regional medicinal(s) (dao di yao cao) because of their fine and pure quality. The genuine regional medicinals refer to the materia medica with long history, proper habitat, fine species, large production, particular processing, outstanding therapeutic effect, and regional characteristics, such as Radix Angelicae Sinensis (dang gui) from Gansu (China), Fructus Lycii (gou qi zi) from Ningxia, Radix et Rhizoma Rhei (da huang) from Qinghai, Radix Astragali (huang qi) from Inner Mongolia, Radix et Rhizoma Ginseng (ren shen), Radix et Rhizoma Asari (xi xin) and Fructus Schisandrae Chinensis (wu wei zi) from China northeast, Rhizoma Coptidis (huang lian), Rhizoma Chuanxiong (chuan xiong), Bulbus Fritillaria (bei mu) and Radix Aconiti (chuan wu) from Sichuan, Colla Corii Asini (e jiao) from Shandong, Radix Rehmanniae (di huang), Radix Achyranthis Bidentatae (niu xi) and Rhizoma Dioscoreae (shan yao) from Henan, Pericarpium Citri Reticulatae (chen pi) and Fructus Amomi (sha ren) from Guangdong, and Radix et Rhizoma Notoginseng (san qi) and Poria (fu ling) from Yunnan. As production of various genuine regional medicinals is limited, it is necessary to investigate the ecological environment and cultivation technology of these medicinals to develop high-quality materia medica and open up new resources for medicinal herbs.

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2 PART | I Chinese Materia Medica

Collection The season and methods of collecting medicinals are closely related with ensuring the quality of medicinals. Generally, Chinese medicinals should be collected according to the maturity of medicinal parts, as it is only in that season that the content of active ingredients is the highest. Specifically, for medicinals that are used as entire plants, their aerial parts above the roots usually should be cut when the branches and leaves are flourishing and flowers are just blooming, such as Herba Leonuri (yi mu cao), Herba Schizonepetae (jing jie), and Folium Perillae (zi su ye); or whole plants, including roots as the medicinals, such as Herba Plantaginis (che qian cao), Herba Violae (zi hua di ding), and Radix Bupleuri (chai hu). For medicinals that use leaves, they usually should be collected when the flower buds are going to bloom or just in full bloom, such as Folium Isatidis (da qing ye), Folium Eriobotryae (pi pa ye), and Folium Artemisiae Argyi (ai ye). For medicinals that are flowers or pollen, unbloomed flower buds or just-bloomed flowers are collected, such as Flos Rosae Chinensis (yue ji hua), Flos Inulae (xuan fu hua), and Flos Lonicerae Japonicae (jin yin hua). For medicinals that are fruits or seeds, fruit medicinals usually should be collected when fruits are matured, such as Semen Arecae (bing lang) and Fructus Trichosanthis (gua lou), except Pericarpium Citri Reticulatae Viride (qing pi), Fructus Aurantii Immaturus (zhi shi), Fructus Rubi (fu pen zi), and Fructus Mume (wu mei) that should be collected they are unmatured; seed medicinals should be collected when seeds are in full maturity, such as Semen Astragali Complanati (sha yuan zi), Semen Nelumbinis (lian zi), and Semen Ginkgo (bai guo); for those seeds that fall off easily upon maturation, they should be collected when seeds are just matured, such as Semen Pharbitidis (qian niu zi) and Fructus Amomi Kravanh (bai dou kou); for some perishable berries, such as Fructus Ligustri Lucidi (nü zhen zi) and Fructus Lycii (gou qi zi), they should be collected in the early morning or at dusk, when they are slightly matured. Root or rhizome medicinals usually should be collected in the late autumn (August) or early spring (February), such as Rhizoma Gastrodiae (tian ma), Radix Puerariae Lobatae (ge gen), and Rhizoma Polygonati Odorati (yu zhu). Tree bark or root bark medicinals usually should be collected in the spring and summer when the plants are in vigorous growth, such as Cortex Phellodendri Chinensis (huang bai), Cortex Eucommiae (du zhong), and Cortex Magnoliae Officinalis (hou po). Small animal or insect medicinals, such as Scorpio (quan xie), Eupolyphaga seu Steleophaga (tu bie chong), Pheretima (di long), Gryllotalpa (lou gu), and Mylabris (ban mao) should be usually captured in the late summer and early autumn; and medicinals from big animals should be usually captured in the autumn. Mineral medicinals can be collected throughout the year.

Chinese Medicinal Processing Chinese medicinal processing refers to the necessary process to medicinals before application or their processing for various preparations according to the requirements of medical treatment, concoction, and preparation. It is a traditional pharmaceutical technology in China. In brief, it is a processing from crude materia medica to decoction pieces. Medicinal styles obtained from processing raw Chinese materia medica and used for formula and preparation are called “Chinese medicinal decoction pieces.” Expedient processing is directly related with the efficacy. The proper processing of poisonous or fierce medicinals is an important safeguard to ensure the safety of medication.

Purposes of Processing 1. Strengthen the medicinal actions to improve the clinical therapeutic effect. For example, after stir-fried with honey, Radix Stemonae (bai bu), Flos Farfarae (kuan dong hua), Herba Ephedrae (ma huang), and Radix et Rhizoma Asteris (zi wan) will have stronger effects on moistening the lung and relieving cough; after processed with vinegar, Rhizoma Corydalis (yan hu suo) and Rhizoma Cyperi (xiang fu) will have stronger effects on relieving pain; if prepared with ginger juice, the effects of Rhizoma Pinelliae (ban xia) and Caulis Bambusae in Taenia (zhu ru) on arresting vomiting can be strengthened; and if stir-fried with wine, the effects of Radix Angelicae Sinensis (dang gui), Rhizoma Chuanxiong (chuan xiong), and Flos Carthami (hong hua) on invigorating blood can be increased. 2. Eliminate or decrease the medicinal toxicity, drastic actions, or side effects. For example, Radix Aconiti (chuan wu), Radix Aconiti Kusnezoffii (cao wu), Radix Aconiti Lateralis Praeparata (fu zi), Rhizoma Pinelliae (ban xia), Rhizoma Arisaematis (tian nan xing), and Semen Strychni (ma qian zi) have comparatively large toxicities and can easily cause poisoning if taken in the raw form orally; if processed, the toxicity will be decreased. Fructus Crotonis (ba dou) and Semen Euphorbiae (qian jin zi) have strong toxicity and drastic purgation; however, if they are deoiled and their frost-like powder is used, the toxicity and purgation will be decreased. 3. Change the medicinal properties and actions to enlarge the application scope and meet more pathogenic conditions. For example, Radix Rehmanniae (sheng di huang) with cool nature can cool the blood, while processed Radix Rehmanniae

Chinese Materia Medica

3

Praeparata (shu di huang) changes its property to warm and is good at supplementing the blood. If Rhizoma Arisaematis (tian nan xing) is prepared with dried ox bile juice, its warm nature can be changed into cool nature and its effects of extinguishing wind and arresting convulsion are also strengthened. The raw Radix Polygoni Multiflori (he shou wu) can moisten the intestines and promote defecation; however, if processed into Radix Polygoni Multiflori Praeparata cum Succo Glycines Sotae (zhi he shou wu), its activities change to enrich and supplement the liver and kidney, as well as supplement and boost essence and blood. 4. Dry materia medica decrease moisture, avoid mold development, prevent decaying of herbs, and are easy to store. For example, the plant medicinals usually need to be dried before storage. 5. Clean materia medica, such as earth, sands, stones, impurities, and nonmedicated portions need to be removed from crude materia medica, which can ensure medicinal quality and purity. For example, earth and sands need to be removed from the crude Poria (fu ling) and the basal part of the stem of Radix Saposhnikoviae (fang feng) needs to be removed. 6. Use stir-frying with bran, stir-frying with wine, processing with vinegar, or rinsing to modify the taste and smell for some animal medicinals or other off-odor materia medica to facilitate administration. 7. Process some materia medica of mineral, animal shells, or seeds into pieces to facilitate formula preparation and easily dissolve effective components in a decoction. For example, Magnetitum (ci shi) and Concha Ostreae (mu li) are calcined and become brittle, so their therapeutic components are easy to dissolve in decoction. 8. Preserve efficacy. Plant seed medicinals, such as Semen Raphani (lai fu zi) and Fructus Perillae (zi su zi) should be steamed and dry-fried to prevent sprouting and preserve efficacy. Some medicinals containing lots of saponin need to be processed with heat to destroy enzymes, to preserve their biological activities, such as Semen Armeniacae Amarum (ku xing ren).

Commonly Used Processing Methods 1. Preparatory processing. These processes are to prepare medicinals from raw herbs that are ready to decoct. There are three processes. (1) Some materia medica should be cleaned by using methods, such as selecting, sifting, winnowing, brushing, scraping, spading, and bumping, to remove earth, impurities, and nonmedicament portions. For example, the floss on the back of leaf of Folium Eriobotryae (pi pa ye) and Folium Pyrrosiae (shi wei) is brushed; the flesh of Concha Meretricis seu Cyclinae (hai ge qiao) and Concha Haliotidis (shi jue ming) is spaded to keep the shells. (2) Some materia medica should be broken into pieces by methods of pounding, grinding, milling, flaking, and filing to make the preparation consistent. For example, Succinum (hu po) is ground into powder to benefit deglutition; Bulbus Fritillaria (bei mu) is pounded into pieces to benefit decoction. (3) Some materia medica should be cut into pieces, segments, slivers, or masses according to certain standards by cutting tools. For example, Rhizoma Atractylodis Macrocephalae (bai zhu) is cut into thick pieces; Cortex Mori (sang bai pi) is cut into slivers; Fructus Perillae (zi su zi) is cut into segments, and Poria (fu ling) is cut into masses. 2. Processing with water. It refers to the processing methods that use water or other liquid materials to process materia medica to clean and soften medicinal, or modify the medicinal nature. There are four processes. (1) Rinsing or washing: some materia medica should be put into water that is changed frequently to remove impurities, salt taste, and offensive smell of fish. For example, Rhizoma Phragmitis (lu gen) is washed to remove earth; Sargassum (hai zao) is rinsed to remove salt matter, and Placenta Hominis (zi he che) with the same processing to remove odor of blood. (2) Moistening: according to property of materia medica, they should be moistened with clean water or other adjuvant liquids. To allow well distribution of humidity in the exterior and interior, as well as easier cutting into decoction pieces, water or liquids should be slowly percolated into the interior by sprinkling-moistening, washing-moistening, soaking-moistening, open-moistening, and covered-moistening. For example, Radix Angelicae Sinensis (dang gui) is moistened with wine and Cortex Magnoliae Officinalis (hou po) is soaked with ginger juice. (3) Soaking: some materia medica should be put into clean water or adjuvant liquids to allow water to permeate thoroughly and soften herbs to facilitate cutting and removal of toxins and nonmedicament portions. For example, Rhizoma Pinelliae (ban xia) and Rhizoma Arisaematis (tian nan xing) are soaked with alum water; Radix Aconiti Lateralis Praeparata (fu zi) is soaked with bittern. (4) Grinding with water: it is a processing method that uses sedimentation property of materia medica in water to separate very fine powder. It is often used in preparing the mineral and shell medicinals, such as Cinnabaris (zhu sha) and Talcum (hua shi). 3. Processing with heat. It refers to the processing methods that use heat, such as fire, frying, and oven baking to process materia medica to change their properties and modify their functions. There are five processes. (1) Dry-frying can be divided into dry-frying until yellow, dry-frying until scorched, and dry-frying until charred. For example, Fructus Arctii (niu bang zi) is dry-fried until yellow and Fructus Gardeniae (zhi zi) is dry-fried until scorched, which can moderate their cold nature and facilitate the effective components to dissolve into the decoction. Fructus Mume (wu mei)

4 PART | I Chinese Materia Medica

is dry-fried until charred and its effects of astringing and stanching bleeding can be strengthened. (2) Liquid-frying refers to the method when materia medica is fried with liquid materials, such as honey, wine, ginger juice, and salt water to make the liquid percolate into the medicinal interior to modify the medicinal nature and strengthen the therapeutic effects or decrease toxicity. For example, Radix Stemonae (bai bu) is honey-fried and its effects of moistening the lung and relieving cough can be strengthened; Rhizoma Chuanxiong (chuan xiong) is wine-fried and the effect of invigorating blood can be enhanced; Radix Bupleuri (chai hu) and Rhizoma Cyperi (xiang fu) are vinegar-fried and the effects of soothing the liver and relieving pain can be strengthened; and Flos Genkwa (yuan hua) is vinegar-fried and its toxicity can be decreased. (3) Calcining refers to the method when materia medica is directly or indirectly calcinated to make the medicinal texture become loose and crisp, which allows the effective components to be easy to dissolve into the decoction. For example, calcined Os Draconis (duan long gu), calcined Concha Ostreae (duan mu li), Crinis Carbonisatus (xue yu tan), and Petiolus Trachycarpi Carbonisatus (zong lü tan). (4) Roasting refers to the method when materia medica is wrapped with moist flour or wet paper, placed in hot fire ashes directly or indirectly by oil-absorbing sheets, and heated up until the flour or paper is scorched black to remove stimulatory or volatile components, reduce the side effects, and strengthen the therapeutic effect. For example, Radix Aucklandiae (mu xiang) or Semen Myristicae (rou dou kou) is roasted. (5) Baking refers to the method when materia medica is directly or indirectly heated until thorough drying to facilitate crushing, storage, or toxins decrease. For example, Tabanus (meng chong) is baked. 4. Processed with both water and heat. There are four processes. (1) Decocting refers to the method when materia medica and clean water or adjuvant liquids are heated together to decrease toxicity and fierceness. For example, Flos Genkwa (yuan hua) is decocted with vinegar. (2) Steaming refers to the method when materia medica is heated with water vapor or steamed in a container to moderate fierce nature or reinforce the medicinal nature. For example, if Radix Polygoni Multiflori (he shou wu) is repeatedly steamed and exposed under the sun, its effect of purging will be lost and it will be good at supplementing the liver and kidney, as well as boosting essence and blood. If Rhizoma Polygonati (huang jing) is steamed, its effects of supplementing the spleen and boosting qi, as well as enriching yin and moistening the lung, will be reinforced. (3) Scalding refers to the method when materia medica, such as seeds or juicy plant-origin herbs, are quickly put into boiling water, blanched for a short time, and immediately taken out to remove the skin or facilitate drying under the sun thoroughly. For example, Semen Persicae (tao ren) and Semen Armeniacae Amarum (ku xing ren) are scalded to decorticate; Radix Asparagi (tian dong) and Herba Portulacae (ma chi xian) are scalded to facilitate drying easily. (4) Quenching refers to the method when materia medica, such as minerals or shells, are burned until red hot and then immediately put them into cold water or liquids to make them more brittle and bring effects into full play easily. For example, Carapax Trionycis (bie jia) and Pyritum (zi ran tong) should be quenched by vinegar.

Properties and Actions of Chinese Medicinals Properties and actions of Chinese medicinals are generalized extractions of the fundamentals and characteristics of Chinese medicinal functions, also known as “medicinal nature.” Its contents include the four qi (i.e., the four natures); the five flavors; ascending and descending, floating and sinking (of qi movement or medicinal action); channel entry; and toxicity. In TCM, the fundamental principles of preventing and treating diseases with Chinese medicinals are no more than reinforcing healthy qi and dispelling pathogen, eliminating etiological factors, regaining coordination of zang-fu organs’ function, rectifying abnormal exuberance or debilitation of yin or yang, and allowing the body return to normal as much as possible. Chinese medicinals can have the aforementioned functions and can directly target each pathogenic condition because each Chinese medicinal has its unique properties, which is also called the “preference nature” by ancient TCM physicians. It is said that medicinal preference nature can rectify the abnormal exuberance or debilitation of yin or yang manifested by diseases. The actions of Chinese medicinals on the body include the therapeutic effects and adverse reactions. In the clinic, medicinal therapeutic effect should be fully and reasonably utilized, while adverse reaction should be avoided as much as possible. These are the guarantee of high efficacy in medicinals and safe practice in medication; moreover, these are the basic principles of clinical medication. Characteristics of Chinese medicinals refer to the medicinal shape, color, odor, taste and texture (light or heavy, sparse or dense, hard or soft, moist or dry), which are based on the object of Chinese medicinal (materia medica). But properties and actions of Chinese medicinals are summarized from human body reactions to medication, which the object is the human body. Ancient TCM physician usually linked these two together to explain the mechanisms of medicinal action. However, the characteristics and properties/actions of Chinese medicinals are quite different in their meanings and observation objects. They should not be used intermittently and confused.

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Four Qi Four qi, also known as “four natures,” refer to the four different medicinal natures, such as cold, heat, warm, and cool. It reflects the characteristics of how medicinals affect the exuberance or debilitation of yin or yang, and change of cold or heat in the human body. It is one of the important concepts of describing medicinal functions. Moreover, there is another qi called “neutral nature,” which refers the medicinals not having obvious cold or heat nature. However, this is just relative, in fact, these medicinals still have slight warm or slight cold natures, and they are not beyond the scope of four qi. Medicinal natures (cold, heat, warm, and cool) are summarized from the reactions of medicinals on the human body and they are opposite to the cold or heat property of treated diseases. In other words, medicinal natures are determined according to the reaction of medicinals on the human body and are relative to the cold or heat property of disease and syndrome. Medicinals that can alleviate or eliminate heat pattern usually have cold or cool nature. For example, Gypsum Fibrosum (shi gao) and Radix et Rhizoma Sophorae Tonkinensis (shan dou gen) can treat the heat pattern with symptoms of fever, thirst, swelling, and pain of the throat, and reddish complexion and eyes, as well as can clear heat and drain fire, and relieve sore throat and resolve toxins. These medicinals are considered as cold or cool in nature. On the contrary, medicinals that can relieve or eliminate cold pattern usually have heat or warm nature. For example, Rhizoma Zingiberis (gan jiang), Cortex Cinnamomi (rou gui), and Radix Aconiti Lateralis Praeparata (fu zi) can treat the cold pattern with symptoms of cold pain in the stomach cavity and abdomen, extreme cold of the four limbs due to cold moving proximally (sì zhī jué nì), and pale complexion, as well as have the effects of warming the center and dissipating cold, and restoring yang to rescue counterflow (desertion). These medicinals are indicated as having warm or heat nature. To understand the four qi theory, medicinals must be selected according to the medicinal nature. There are three principles. (1) Select corresponding medicinals based on cold and heat properties of disease and syndrome. Disease with heat pattern should be treated with medicinals of cold nature. Disease with cold pattern should be treated with medicinals of heat nature. For example, high fever and excessive thirst caused by external pathogen can be treated with Gypsum Fibrosum (shi gao), Rhizoma Anemarrhenae (zhi mu), and Fructus Gardeniae (zhi zi) with cold nature; yang collapse verging on desertion can be treated with Radix Aconiti Lateralis Praeparata (fu zi) and Rhizoma Zingiberis (gan jiang) with heat nature. (2) Select corresponding medicinals based on the different degree of cold and heat in disease and syndrome. For example, yang collapse verging on desertion should be treated with herbs in extreme hot nature, such as Radix Aconiti Lateralis Praeparata (fu zi); but the general abdominal pain due to center cold (cold in the middle jiao) should be treated with herbs in warm nature, such as roasted Rhizoma Zingiberis Recens (wei sheng jiang). (3) Disease or syndrome with both cold and heat patterns should be treated with medicinals with both cold and heat natures. The respective dosage of these medicinals should be determined based on the degree of cold and heat condition. (4) Diseases or syndromes with the pattern of true cold with false heat or the pattern with true heat with false cold should be treated with medicinals with heat nature or medicinals with cold nature, respectively. If necessary, paradoxical assistant medicinals with opposite medicinal nature can be added.

Five Flavors Five flavors are based on different effects. Chinese medicinals have sour, bitter, sweet, acrid, and salty flavors according to their different biological activities. It is not only the concise summary of medicinal functional activity, but also the real taste of some medicinals. The theory of five flavors provides a tool for TCM to reason, summarize, and explain the medicinal efficacy. Five flavors are felt initially, determined by tasting medicinal, and consistent with their flavors in healthy people. For example, Saccharum Granorum (yi tang) has a sweet flavor; Radix Scutellariae (huang qin) is bitter in taste; Rhizoma Chuanxiong (chuan xiong) has a acrid flavor; Fructus Mume (wu mei) is sour in taste; and Sargassum (hai zao) has a salty flavor. A close correlationship and correspondence between medicinal flavors and efficacy exists. For example, medicinals with activities of exterior-releasing, (qi-) moving and dissipating are usually acrid in taste; medicinals with activities of deficiency-supplementing and spasm-relaxing are usually sweet in taste; medicinals with activities of astringing the lung and intestines are usually sour in taste; medicinals with activities of descending, purging, and dampness-drying are usually bitter in taste; and medicinals with activities of softening hardness and dissipating masses are usually salty in taste. In addition, if medicinal activities cannot be explained by flavor tasted by mouth, people can conversely figure out medicinal flavor according to the aforementioned relationship. This deduced flavor is not associated with flavor tasted by mouth. For example, Radix Puerariae Lobatae (ge gen) usually has activities of promoting fluid production and quenching thirst, venting pathogen through the exterior, and promoting eruption of papules in the clinic, but the sweet flavor tasted by mouth can only explain its activities of promoting fluid production and quenching thirst, but is difficult to explain its activities venting pathogen through the exterior and promoting eruption of papules. Therefore, according to the relationship between activities (exterior-releasing, venting, and dispersing) and acrid in taste, the acrid flavor is endued to Radix Puerariae Lobatae (ge gen). So Radix Puerariae Lobatae (ge gen) not only has a sweet flavor, but also an acrid flavor. After countless deductions

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and comparisons, TCM physicians gradually realize that medicinal flavor obtained by this kind of practice and deduction is more reasonable and effective in clinical practice. Therefore, in today’s practice, medicinal flavor is mainly determined based on medicinal efficacy and referred by the flavor tasted by the mouth. Generally speaking, medicinals with different flavors have different effects on the human body. (1) Acrid: the acrid medicinals can dissipate and move; therefore they have the activities of dispersing, moving qi, and invigorating the blood. For example, Herba Schizonepetae (jing jie) and Herba Menthae (bo he), for treating exterior pattern; Rhizoma Cyperi (xiang fu), for treating qi stagnation; and Rhizoma Chuanxiong (chuan xiong), for treating blood stasis, are acrid in taste. The acrid medicinals can usually consume qi and damage the liquid (thin fluid), so patients with qi deficiency and fluid inadequacy should use them with caution. (2) Sweet: the sweet medicinals can supplement, moderate, and harmonize; therefore they have the activities of supplementing deficiency, harmonizing the center, moderating spasms, and harmonizing different medicinal natures. For example, Radix et Rhizoma Ginseng (ren shen), Radix Rehmanniae Praeparata (shu di huang), Fructus Jujubae (da zao), and Fructus Lycii (gou qi zi), for treating deficiency pattern; Saccharum Granorum (yi tang) and Radix et Rhizoma Glycyrrhizae (gan cao), for treating spasm with pain and harmonizing medicinal nature, have a sweet flavor. Some sweet medicinals, such as Mel (feng mi) and Radix et Rhizoma Glycyrrhizae (gan cao), can resolve toxins from drugs and food. In addition, sweet medicinals usually have a moist texture and can moisten dryness. Moreover, most sweet medicinals are greasy, can easily influence digestion, and cause abdominal fullness; so patients with dampness obstruction, food accumulation, and abdominal flatulence due to qi stagnation should use them with caution. (3) Sour: the sour medicinals can astringe and have the activities of restraining (preventing something from leaking) and consolidating (essence). For example, Galla Chinensis (wu bei zi), for treating chronic diarrhea and dysentery; Fructus Mume (wu mei), for treating chronic cough; Fructus Schisandrae Chinensis (wu wei zi), for treating spontaneous sweating and night sweating; Fructus Corni (shan zhu yu), for treating seminal emission or spontaneous seminal emission; and Halloysitum Rubrum (chi shi zhi), for flooding and spotting (uterine bleeding) and morbid leukorrhea in large amounts, are sour in taste. Moreover, sour medicinals, such as Fructus Chaenomelis (mu gua) and Fructus Mume (wu mei), can promote fluid production and calm roundworms. Most of sour medicinals can astringe pathogens, so patients with pathogens that have not been removed should use them with caution. (4) Bitter: the bitter medicinals can discharge, and dry and strengthen yin; therefore they have the activities of clearing and draining fire-heat, discharging and descending counterflow of qi, purging or promoting defecation, drying dampness, and draining fire to preserve yin. For example, Radix Scutellariae (huang qin) and Fructus Gardeniae (zhi zi) have a bitter flavor, can clear heat and drain fire, and treat pattern of fire-heat accumulated in interior; Semen Armeniacae Amarum (ku xing ren) and Semen Lepidii (ting li zi) are bitter in taste, they can lower and discharge lung qi, relieve panting, and can treat cough and panting due to lung qi counterflow; Radix et Rhizoma Rhei (da huang) and Fructus Aurantii Immaturus (zhi shi) are bitter in taste, can discharge heat and promote defecation, and treat constipation due to heat accumulation; Radix et Rhizoma Gentianae (long dan) and adix Sophorae Flavescentis (ku shen) have a bitter flavor, can clear heat and dry dampness, and treat damp-heat jaundice; Rhizoma Atractylodis (cang zhu) and Cortex Magnoliae Officinalis (hou po) can dry dampness with bitter and warm natures and treat dampness obstruction in the middle jiao; Cortex Phellodendri Chinensis (huang bai) and Rhizoma Anemarrhenae (zhi mu) are bitter in taste, can drain fire to preserve yin, and treat steaming bone fever and tidal fever due to yin deficiency that causes vigorous fire. Bitter medicinals usually can damage liquid (thin fluid) and stomach, so patients with fluid consumption and spleen-stomach deficiency should not use them a lot. (5) Salty: the salty medicinals can soften and purge; therefore they have the activities of softening hardness and dissipating masses, and relieving constipation by purgation. For example, Natrii Sulfas (mang xiao), for treating constipation due to heat accumulation; Sargassum (hai zao) and Thallus Eckloniae (kun bu), for treating goiter and scrofula; Carapax Trionycis (bie jia) and Concha Ostreae (mu li), for treating concretions and conglomerations (lower abdominal masses; zhēng jiă), are salty in taste. (6) Astringent: the astringent medicinals can astringe and have similar activities as those as sour medicinals. For example, Endoconcha Sepiae (hai piao xiao), for treating uterine bleeding and hematemesis; Semen Nelumbinis (lian zi), for treating seminal emission and morbid leukorrhea; and Pericarpium Granati (shi liu pi), for treating chronic diarrhea and dysentery, are astringent in taste. (7) Bland: the bland medicinals can percolate; therefore they have the activities of promoting urination and percolating dampness. For example, Poria (fu ling), Polyporus (zhu ling), Rhizoma Alismatis (ze xie), and Medulla Junci (deng xin cao) are bland in taste.

Ascending and Descending, Floating and Sinking Ascending and descending, as well as floating and sinking refer to the different tendencies of Chinese medicinals on the human body. These tendencies are opposite to that of the treated disease, but similar to the location of the treated disease. It is one of the concepts that explain the properties of medicinal function. Generally, light medicinals, such as flower, leaf, bark, and branch, usually belong to the ascending and floating medicinals, such as Folium Perillae (zi su ye), Flos Chrysanthemi (ju hua), and Folium Mori (sang ye). Heavy medicinals, such as seed, fruit, mineral, and shell usually belong to the

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descending and sinking medicinals, such as Fructus Perillae (zi su zi), Fructus Aurantii Immaturus (zhi shi), Magnetitum (ci shi), Concha Ostreae (mu li), and Haematitum (dai zhe shi). The clinical therapeutic effects of Chinese medicinals are the main basis used for determining the medicinal nature: ascending and descending, or floating and sinking. For example, Rhizoma et Radix Cynanchi Stauntonii (bai qian) can dispel phlegm, direct qi downward, and is good at treating cough and panting, excessive phlegm, and counterflow of qi with an excess pattern; so its medicinal nature is descending and sinking. Radix Platycodonis (jie geng) can dissipate and elevate lung qi, diffuse the lung, and relieve sore throat, and specialize in treating cough with profuse phlegm, sore throat, and hoarseness,; so it has the medicinal nature of ascending and floating. Generally speaking, the ascending and floating medicinals can act upward and promote pathogens outward, and have the effects of raising yang and releasing the exterior, dispelling wind and dissipating cold, inducing vomit, and opening the orifices (resuscitating), and are suitable for the prevention and treatment of diseases in the upper or exterior, or diseases with sunken tendency. The descending and sinking medicinals can act downward and interior, and have the effects of purgation, clearing heat, promoting urination and percolating dampess, tranquilizing the heart and calming the mind, subduing yang and extinguishing wind, disperse accumulation and guiding out (food) stagnation, directing counterflow downward and arresting vomiting, astringing and consolidating (essence), relieving cough and calming panting, and they are suitable for the prevention and treatment of diseases in the lower or interior body, or diseases with tendencies of ascending and counterflow.

Channel Entry Channel entry refers to the selective therapeutic actions of Chinese medicinals acting on one part or several parts of the human body. This means that some medicinals have a special affinity to enter or interact with certain zang-fu organs. Therefore, they can be mainly used to treat pathological conditions present in these parts of the human body. Channel entry points out where the medicinal can be used and explained where the medicinal is effective, so it is one of the basic concepts of medicinal nature to guide clinical practice. The formation of channel entry theory is based on the theories of zang-fu and channel-collateral, as well as the efficacy of medicinals on specific diseases and syndromes. For example, Fructus Perillae (zi su zi) and Rhizoma et Radix Cynanchi Stauntonii (bai qian) can treat cough and panting, which are caused by a disorder of lung function, so they attribute to the lung channel. Sclerotium Poriae Pararadicis (fu shen) and Semen Platycladi (bai zi ren) can treat palpitation and insomnia, which are caused by a disorder of heart function, so they attribute to the heart channel. In clinical practice, doctors can select attributive medicinals according to affected zang-fu or channel-collateral. For example, heat patterns include lung-heat pattern and liver-heat pattern. To treat cough and panting with lung-heat pattern, doctors should select the medicinals that attribute to the lung channel and specialize in clearing lung-heat, such as Radix Scutellariae (huang qin) and Cortex Mori (sang bai pi). To treat liver-heat pattern or liver-fire pattern, doctors should select the medicinals that attribute to the liver channel and specialize in clearing liver-fire, such as Radix et Rhizoma Gentianae (long dan) and Spica Prunellae (xia ku cao). Moreover, doctors can also select medicinals according to the role of transmission and change of disease through the zang-fu organs or channel and collateral. For example, if cough and phlegm panting is caused by liver-fire invading the lung, doctors cannot just use medicinals that attribute to the lung channel only. They should select medicinals that attribute to the lung channel and can clear lung heat and dissolve phlegm, such as powder of Concha Meretricis seu Cyclinae (hai ge fen), as well as medicinals that attribute to the liver channel and can clear heat and cool the liver, such as Indigo Naturalis (qing dai). In this way, the medicinals can clear both liver- and lung-heat to heal cough and panting. If patients with cough and phlegm panting complicate with spleen deficiency, doctors should select medicinals that attribute to the lung channel and can relieve cough and dissolve phlegm, as well as medicinals that attribute to the spleen channel and can fortify the spleen to disperse phlegm. In this way, the medicinals can heal coughing and panting.

Toxicity Chinese medicinal toxicity refers to the adverse effects and injuries caused by medicinals to the human body. Chinese medicinal side effects refer to ill effects, which are undesirable at conventional dosage. Toxic reaction may do great harm to the human body and is usually caused by an overdose and long-term use of certain medicinals. Side effects may slightly harm the human body and disappear after discontinuance of the medicinal. In the clinic, poisonous medicinals should be applied correctly, so as to transform the toxic substance into a nontoxic one. For poisonous or extremely poisonous medicinals, the dose must be strictly controlled. For nontoxic medicinals, large doses with long-term use should be avoided; otherwise, a nontoxic substance may become toxic. Strictly controlling the quality of medicinals is the basic measure to attenuate toxicity, and proper usage is an important step to avoid toxicity. Toxicity or nontoxicity, in a narrow sense, refers to whether medicinals can cause harm to the human body after receiving treatment; in a broad sense, besides referring to whether medicinal actions can cause damage to body, it should also

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include the strength of therapeutic effects of medicinals on the human body. In other words, the medicinal toxicity or nontoxicity reflects its dual characters of “preference nature” on the human body.

Efficacy and Indications of Chinese Medicinals Efficacy and indications (indicated diseases and syndromes) of Chinese medicinal are not only the principles of forming a formula and selecting medicinals, as well as the basis of preventing and treating diseases, but also the kernel contents of clinical Chinese materia medica and the component of Chinese materia medica in TCM. Efficacy refers to the functions of preventing diseases with Chinese medicinals, diagnosis and treatment of diseases, and enhancement of health. The recognition, summarization, and determination of Chinese medicinal efficacy by traditional Chinese physician are concluded according to the human body reactions to medicinals (changes of symptoms and signs after or before medication) and reverse reasoning through the identification of etiology based on the differentiation of symptoms and signs, establishment of treatment based on pattern differentiation, and analysis and summarization based on guidance of TCM theory. The expression phraseology, in principle, is in concert with TCM therapeutics or pattern differentiation. (1) Efficacy aiming at etiology refers to the therapeutic actions of Chinese medicinals aiming at etiological factors. It includes dispelling pathogen, reinforcing healthy qi, regulating the function of zang-fu organs, and eliminating pathological products. Among these, efficacy on dispelling pathogen includes dispelling wind, dissipating cold, eliminating dampness, clearing heat, drastic purgation, inducing vomiting, resolving toxins, and killing worms; efficacy on reinforcing health qi includes supplementing qi, assisting yang, enriching yin, and nourishing the blood. Efficacy on regulating zang-fu organs or qi and blood includes soothing the liver, softening the liver, diffusing the lung, harmonizing the center, rectifying qi, invigorating the blood, calming the mind, opening the orifices, subduing yang, and extinguishing wind. Efficacy on eliminating pathological products includes promoting digestion, promoting urination, dispelling phlegm, dissolving blood stasis, expelling stones, and evacuating pus. (2) Efficacy aiming at symptom refers to some Chinese medicinals that can moderate or eliminate certain or some kinds of symptoms manifested in disease process, contributing to alleviate the suffering of patients, and preventing deteriorated pathogenic condition. It includes relieving pain, stanching bleeding, arresting vomiting, calming panting, arresting sweating, astringing the intestines to arrest diarrhea, and astringing essence to arrest enuresis and emission. (3) Efficacy aiming at disease or syndrome refers to some Chinese medicinals that have more evident therapeutic effects than other medicinals on malaria, cutaneous tubercle, bì syndrome (arthromyodynia), sinusitis, jaundice, lung abscess, and cestodiasis. It includes preventing attack of malaria, eliminating warts, dispelling wind-damp, unblocking the nasal cavity, promoting gallbladder function to relieve jaundice, dispersing carbuncle and expelling pus, and expelling and killing tapeworms. (4) Efficacy aiming at modern disease: some Chinese medicinals have evident therapeutic effects on hypertensive disease, hyperlipidemia, diabetes mellitus, and neoplasms described in modern medicine. For example, Spica Prunellae (xia ku cao) can decrease blood pressure; Semen Cassiae (jue ming zi) can lower blood fatty acids; and Radix Trichosanthis (tian hua fen) can drop blood glucose. In fact, one Chinese medicinal usually has multiple effects. Indications (indicated diseases and syndromes) are determined through both living and clinical practice, and it refers to chief adaptable diseases and syndromes treated by medicinals, also known as chief adaptable scope, abbreviated as “indications.” Indications can be divided into three categories. (1) Indications named as disease names refers to indicated diseases and syndromes of Chinese medicinals expressed by disease names, such as malaria, lung abscess, intestinal abscess, burn due to hot liquid or fire, and thanatophidia bite. (2) Indications named as syndrome or pattern, such as heat strangury, blood strangury, heat cough, cold wheezing, damp-heat jaundice, wind-heat exterior pattern, wind-cold exterior pattern, and wind-cold exterior pattern complicated by dampness. (3) Indications named as symptoms, such as palpitations due to fright, tinnitus, deafness, and foul breath.

Application of Chinese Medicinals Contents of application of Chinese medicinals include combination of medicinals, medication contraindication, dosage, and administration. Mastering this knowledge is necessary to ensure the safety and effectiveness of medication.

Combination of Medicinals Combination of medicinals refers to medication methods that combine two or more kinds of medicinals together to use according to the pathogenic condition, treatments, and medicinal properties and actions. In the book of Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing), seven combinations of medicinal have been summarized according to various relationships of medicinal compatibility. They are singly action (ability of a medicinal to be used alone), (mutual) reinforcement (xiāng xū), (mutual) assistance (xiāng shĭ), (mutual) restraint (xiāng wèi), (mutual) suppression (xiāng shā),

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(mutual) inhibition (xiāng wù), and (mutual) antagonism (xiāng făn). These seven combinations of medicinals describe the changes in the medicinal nature after a brief combination of medicinals. The seven combinations of medicinals highly summarize the seven general principles used in TCM clinical application, and are the foundation of selecting medicinals and establishing a formula by TCM doctors. (1) Single action refers to a medicinal that is used to treat a single pathogenic condition of some diseases. For example, in the Unaccompanied Ginseng Decoction (du shen tang), Radix et Rhizoma Ginseng (ren shen) is used singly for treating desertion of original qi caused by a large amount of blood loss. In Lung-Clearing Powder (qing jin san), Radix Scutellariae (huang qin) is used singly for treating bleeding due to lung-heat. (2) Mutual reinforcement refers to medicinals with similar effectiveness that are combined to strengthen each other’s activities. For example, Pericarpium Citri Reticulatae (chen pi) combined with Rhizoma Pinelliae (ban xia) can strengthen the effects of drying dampness and dissolving phlegm, rectifying qi, and harmonizing the center. (3) Mutual assistance refers to that one medicinal that is the primary and another that is auxiliary. The auxiliary one can strengthen the effects of the primary one. For example, Radix Astragali (huang qi) that can supplement qi and promote urination is the primary. After combination with Poria (fu ling), which can promote urination and fortify the spleen as the auxiliary, Poria (fu ling) can strengthen the effects of Radix Astragali (huang qi) on supplementing qi and promoting urination. (4) Mutual restraint refers to toxicity and side effects of one medicinal that can be restrained by another medicinal. For example, toxicity of raw Rhizoma Pinelliae (sheng ban xia) can be alleviated by Rhizoma Zingiberis Recens (sheng jiang). (5) Mutual suppression refers to that one medicinal can suppress toxicity and side effects of another medicinal. For example, Herba Lysimachiae (jin qian cao) can reduce the toxins of Radix Tripterygii Wilfordii (lei gong teng). (6) Mutual inhibition refers to one medicinal that can inhibit the effects of another medicinal. For example, Rhizoma Zingiberis Recens (sheng jiang) can inhibit the effects of Radix Scutellariae (huang qin) on warming the stomach and arresting vomiting. (7) Mutual antagonism refers to two medicinals are applied together that can generate toxicity and side effects. For example, Aconitum Carmichaeli (wu tou) antagonizes Rhizoma Pinelliae (ban xia), which can generate significant toxicity. Among these seven combinations of medicinals, (mutual) reinforcement (xiāng xū) and (mutual) assistance (xiāng shĭ) can increase the efficiency of medicinals, which should be fully utilized; and (mutual) restraint (xiāng wèi) and (mutual) suppression (xiāng shā) decrease the toxicity of medicinals, which should be utilized when the poisonous and fierce medicinals are used. However, (mutual) inhibition (xiāng wù) can reduce the efficiency of medicinals, which should be paid attention to in the combination. (Mutual) antagonism (xiāng făn) increases that the toxicity of medicinals, which should be absolutely prohibited.

Medication Contraindication To ensure the therapeutic effect and medication safety, as well as to avoid the generation of toxicity and side effects, medicinal contraindication of Chinese medicinals should be paid attention to. (1) Prohibited combination includes “eighteen antagonisms” and “nineteen mutual inhibitions.” The eighteen antagonisms refer to Aconitum Carmichaeli (wu tou) that is incompatible with Rhizoma Pinelliae (ban xia), Fructus Trichosanthis (gua lou), Bulbus Fritillaria (bei mu), Radix Ampelopsis (bai lian), and Rhizoma Bletillae (bai ji); Radix et Rhizoma Glycyrrhizae (gan cao) is incompatible with Radix Euphorbiae Pekinensis (jing da ji), Radix Kansui (gan sui), Flos Genkwa (yuan hua), and Sargassum (hai zao); and Radix et Rhizoma Veratri Nigri (li lu) is incompatible with Radix et Rhizoma Ginseng (ren shen), Radix et Rhizoma Salviae Miltiorrhizae (dan shen), Radix Scrophulariae (xuan shen), Radix Glehniae (bei sha shen), Radix et Rhizoma Asari (xi xin), and Radix Paeoniae Alba (bai shao). The nineteen mutual inhibitions refer to Sulfur (liu huang) that antagonizes Natni Sulfas Natura (po xiao); Hydrargyrum (shui yin) antagonizes Arsenicum Sublimatum (pi shuang); Radix Euphorbiae Fischerianae (lang du) antagonizes Lithargyrum (mi tuo seng); Fructus Crotonis (ba dou) antagonizes Semen Pharbitidis (qian niu zi); Flos Caryophylli (ding xiang) antagonizes Radix Curcumae (yu jin); Radix Aconiti (chuan wu) and Radix Aconiti Kusnezoffii (cao wu) antagonize Cornu Rhinocerotis (xi jiao); Natrii Sulfas (mang xiao) antagonizes Rhizoma Sparganii (san leng); Cortex Cinnamomi (rou gui) antagonizes Halloysitum Rubrum (chi shi zhi); and Radix et Rhizoma Ginseng (ren shen) antagonizes Faeces Trogopterori (wu ling zhi). The “eighteen antagonisms” and “nineteen mutual inhibitions” are the summary of predecessor’s experiences on medication contraindication, and have a significant impact on the safety practice of TCM in the clinic. (2) Contraindication between syndrome (pattern) and medicinals: as medicinals have different medicinal natures, specialized effects, and certain applications, some medicinals or categories of medicinals are not suitable to treat certain diseases or syndromes. Therefore, this situation should be avoided when prescribing formula to patients. For example, Herba Ephedrae (ma huang) is acrid and warm in nature, can induce sweating and release the exterior, dissipate wind and cold, diffuse the lung and relieve panting; so it is only suitable for treating externally contracted excess pattern without sweating or cough and panting due to lung qi failing to diffuse. Its use should also be prohibited in treating spontaneous sweating due to exterior deficiency, night sweating due to yin deficiency, and panting due to lung-kidney deficiency. Moreover, female patients with profuse menstruation and uterine bleeding should be banned to use Rhizoma Sparganii (san leng) and Rhizoma Curcumae (e zhu) to avoid aggravated bleeding. Furthermore, patients with thin and unformed stool due

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to deficiency-cold of the spleen and stomach should be banned to use herbs with bitter-cold nature or purgatives, such as Radix et Rhizoma Rhei (da huang). Except medicinals with neutral nature, most medicinals generally have the syndrome (pattern) contraindication. (3) Medication contraindication for pregnancy: some Chinese medicinals can damage the fetus or cause an abortion; therefore their use should be banned or be used with caution for pregnant patients. Most of extremely poisonous medicinals or medicinals with fierce nature should be banned, such as Hydrargyrum (shui yin), Arsenicum Sublimatum (pi shuang), Realgar (xiong huang), Calomelas (qing fen), Mylabris (ban mao), Semen Strychni (ma qian zi), Venenum Bufonis (chan su), Radix Aconiti (chuan wu), Radix Aconiti Kusnezoffii (cao wu), Radix et Rhizoma Veratri Nigri (li lu), Chalcanthitum (dan fan), Pedicellus Melo (gua di), Fructus Crotonis (ba dou), Radix Kansui (gan sui), Radix Euphorbiae Pekinensis (jing da ji), Semen Euphorbiae (qian jin zi), Flos Genkwa (yuan hua), Semen Pharbitidis (qian niu zi), Radix Phytolaccae (shang lu), Moschus (she xiang), Resina Toxicodendri (gan qi), Hirudo (shui zhi), Tabanus (meng chong), Rhizoma Sparganii (san leng), and Rhizoma Curcumae (e zhu). Medicinals that invigorate blood and dispel stasis, break stagnant qi and move stagnation, or promote defecation by purgation; or medicinals with acrid, hot, and descending nature should be used with caution, such as Radix Achyranthis Bidentatae (niu xi), Rhizoma Chuanxiong (chuan xiong), Flos Carthami (hong hua), Semen Persicae (tao ren), Rhizoma Curcumae Longae (jiang huang), Cortex Moutan (mu dan pi), Fructus Aurantii Immaturus (zhi shi), Radix et Rhizoma Rhei (da huang), Natrii Sulfas (mang xiao), Folium Sennae (fan xie ye), Aloe (lu hui), Radix Aconiti Lateralis Praeparata (fu zi), Cortex Cinnamomi (rou gui), and Fructus Malvae Vertillatae (dong kui zi). (4) Dietary incompatibility: during administration, patients should generally avoid eating raw or cold, acrid and hot, greasy, fishy, sticky, or stimulating food to avoid side effects, such as indigestion, gastrointestinal irritation, or promoting heat, promoting ascending-dissipating, and astringing pathogens. Patients with cold pattern should avoid eating raw or cold food. Patients with heat pattern should avoid eating acrid, hot, and greasy food. Patients with pectoral stuffiness pain should avoid eating fat meat, fat, animal internal organs, and heavy alcoholic drink. Patients with ascendant hyperactivity of liver yang should avoid eating foods that assist yang with acrid and hot nature, such as piper nigrum, hot pepper, garlic, and wine. Patients with weakness of the spleen and stomach or dyspepsia should avoid eating indigestible food, such as fried, sticky, greasy, cold, solid, or hard food. Patients with sores and ulcers or other skin diseases should avoid eating fish, lobster and crab, or pungent and stimulating food. Patients with externally contracted exterior pattern should avoid greasy or oily food.

Dosage Chinese medicinal dosage refers to the daily amount of each medicinal for adult oral administration. It also can refer to the relative amount of one medicinal in a formula, which is “relative dosage.” The regular daily dosage of each medicinal for adult oral administration is generally 3–9 g of the dried medicinals and sometimes 15–30 g, except medicinals with fierce nature and (or) toxicity, and refined medicinals. For poisonous medicinals, the dosage should be strictly controlled and should not be over the safety dosage range; they should be discontinued as soon an effect is observed. Medicinals that are lightweight, such as flower, leaf, bark, and branch herbs, as well as medicinals that are strong in taste and smell, and with fiercer effects, should be used in relatively smaller doses. Medicinals that are heavyweight, such as mineral and shell substances, as well as medicinals that are light in taste and smell or with milder effects, should be applied in larger doses. Dosage of fresh herbs should be used in a relatively larger amount than a dried one (usually 2–4 times dosage) because they contain more water. Dosage of medicinals used in decoction should be relatively larger than that in pill or powder. For old patients, children, female after childbirth, and patients with weak constitution, dosage should be decreased. For the adult and patients with usual strong constitution, dosage should be relatively larger. The dosage for a child under 5 years is normally one-fourth of the amount of that of an adult, and or child over 5 years, it is usually half of the amount of that of an adult. The dosage for patients with a mild pathogenic condition, moderate tendency, and long course should be relatively smaller. For patients with a severe pathogenic condition, acute tendency, and short course, dosage should be larger. Medicinals that induce sweating and release the exterior, as well as medicinals with acrid, warm, or extremely hot nature should not be used in large amounts in summer, but in winter, their dosage can be increased. Medicinals that subdue fire with bitter and cold nature should usually be used in large amounts in summer, but in winter, their dosage should be decreased. Generally, large or small dosage of medicinals is closely related with their therapeutic effects. Medicinal effects are usually strengthened with an increase in dosage. For example, a large dosage of Radix et Rhizoma Ginseng (ren shen) can greatly supplement original qi and treat qi deficiency verging on desertion; but regular or a small dosage can supplement lung-spleen qi and treat the common qi deficiency. Large dosage of Radix et Rhizoma Rhei (da huang) can drastically purge the accumulated heat and treat constipation with severe heat accumulation, while small dosage can moderately purge and treat constipation with mild heat accumulation. Some medicinal effects may be changed following the increase or decrease in dosage. For example, regular dosage of Rhizoma Atractylodis Macrocephalae (bai zhu) can fortify the spleen and boost qi, dry dampness, and promote urination and treat thin and unformed stool due to spleen deficiency complicated by

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dampness; however, large dosage can fortify the spleen and boost qi to moderately promote defecation and treat constipation due to spleen deficiency.

Usage As to the usage of Chinese medicinal in this book, decocting methods for decoction and administration methods of other different dosage forms are mainly introduced. 1. Decocting methods for decoction. Marmite, earthen jar, or pottery container can be selected for decocting; but iron or copper cooker should be avoided. Medicinals can be soaked with clean tap water, well water, or distilled water for 30–60 min. The amount of water over the materia medica should be about 2–3 cm. Generally, one prescription of medicinals should be decocted 2 times; and the amount of water in the second decoction is about one-third to one-half of the amount in the first decoction. The 2-time decocted solutions can be filtered and mixed for oral administration twice. The duration and degree of heating should be determined by medicinal nature. Generally speaking, medicinals that release the exterior and medicinals that clear heat should be quickly decocted with high heat; time should be short and decocting for 3–5 min after boiling is suitable. Medicinals that supplement and nourish should be slowly decocted with median heat; time should be long and decocting for 30–60 min after boiling is needed. Some medicinals with different textures should be decocted with special decocting methods. (1) Decocted first: some medicinals with active ingredients that are difficult to dissolve in water should be broken into pieces and decocted first for 20–30 min before adding other medicinals. For example, Magnetitum (ci shi), Haematitum (dai zhe shi), Gypsum Fibrosum (shi gao), Concha Meretricis seu Cyclinae (hai ge qiao), Concha Arcae (wa leng zi), Concha Ostreae (mu li), Carapax et Plastrum Testudinis (gui jia), or Carapax Trionycis (bie jia) should be broken and decocted first and longer. Some medicinals with strong toxicity and side effects, such as Radix Aconiti Lateralis Praeparata (fu zi) and Aconitum Carmichaeli (wu tou), should also be decocted first for 45–60 min to decrease their toxicity and then decocted with other medicinals. (2) Decocted later: some medicinals with fragrant odors or with active ingredients that are easy volatilized after long decocting should be added and decocted for 5–10 min after other medicinals have been cooked. For example, Lignum Aquilariae Resinatum (chen xiang), Radix Aucklandiae (mu xiang), Herba Menthae (bo he), Herba Artemisiae Annuae (qing hao), Herba Moslae (xiang ru), Fructus Amomi (sha ren), or Fructus Amomi Kravanh (bai dou kou) should be added later in a decoction. Some medicinals, such as Folium Sennae (fan xie ye) and Ramulus Uncariae Cum Uncis (gou teng), should be added later because their active ingredients are easily destroyed after long decocting. (3) Decocted while wrapped: some medicinals, such as pollen, tiny seeds, and fine powder, such as Pollen Typhae (pu huang), Semen Lepidii (ting li zi), and powder of Talcum (hua shi), should be wrapped for decocting. Some medicinals containing more starch and (or) mucoid substances that easily stick the cooker and gelatinize, such as Semen Plantaginis (che qian zi), should also be wrapped for decocting. Medicinals with floss, such as Flos Inulae (xuan fu hua), should also be decocted with wrap because the floss is difficult to filter clean and easily stimulates the throat when taking orally. (4) Decocted separately: a few expensive medicinals should be decocted separately to avoid absorption of active ingredients, resulting in a loss of their activity, such as Radix et Rhizoma Ginseng (ren shen) and Radix Panacis Quinquefolii (xi yang shen). (5) Melted: gels, such as Colla Corii Asini (e jiao), Colla Cornus Cervi (lu jiao jiao), and Colla Carapacis et Plastri Testudinis (gui jia jiao), can easily stick to other medicinals or cooking pot, and influence decocting. They should be melted first with warm water and then added into the decocted solution before oral administration. (6) Infused: some medicinals dissolve easily in water or solutions, such as Natrii Sulfas (mang xiao), Mel (feng mi), and Succus Bambusae (zhu li). They should be infused with boiling water or another decocted solution. Some expensive medicinals should be ground into powder and infused because their active ingredients are neither dissolved nor active during decoction, such as Calculus Bovis (niu huang) and Cornu Saigae Tataricae (ling yang jiao). (7) Decocted with decoction: some medicinals, such as Terra Flava Usta (zao xin tu), are difficult to dissolve in water and may cause turbidity that is hard to be ingested. They should be decocted separately and the supernatant should be collected, which can be added into medicinals for further decoction. 2. Administration method. Patients usually take one dose of prescribed medicinals a day, of which decoction is divided into two oral administrations with an interval of 4–6 h. For acute or febrile disease, patients can take two doses a day. Generally, patients with diseases above the chest and diaphragm, such as vertigo, headache, disease of the eye, and sore throat, should take decoction after meals; patients with diseases under the chest, such as diseases of the stomach, liver, and kidney, should take decoction before meals. Medicinals that promote digestion and fortify the stomach and some medicinals that can stimulate the stomach and intestines should be taken after meals. Medicinals that expel water by drastic purgation, medicinals that purge accumulation and guide out (food) stagnation, medicinals that expel worms, and tonifying medicinals with potential of greasiness and blocking stomach function should be taken on an empty stomach. Medicinals that calm the mind should be taken 30–60 min before retiring. Medicinals that astringe essence and

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arrest enuresis and emission should be taken before bedtime so as to treat nocturnal emission and spontaneous seminal emission. Medicinals that moderately purge should be taken before bedtime. Patients with chronic diseases usually take herbal decoction at a regular time. Patients with acute disease, vomiting, convulsion, stony strangury, and disease of the throat should take decoction as tea randomly. Usually decoction should be taken when warm. However, medicinals that release the exterior should be taken hot to assist sweating; medicinals for treating cold pattern should be taken hot and medicinals for treating heat pattern should be taken cold. Small pills should be directly taken with warm boiled water; large honey pills can be divided into small particles for swallowing; and water pills with hard texture can be dissolved in water for oral use. Powder can be mixed with honey or encapsulated for oral use to avoid directly stimulating the throat. Paste should be infused with boiled water. Syrup can be swallowed directly. In addition, patients with a critical illness should frequently take small amounts of decoction. Patients with vomiting should frequently take the concentrated decoction in a small amount to avoid large amounts of decoction that may cause vomiting again. When administrating medicinals that induce sweating and medicinals that purge and if their effects are too strong, these medications should be discontinued as soon as sweating and purgation is induced to avoid damaging the healthy qi.

Chapter 1

Herbs That Release the Exterior Chapter Outline Section 1 Herbs That Dispel Wind-Cold Outline Specific Application Knowledge of Herbs

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Section 2 Herbs That Dispel Wind-Heat Outline Specific Application Knowledge of Herbs

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ABSTRACT Chinese herbal medicinals that mainly disperse exterior pathogen and treat exterior pattern are called “herbs that release the exterior,” which are commonly divided into two kinds: herbs that dispel wind-cold and herbs that dispel wind-heat. They mainly act on the fleshy exterior and can promote sweating to let the exterior pathogen out for curing the exterior patterns to avoid the pathological transmission. Some herbs that release the exterior also can promote urination to alleviate edema, relieve cough and panting, promote eruption of papules, relieve pain, and remove sores. Keywords: herbs that release the exterior; herbs that dispel wind-cold; herbs that dispel wind-heat; induce sweating to release the exterior; scatter and dissipate wind-heat

Chinese herbal medicinals that mainly disperse exterior pathogen and treat exterior pattern are called “herbs that release the exterior.” Most medicinals in this chapter are acrid in flavor and dispersing in nature. Most of them act on the lung and bladder channels. They mainly act on the fleshy exterior and can promote sweating to let the exterior pathogen out for curing the exterior patterns to avoid the pathological transmission. Some herbs that release the exterior also can promote urination to alleviate edema, relieve cough and panting, promote eruption of papules, relieve pain, and remove sores. Herbs that release the exterior are mainly used in the treatment of externally contracted exterior patterns with aversion to cold and fever, headache and body pain, absence of sweating or inhibited sweating, and floating pulse. Certain herbs that release the exterior are used in the treatment of edema, cough and panting, measles, rubella, bi syndrome pain due to wind-damp, and sores and ulcers in the initial stage accompanied by the exterior patterns. In clinical application, selection of the herbs that dispel wind-cold or wind-heat should be based on the different clinical patterns between externally contracted wind-cold pathogen and wind-heat pathogen. Combination of the herbs that dispel summer heat or remove dampness or moisten dryness should be on the basis of different features of four seasons’ climate change with more wind-cold in winter, more wind-heat in spring, more summer heat-damp complicated in summer, or more dryness in autumn. If the weak patients have been externally contracted and complicated by deficiency of healthy qi and excess of pathogenic qi, combination of the herbs that boost qi, assist yang, nourish yin, or supplement blood should be aimed at the different body constitutions. Treatment of the warm disease in the initial stage with pathogenic qi in the wei (defensive) aspect, besides selection of the herbs that dispel wind-heat, should combine the herbs that clear heat and resolve toxins at the same time. The dosage of herbs that strongly induce sweating should not be used too much to avoid over sweating to consume the yang qi and body fluids. As sweat belongs to body fluids, as well as blood and sweat sharing the same origin, the patients with conditions of spontaneous sweating due to exterior (wei qi) deficiency, night sweating due to yin deficiency, sores and ulcers for a long time, strangury, or blood loss that combined the exterior pattern should be cautious to use herbs that release the exterior. In spring and summer, striae of the skin and muscles are loose and it is easy to sweat, the dosage of herbs that release the exterior should be appropriately reduced. In winter, striae of the skin and muscles are tightly closed and it is not easy to sweat, the dosage of herbs that release the exterior should be appropriately increased. As most of the herbs that release the exterior have the acrid property and dispersing effect, they should not be decocted for a long time when used in decoction to avoid volatilizing of active components and prevent loss of efficacy. Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00001-4 Copyright © 2017 Elsevier Inc. All rights reserved.

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Herbs that release the exterior are commonly divided into two kinds: (1) herbs that dispel wind-cold and (2) herbs that dispel wind-heat according to the difference of properties and actions, efficacy, and indications. The modern pharmacological research indicates the herbs that release the exterior generally have different levels of actions, such as sweating, relieving fever, relieving pain, inhibiting bacterium, antagonizing virus, expelling phlegm, preventing cough, relieving asthma, and promoting urination.

SECTION 1 HERBS THAT DISPEL WIND-COLD Outline The properties and flavors of the herbs that dispel wind-cold are most pungent-warm, which the pungent flavor has the dispersing effect and warm property has the dispelling cold effect. So medicinals in this section have the main effect of dispersing the wind-cold pathogen from muscle layer, and are mainly applied to treat the exterior syndrome caused by windcold that manifests the symptoms of aversion to cold with fever, an absence of sweating or no smooth sweating, head and body pain, nasal obstruction and nasal discharge, no thirst, thin and white coating, and floating and tight pulse. Some herbs have combined the effects of dispelling wind and arresting itching, relieving pain, relieving cough and panting, inducing diuresis to alleviate edema, and removing sores, respectively. Moreover, these herbs can be applied to treat rubella itching, rheumatic arthralgia, cough and dyspnea, edema, sores, and ulcers in the initial stage complicated by wind-cold exteriorexcess pattern or exterior-deficiency pattern.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 1.1)

TABLE 1.1 Properties, Actions, and Application of Common Herbs That Dispel Wind-Cold Name of Medicinal Ephedra (ma huang) (Herba Ephedrae)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried herbaceous stem of Ephedra sinica Stapf, Ephedra intermedia Schrenk et C.A.Mey., or Ephedra equisetina Bge. of the Ephedraceae family. Green herbaceous stem is collected in the late autumn; after woody stem, residual root, and impurities are removed, it is dried under the sun

Property, Channel Entry Acrid, slightly bitter, warm; act on the lung and bladder channels

Efficacy and Action

Clinical Application and Usage

Induce sweat and dispel exogenous pathogen, disperse lung qi for relieving panting, and induce diuresis to alleviate edema

Indicated for the treatment of common cold due to windcold, cough and panting with an excess pattern due to lung qi obstruction, wind edema (edema caused by wind-pathogen), and bronchial asthma. Ephedra processed with honey (the honey-fried one) can moisten lung to arrest cough, which is always used for asthma and cough with exterior syndrome having been resolved. It can also be used for the treatment of windcold bì syndrome, dorsal furuncle, and phlegm nodule. Normally, 2–10 g is decocted with water as an oral dose

Caution for Use Its use is cautious in patients with spontaneous sweating due to exterior deficiency, night sweating due to yin deficiency, or dyspnea of lung and kidney deficiency

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TABLE 1.1 Properties, Actions, and Application of Common Herbs That Dispel Wind-Cold (cont.) Name of Medicinal Cassia Twig (gui zhi) (Ramulus Cinnamomi)

Source and Collection Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried twig of Cinnamomum cassia Presl of the Lauraceae family. The twig is collected in the spring and summer; after the leaf is removed, it is cut into slices and dried under the sun

Perilla Leaf Initially recorded in Miscellaneous (zi su ye) Records of Famous Physicians (ming yi (Folium Perillae) bie lu). It is the dried leaf (or with twig) of Perilla frutescens (L.) Britt. of the Labiatae family. The leaf is collected when the branch and leaf are plentiful in summer; after impurities are removed, it is dried under the sun

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Acrid, sweet, warm; act on the heart, lung, and bladder channels

Induce sweating to expel pathogenic factors from muscles, warm and unblock the channels, assist yang to transform qi, and calm and lower the adverserising qi

Indicated for the treatment of common cold due to windcold with excess or deficiency pattern, pain syndrome of stagnant blood due to coagulated cold, joint arthralgia spasm with cold pain, amenorrhea due to cold in blood, cold pain in gastric cavity and abdomen, retention of phlegm and fluid, stagnated fluid syndrome, difficulty in urination, edema, palpitation, and dashing piggy zheng. Normally, 3–10 g is decocted with water as an oral dose

Its use is prohibited in patients with fever caused by exogenous diseases, hyperactivity of fire due to yin deficiency and hemopyretic bleeding, and to be used with caution in pregnant or menorrhagia women

Acrid, warm; act on the lung and spleen channels

Release the exterior and dissipate cold, move qi and harmonize the stomach, and relieve the seafood poisoning

Indicated for the treatment of common cold, cough with vomiting and nausea due to wind-cold, wind-cold exterior pattern with fullness and oppression in the chest and stomach cavity, vomiting of pregnancy due to qi stagnation in the stomach and spleen, cough and panting with excessive phlegm, abdominal pain with vomiting, and diarrhea due to poisoning from fish and crabs. Normally, 5–10 g is decocted with water as an oral dose

It shouldn’t be decocted for a long time. Due to its acrid and warm properties, it is cautiously used in patients with qi deficiency or exterior deficiency and without externally contracted windcold

Caution for Use

(Continued )

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TABLE 1.1 Properties, Actions, and Application of Common Herbs That Dispel Wind-Cold (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Fresh Ginger (sheng jiang) (Rhizoma Zingiberis Recens)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the fresh rhizome of Zingiber officinale Rosc. of the Zingiberaceae family. The rhizome is collected in autumn and winter. Then, earth, sand, and fibrous root are removed

Acrid, slightly warm; act on the lung, spleen, and stomach channels

Release the exterior and dissipate cold, warm the center and arrest vomiting, dissolve phlegm and relieve cough, and resolve toxins from fish and crabs

Indicated for the treatment of common cold with a pattern of wind-cold, spleen-stomach cold pattern or syndrome, vomiting due to stomach cold, cough due to cold-phlegm or lung cold, and also for the treatment of poisoning from fish and crabs and medicinals, such as raw Rhizoma Arisaematis (sheng tian nan xing) and raw Rhizoma Pinelliae (sheng ban xia). Normally, 3–10 g is decocted with water as an oral dose, or pounded to extract the juice for oral use or an appropriate amount is used externally

As it can assist fire and damage the yin, its use is prohibited in patients with exuberant heat, yin deficiency, and internal heat

Aromatic Madder (xiang ru) (Herba Moslae)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried aerial part of Mosla chinensis Maxim. or M. chinensis “jiangxiangru” of the Labiatae family. The aerial part is collected on sunny days when the stem, leaf, and blossom are plentiful in summer; after impurities are removed, it is dried in the shade

Acrid, slightly warm; act on the lung, spleen, and stomach channels

Induce sweating to release the exterior, remove dampness and harmonize the center, and promote urination to relieve edema

Indicated for the treatment of externally contracted windcold and internal damage caused by summer heat-damp, aversion to cold, fever, headache, no sweating, abdominal pain with vomiting and diarrhea, edema with an exterior pattern, and difficulty in urination. Normally, 3–10 g is decocted with water as an oral dose. If used for releasing the exterior, overdosage is unfavorable, and it shouldn’t be decocted for a long time

Its use is prohibited in patients with exterior deficiency accompanied by sweating, and summer heat heat syndrome

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TABLE 1.1 Properties, Actions, and Application of Common Herbs That Dispel Wind-Cold (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Schizonepeta (jing jie) (Herba Schizonepetae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried aerial part of Schizonepeta tenuifolia Briq. of the Labiatae family. When the flower is blooming and the spica is green during the summer and autumn, it is collected and dried under the sun

Acrid, slightly warm; act on the lung and liver channels

Release the exterior and dissipate wind, promote eruption of papules, resolve sore, and stanch bleeding

Indicated for the treatment of common cold with exterior wind-cold pattern or exterior wind-heat pattern, headache, initial measles without adequate eruption, rubella and urticaria with itching, dermatic sores and ulcers in the initial stage with an exterior pattern, blood spitting, nosebleed, blood stool, flooding, and spotting (uterine bleeding). Normally, 3–10 g is decocted with water as an oral dose. It should not be decocted for a long time or it is dry-fried for stanching bleeding

Its use is prohibited in patients with exterior deficiency accompanied by spontaneous sweating, and headache due to yin deficiency

Saposhnikovia Root (fang feng) (Radix Saposhnikoviae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Saposhnikovia divaricata (Turcz.) Schischk. of the Umbelliferae family. The root is collected before blooming in spring and autumn; after fibrous root and sediment are removed, it is dried under the sun

Acrid, sweet, slightly warm; act on the bladder, liver and spleen channels

Dispel wind and release the exterior, overcome dampness to relieve pain, and arrest convulsion

Indicated for the treatment of common cold with a pattern of wind-cold, winddamp, or wind-heat exterior, arthralgia spasm pain due to wind-damp, recurrent headache caused by exterior wind attack, urticaria, eczema with itching, tetanus (a.k.a. lockjaw), infantile convulsions, diarrhea due to spleen deficiency and excessive damp, and abdominal pain with diarrhea caused by disharmony between the liver and spleen. Normally, 5–10 g is decocted with water as an oral dose

For its property is partial to warm, it is not suitable for patients with yin-blood (blood and body fluids) depletion or exuberant heat stirring wind

(Continued )

18 PART | I Chinese Materia Medica

TABLE 1.1 Properties, Actions, and Application of Common Herbs That Dispel Wind-Cold (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Notoptetygium Root (qiang huo) (Rhizoma et Radix Notopterygii)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome and root of Notopterygium incisum Ting ex H. T. Chang or Notopterygium franchetii H. de Boiss. of the Umbelliferae family. It is collected in spring and autumn; after fibrous root is removed, it is dried under the sun

Acrid, bitter, warm; act on the bladder and kidney channels

Release the exterior and dissipate cold, dispel wind and eliminate dampness, and relieve pain

Indicated for the treatment of common cold with an exterior pattern due to externally contracted wind-cold and especially for which complicated by dampness, aversion to cold and fever, absence of sweating of the fleshy exterior, headache and stiff nape, more severe aching pain of limbs, or painful bì syndrome due to wind-cold-damp, especially pain in joints of shoulder and back. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder

Its use is cautious in patients with yin-blood (blood and body fluids) depletion. If overdose, vomiting is easy to occur, so it also not suitable for patients with spleen-stomach weakness

Angelica Root (bai zhi) (Radix Angelicae Dahuricae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Angelica dahurica (Fisch.ex Hoffm.) Benth.et Hook.f. or A. dahurica (Fisch.ex Hoffm.) Benth.et Hook. f. var. formosana (Boiss.) Shan et Yuan of the Umbelliferae family. When leaf is turning yellow during the summer and autumn, the root is collected and dried under the sun or at low temperature

Acrid, warm; act on the stomach, large intestine and lung channels

Release the exterior, dissipate cold, dispel wind and relieve pain, unblock the nasal orifices, dry dampness and arrest vaginal discharge, relieve swelling, and expel pus

Indicated for the treatment of common cold due to externally contracted windcold, with headache and body pain, nasal obstruction, nasal discharge, allergic rhinitis, thick rhinorrhea, gingiva pain with swelling, supraorbital bone pain and painful bì syndrome (cold bì) due to wind-damp, abnormal vaginal discharge, sores and ulcers with swelling pain, and skin pruritus due to winddamp. Normally, 3–10 g is decocted with water as an oral dose, and an appropriate amount is used externally

Due to its acrid and warm properties, its use is prohibited in patients with yin deficiency and blood heat

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TABLE 1.1 Properties, Actions, and Application of Common Herbs That Dispel Wind-Cold (cont.) Name of Medicinal Chinese Lovage Root (gao ben) (Rhizoma Ligustici)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome and root of Ligusticum sinense Oliv. or Ligusticum jeholense Nakai et Kitag. of the Umbelliferae family. When stem and leaf are withered or seedling emerges in autumn, it is collected and dried under the sun or by baking

Xanthium Fruit Initially recorded in Shen Nong’s Classic (cang er zi) of the Materia Medica (shen nong ben cao (Fructus Xanthii) jing). It is the dried ripe fruit with involucres of Xanthium sibiricum Patr. of the Compositae family. The fruit is collected when matured in autumn; after stalk and leaf are removed, it is dried under the sun

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Acrid, bitter, warm; act on the bladder channel

Dispel wind and dissipate cold, eliminate dampness and relieve pain

Indicated for the treatment of common cold due to externally contracted wind-cold, accompanied by parietal headache, nasal obstruction and body pain, or painful bì syndrome due to wind-damp or wind-cold, abdominal pain and diarrhea due to cold-damp, pain from hernia and conglomerations (movable lower abdominal masses of indefinite shape; jia˘ ), scabies, and tinea. Normally, 3–10 g is decocted with water as an oral dose

Its use is prohibited in patients with headache due to yin-blood (blood and body fluids) depletion, ascendant hyperactivity of liver yang, or internal exuberant fire-heat

Acrid, bitter, warm; slightly poisonous; act on the lung channel

Dissipate wind-cold, unblock the nasal orifices, and dispel winddamp

Indicated for the treatment of common cold caused by windcold, with aversion to cold, fever, headache, body pain, nasal obstruction and nasal discharge; or allergic rhinitis, loss of smell, sinusitis with a pattern of externally contracted windcold, rubella with itching, and painful bì syndrome with pain of joints and spasms due to wind-damp. Normally, 3–10 g is decocted with water, or made into pills or powder for oral use

It is not suitable for patients with headache due to blood deficiency. If overdose, poisoning is easy to occur

Caution for Use

(Continued )

20 PART | I Chinese Materia Medica

TABLE 1.1 Properties, Actions, and Application of Common Herbs That Dispel Wind-Cold (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Manchurian Wild Ginger (xi xin) (Radix et Rhizoma Asari)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome and root of Asarum heterotropoides Fr. Schmidt var. mandshuricum (Maxim.) Kitag., Asarum sieboldii Miq. var. seoulense Nakai, or A. sieboldii Miq. of the Aristolochiaceae family. It is collected when fruit is matured in summer or in the early autumn; after aerial part and sediment are removed, it is dried in the shade

Acrid, warm; act on the heart, lung, and kidney channels

Release the exterior and dissipate cold, dispel wind and relieve pain, unblock the orifices, warm the lung, and dissolve rheum (fluid retention)

Indicated for the treatment of common cold with a pattern of windcold, accompanied by headache and body pain, nasal obstruction, nasal discharge, allergic rhinitis, or thick rhinorrhea; toothache due to wind cold or dental caries, and painful bì syndrome due to wind-colddamp, panting and cough due to phlegmrheum or lung cold. Normally, 1–3 g of the crude one is decocted with water as an oral dose, or 0.5–1 g of its powder is taken infused as an oral dose each time, or an appropriate amount is used externally

Its use is prohibited in patients with headache due to yin deficiency and yang hyperactivity and dry cough due to lung dryness and yin damaged. It should not be used together with Radix et Rhizoma Veratri Nigri (li lu)

Blond Magnolia Flower (xin yi) (Flos Magnoliae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried flower bud of Magnolia biondii Pamp., Magnolia denudata Desr. or Magnolia sprengeri Pamp. of the Magnoliaceae family. Before the flower blooms in the early spring and later winter, the bud is collected and dried in the shade

Acrid, warm; act on the lung and stomach channels

Dissipate wind-cold, and unblock the nasal orifices

Indicated for the treatment of common cold due to externally contracted wind-cold, with aversion to cold and fever, sinusitis with headache, nasal obstruction, nasal discharge, allergic rhinitis, and thick rhinorrhea. It can also be used for common cold due to wind-heat through combination with medicinals that scatter and dissipate wind-heat. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder for oral use

It has floss and is easy to stimulate throat, so it should be wrapped first for decocting. Its use is prohibited in patients with vigorous fire due to yin deficiency

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TABLE 1.1 Properties, Actions, and Application of Common Herbs That Dispel Wind-Cold (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Fistular Onion Bulb (cong bai) (Bulbus Allii Fistulosi)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the squamous bulb near the root of Allium fistulosum L. of the Liliaceae family. It is collected any time. The fibrous root and leaf are removed and the involucre is shucked before use

Acrid, warm; act on the lung and stomach channels

Induce sweating to release the exterior, dissipate cold and unblock yang, resolve toxins and kill worms

Indicated for the treatment of mild common cold due to wind-cold, exuberant yin-repelling yang with abdominal cold pain, inhibited lactation due to qi constraint, and stagnation; distending pain of the breasts, sores, and carbuncles with swelling; and abdominal pain due to parasitic infestation. Normally, 3–9 g is decocted with water as an oral dose or an appropriate amount is used externally

Its cautiously used in patients with exterior deficiency accompanied by profuse sweating

Small Centipeda (e bu shi cao) (Herba Centipedae)

Initially recorded in Materia Medica for Food Habit (shi xing ben cao). It is the dried herb of Centipeda minima (L.) A. Br. et Aschers. of the Compositae family. When the flower blooms during the summer and autumn, the herb is collected; after sediment is washed away, it is dried under the sun

Acrid, warm; act on the lung channel

Dissipate wind-cold, unblock the nasal orifices, relieve cough and resolve toxins

Indicated for the treatment of common cold due to windcold, accompanied by nasal obstruction, thick rhinorrhea, and nasal discharge with headache; nasal polyps, cough and panting with excessive cold phlegm, cold wheezing, throat bì (pharyngitis) and whooping cough; also for the treatment of sores and abscesses (carbuncles) with swelling, scabies, and tinea, and snake bites. Normally, 6–9 g is decocted with water as an oral dose, or pounded to extract the juice for use or an appropriate amount is used externally

It is not suitable for patients with pregnancy, qi deficiency, blood deficiency, and heat accumulated in the lung and stomach, or exuberant fireexcess pattern

(Continued )

22 PART | I Chinese Materia Medica

TABLE 1.1 Properties, Actions, and Application of Common Herbs That Dispel Wind-Cold (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Coriander (hu sui) (Herba Coriandri Sativi)

Initially recorded in Materia Medica for Dietary Therapy (shi liao ben cao). It is the herb of Coriandrum sativum L. of the Umbelliferae family. It is collected when the fruit is matured in August; after sediment is removed, it is cut into segments and used, or dried under the sun for use

Acrid, warm; act on the lung and stomach channels

Expel pathogen from the exterior and promote eruption of papules, promote appetite and digestion

Indicated for the treatment of measles without adequate eruption caused by wind-cold fettering the exterior, with eruption but recurrence, drink and food without digestion and poor appetite due to accumulation and stagnation, or common cold due to wind-cold, with aversion to cold and fever. Normally, 6–9 g is decocted with water as an oral dose, or pounded to extract the juice for oral use or an appropriate amount is used externally

Its use is prohibited in patients with exuberant heat toxin accompanied by inhibited eruption

Chinese Tamarisk Twig (xi he liu) (Cacumen Tamaricis)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the young branch and leaf of Tamarix chinensis Lour. of the Tamaricaceae family. It is distributed across the whole China, and collected before flower blooms in May and June; then cut into segments and dried in the shade

Acrid, neutral; act on the lung, stomach, and heart channels

Expel pathogen from the exterior and promote eruption of papules, dispel wind, and eliminate dampness

Indicated for the treatment of measles in the initial stage, measles without adequate eruption, exterior pathogen fettering outside, inward invasion of measles toxin, rubella with itching, or painful bì syndrome, with pain of limbs and joints due to wind-damp. Normally, 6–10 g is decocted with water as an oral dose, or made into powder for oral use or an appropriate amount is decocted with water for fumigating and washing the afflicted part externally

It is not suitable for patients with eruptions, which have been let out, and if overdose, vexation, and vomiting are easy to occur

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2. Attached herbs (Table 1.2) TABLE 1.2 Introduction to Attached Herbs That Dispel Wind-Cold Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Perilla Stem (zi su geng) (Caulis Perillae)

It is the dried stem of P. frutescens (L.) Britt. of the Labiatae family. The stem is collected when the fruit is matured in autumn; after impurities are removed, it is dried under the sun or cut into slices while it is fresh

Acrid, sweet, slightly warm; act on the lung, spleen, and stomach channels

Rectify qi to loosen the center, relieve pain, and calm the fetus

Indicated for the treatment of stuffiness and oppression in the chest and diaphragm; pain in the stomach cavity due to qi stagnation, belching, and vomiting; and restless fetus. Normally, 5–10 g is decocted with water as an oral dose and it shouldn’t be decocted for a long time

No special contraindications

Fresh Ginger Peel (sheng jiang pi) (Cortex Zingiberis Rhizomatis)

It is the exodermis of Z. officinale Rosc. of the Zingiberaceae family. The ginger is collected in autumn and washed clean; after the outer skin is scraped by knife, it is dried under the sun

Acrid, cool; act on the spleen and lung channels

Harmonize the spleen and move water (promote urination) to relieve edema

Indicated for the treatment of edema in the initial stage and difficulty in micturition. Normally, 3–10 g is decocted with water as an oral dose

No special contraindications

Ginger Juice (sheng jiang zhi) (Succus Rhizomatis Zingiberis)

It is the fresh juice from pounding the Z. officinale Rosc. of the Zingiberaceae family. The rhizome is collected in the autumn and winter; after sediment and fibrous root is removed, it is washed clean and pounded to extract the juice

Acrid, slightly warm; act on the lung, spleen, and stomach channels

Release the exterior, dissipate cold, warm the center and arrest vomiting, dissolve phlegm and relieve cough, and resolve toxins from fish and crabs

It is partial to dissolve phlegm and arrest vomiting in clinic. Indicated for the treatment of clinical emergency, such as numbness and swelling pain of tongue due to poisoning from raw Rhizoma Arisaematis (sheng tian nan xing) and raw Rhizoma Pinelliae (sheng ban xia), or in combination with Bamboo Sap (zhu li) to treat unceasing vomiting and difficulty in eating, and sudden fainting due to wind-strike. Normally, 3–10 drops is taken infused as an oral dose

Its use is prohibited in patients with exuberant heat, yin deficiency, and internal heat

Fineleaf Schizonepeta Spike (jing jie sui) (Spica Schizonepetae)

It is the dried spica of S. tenuifolia Briq. of the Labiatae family. The spica is collected when the flowers are blooming and the spicas are green during the summer and autumn; after impurities are removed, it is dried under the sun

Acrid, slightly warm; act on the lung and liver channels

Release the exterior and dissipate wind, promote eruption of papules, and resolve sore

Indicated for the treatment of common cold, headache, measles, rubella, sores, and ulcers in the initial stage. Normally, 3–10 g is decocted with water as an oral dose

Its cautions are the same as Herba Schizonepetae (jing jie)

Charred Schizonepeta (jing jie tan) (Herba Schizonepetae Carbonisatum)

It is the processed product of S. tenuifolia Briq. of the Labiatae family. The pieces of Schizonepeta are carbonized by stir-frying until the surface is burned black and the internal part is burned yellow, showered with a little clean water, and dried in the open air after extinguishing the sparks

Acrid, astringent, slightly warm; act on the lung and liver channels

Astringe and stanch bleeding

Indicated for the treatment of bloody stool, flooding and spotting (uterine bleeding), and postpartum fainting due to hemorrhage. Normally, 5–10 g is decocted with water as an oral dose

It is not suitable for patients with blood stasis syndrome

(Continued )

24 PART | I Chinese Materia Medica

TABLE 1.2 Introduction to Attached Herbs That Dispel Wind-Cold (cont.) Name of Medicinal Xanthium (cang er cao)] (Herba Xanthii)

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

It is the stem and leaf of X. sibiricum Patr. of the Compositae family. The stem and leaf are collected in the summer, cut into segments and dried under the sun, or the fresh one is used

Bitter, acrid, slightly cold; slightly poisonous; act on the lung, spleen, and liver channels

Dispel wind and clear heat, eliminate dampness, and resolve toxins

Mainly indicated for the treatment of painful bì syndrome due to wind-damp, and hypertonicity of the limbs; also for the treatment of numbing wind (leprosy), furunculosis, and pruritus of skin. Normally, 6–15 g is decocted with water as an oral dose, or made into pills or powder, and an appropriate amount is used externally

Caution for Use It is not suitable for the weak patients due to its qi-dispersing properties and blood consumption

3. Herb differentiation (Table 1.3) TABLE 1.3 Differentiation Between Similar Efficacy Herbs That Dispel Wind-Cold Name of Medicinal

Similarities

Differences

Ephedra (ma huang) (Herba Ephedrae)

All three are acrid in flavor and warm in nature, act on the lung channel, and the commonly used medicinals that can dissipate wind-cold to release the exterior and treat common cold with a pattern of wind-cold

It has a stronger action of inducing sweating and is indicated for the treatment of severe common cold caused by wind-cold. Furthermore, it can be used for wind edema

Cassia Twig (gui zhi) (Ramulus Cinnamomi) Manchurian Wild Ginger (xi xin) (Radix et Rhizoma Asari)

Schizonepeta (jing jie) (Herba Schizonepetae)

Saposhnikovia Root (fang feng) (Radix Saposhnikoviae)

It has a gentle effect of inducing sweating to release the exterior and is indicated for the treatment of common cold caused by wind-cold, regardless of exterior excess with absence of sweating or exterior deficiency with sweating Its effect of inducing sweating is inferior to that of Herba Ephedrae (ma huang) and Ramulus Cinnamomi (gui zhi), but its effect of dissipating cold is stronger than that of them, and often used for the treatment of the syndrome of yang deficiency and external contraction due to cold invading shaoyin

Both have an acrid flavor and a slightly warm property and are good at releasing the exterior and dissipating wind. Both can treat wind-cold common cold with aversion to cold, fever, headache and absence of sweating, or wind-heat common cold with fever, slight aversion to wind and cold, headache and sore throat, or rubella with itching

It has a light property and is good at venting and dissipating, and has a stronger effect of inducing sweating than that of Radix Saposhnikoviae (fang feng). It is often selected to treat wind-cold common cold and wind-heat common cold, and can promote eruption of papules, remove sores, and stanch bleeding It has loose and moistening properties and a stronger effect of dispelling wind. It is a moistening medicinal and a commonly used one among herbs that can dispel wind. It also can overcome dampness, relieve pain, and arrest convulsion and treat the externally contracted wind-damp with headache as if swathed, heavy body, and painful limbs

SECTION 2 HERBS THAT DISPEL WIND-HEAT Outline The properties and flavors of the herbs that dispel wind-heat are most pungent-bitter and partial to cold-cool, with the pungent flavor having the dispersing effect, and cool nature having the clearing heat effect. Thus herbs in this section have the main effect of dispelling wind-heat pathogen, and the effect of inducing sweating to release the exterior is more moderate than that of herbs that dispel wind-cold. The herbs that dispel wind-heat are mainly applied to treat common cold with syn-

Herbs That Release the Exterior Chapter | 1

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drome of wind-heat and onset of warm disease with pathogen in wei aspect, which manifests the symptoms of fever, mild aversion to wind-cold, dry pharynx and thirst, headache and red eyes, red tip and margin of tongue, thin and red coating, and floating and rapid pulse. Some herbs have the combined effects of mental refreshing, relieving sore throat, promoting eruptions, relieving itching, and relieving cough, respectively. Moreover, these herbs can be applied to treat red eyes and excessive tearing, swelling of throat, measles without adequate eruption, rubella and pruritus, and cough caused by windheat pathogens.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 1.4) TABLE 1.4 Properties, Actions, and Application of Common Herbs That Dispel Wind-Heat Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Field Mint (bo he) (Herba Menthae)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried aerial part of Mentha haplocalyx Briq. of the Labiatae family. When the plant is flourishing, it is collected on sunny days during summer and autumn, and dried under the sun or in the shade

Acrid, cool; act on the lung and liver channels

Scatter wind and clear heat, clear the head heat and relieve sore throat, promote eruption of papules, soothe the liver, and move qi

Indicated for the treatment of common cold due to windheat, wind-warmth in the initial stage, headache with red eyes and throat bì (pharyngitis) due to wind-heat, oral ulcer, rubella, measles, distention, and oppression in the chest and ribside due to liver constraint and qi stagnation. Normally, 3–6 g is decocted with water as an oral dose, and it should be added later

It is not suitable for patients with deficiency of body and profuse sweating because its dispersing property may cause sweating and consume qi

Great Burdock Achene (niu bang zi) (Fructus Arctii)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried matured fruit of Arctium lappa L. of the Compositae family. When fruit is matured in autumn, it is collected and dried under the sun

Acrid, bitter, cold; act on the lung and stomach channels

Scatter and dissipate wind and heat, diffuse the lung and dispel phlegm, relieve sore throat, promote eruption of papules, and resolve toxins

Indicated for the treatment of common cold due to windheat, warm disease in the initial stage, cough with profuse phlegm, measles without adequate eruption, rubella with itching, sore pain of throat, parotic swelling, erysipelas, carbuncles, and sores. Normally, 6–12 g is decocted with water as an oral dose

Due to its laxative property, it is cautiously used in patients with qi deficiency accompanied by thin and unformed stool

(Continued )

26 PART | I Chinese Materia Medica

TABLE 1.4 Properties, Actions, and Application of Common Herbs That Dispel Wind-Heat (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Cicada Molting (chan tui) (Periostracum Cicadae)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the molting of Cryptotympana pustulata Fabricius of the Cicadidae family. It is collected during summer and autumn and dried under the sun

Sweet, cold; act on the lung and liver channels

Scatter and dissipate wind and heat, relieve sore throat and ease up the voice, promote eruption of papules, remove nebula to improve vision, and arrest convulsion

Indicated for the treatment of common cold due to windheat, warm disease in the initial stage, sore throat with hoarse voice, measles without adequate eruption, rubella with itching, red eye with nebula, acute or chronic infantile convulsion and tetanus; or nocturnal fretfulness in infants. Normally, 3–6 g is decocted with water as an oral dose, or taken infused after grinding into powder

It is cautiously used in pregnant women

Mulberry Leaf (sang ye) (Folium Mori)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried leaf of Morus alba L. of the Moraceae family. It is collected after the first frost, refined, and dried under the sun

Sweet, bitter, cold; act on the lung and liver channels

Scatter and dissipate wind and heat, clear lung-heat and moisten dryness, calm and subdue liver yang, clear liver heat, and improve vision

Indicated for the treatment of common cold due to wind-heat, warm disease in the initial stage, cough due to lung-heat or caused by drynessheat, dizziness and headache due to ascendant hyperactivity of liver yang, red eyes and dizzy vision. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder for oral use or an appropriate amount is decocted with water for washing the eyes

It is not suitable for patients with common cold due to wind-cold, bland taste in the mouth, and cough with thin and white phlegm

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TABLE 1.4 Properties, Actions, and Application of Common Herbs That Dispel Wind-Heat (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chrysanthemum Flower (ju hua) (Flos Chrysanthemi)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried flowering head of Chrysanthemum morifolium Ramat. of the Compositae family. It is collected in full bloom in autumn, dried in the shade or in an oven, or steamed first then dried under the sun

Acrid, sweet, bitter, slightly cold; act on the lung and liver channels

Scatter and dissipate wind and heat, calm and subdue liver yang, clear liverheat and improve vision, clear heat and resolve toxins

Indicated for the treatment of common cold due to wind-heat, windwarmth in the initial stage, headache and dizziness due to ascendant hyperactivity of liver yang, excess pattern of liver-wind, red eye with sore pain and dizzy vision, swollen sores and carbuncles due to heat toxin. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder for oral use, or made as tea for drinking, or an appropriate amount is decocted with water for washing or pounded for applying the affected area

It is cautiously used in patients with qi deficiency, stomach cold, eating lessening, and diarrhea

Shrub Chastetree Fruit (man jing zi) (Fructus Viticis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured fruit of Vitex trifolia L. var. simplicifolia Cham. or V. trifolia L. of the Verbenaceae family. When the fruit is matured, it is collected in autumn and dried under the sun

Acrid, bitter, slightly cold; act on the bladder, liver, and stomach channels

Scatter and dissipate wind and heat, clear the head and eyes, dispel wind, and relieve pain

Indicated for the treatment of common cold due to windheat, with dizziness and headache, or hemilateral headache (migraine), sore pain of gums (gingivitis), red eye with swelling and pain, excessive tearing and blurred vision due to windheat attacking the eyes, tinnitus and deafness, or painful bì syndrome due to wind-damp. Normally, 5–10 g is decocted with water as an oral dose, or soaked in wine, or made into pills or powder, and an appropriate amount is used externally

Its use is cautious in patients with stomach deficiency

(Continued )

28 PART | I Chinese Materia Medica

TABLE 1.4 Properties, Actions, and Application of Common Herbs That Dispel Wind-Heat (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Bupleurum (chai hu) (Radix Bupleuri)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Bupleurum chinense DC. or Bupleurum scorzonerifolium Willd. of the Umbelliferae family. It is collected in spring and autumn; after stems, leaves, and mud are removed, it is dried under the sun

Acrid, bitter, slightly cold; act on the liver, gallbladder and lung channels

Release the exterior and abate heat, soothe the liver, resolve constraint, and raise yang

Indicated for the treatment of externally contracted exterior pattern with fever, shaoyang syndrome with alternating chills and fever, distending pain in the chest and ribside, menstrual irregularities due to liver constraint and qi stagnation, prolapse of the uterus or the rectum due to center qi (zhong qi) deficiency, and malaria with chills and fever. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder for oral use

It is not suitable for patients with yin deficiency and yang hyperactivity, internal stirring of liver wind, vigorous fire due to yin deficiency, and ascending counterflow of qi

Black Cohosh Rhizome (sheng ma) (Rhizoma Cimicifugae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Cimicifuga heracleifolia Kom., Cimicifuga dahurica (Turcz.) Maxim., or Cimicifuga foetida L. of the Ranunculaceae family. It is collected in autumn; after sediment is removed and the fibrous root is burned off, it is dried under the sun

Acrid, slightly sweet, slightly cold; act on the lung, spleen, stomach, and large intestine channels

Release the exterior, promote eruption of papules, clear heat and resolve toxins, and raise yang qi

Indicated for the treatment of externally contracted exterior pattern, common cold with headache, toothache, oral ulcer or swelling and pain of the throat due to wind-heat, measles without adequate eruption, macule caused by warm toxin, prolapse or downward displacement of the viscera (rectal or uterine prolapse), and flooding and spotting (uterine bleeding) due to qi deficiency. Normally, 3–10 g is decocted with water as an oral dose

It is not suitable for patients with measles with adequate eruption, vigorous fire due to yin deficiencyand yang hyperactivity

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TABLE 1.4 Properties, Actions, and Application of Common Herbs That Dispel Wind-Heat (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Kudzuvine Root (ge gen) (Radix Puerariae Lobatae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Pueraria lobata (Willd.) Ohwi or Pueraria thomsonii Benth. of the Leguminosae family. It is collected in autumn and winter, then cut into thick slices or small cubes while fresh, and dried under the sun

Sweet, acrid, cool; act on the spleen, stomach, and lung channels

Release the flesh and expel heat, promote eruption of papules, promote fluid production to quench thirst, raise yang and arrest diarrhea, unblock the collaterals, and relieve alcoholism

Indicated for the treatment of externally contracted exterior pattern with fever, headache, painful stiff nape and back, febrile disease with thirst, wasting thirst (xia¯o kĕ) due to yin deficiency, measles without adequate eruption, damp-heat diarrhea and dysentery, diarrhea due to spleen deficiency, dizziness, wind-strike with hemiplegia (halfbody paralysis), chest bì with heart pain (pectoral stuffiness pain), and alcoholism damaging the center. Normally, 10–15 g is decocted with water as an oral dose

It is cautiously used in patients with stomach cold, or profuse sweating in summer due to exterior deficiency

Duckweed (fu ping) (Herba Spirodelae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried entire plant of Spirodela polyrrhiza (L.) Schleid. of the Lemnaceae family. It is collected during June to September, then washed clean, and dried under the sun

Acrid, cold; act on the lung channel

Diffuse and scatter wind and heat, promote eruption of papules, relieve itching, promote urination, and relieve edema

Indicated for the treatment of common cold due to windheat, with fever and absence of sweating, measles without adequate eruption, rubella with itching, edema and scanty urine complicated by wind-heat exterior pattern, dribbling urinary block, sores, tinea, and scald. Normally, 3–9 g is decocted with water as an oral dose, or made into pills or powder for oral use, or an appropriate amount is decocted for fumigating and washing the affected area externally

It is not suitable for patients with exterior deficiency accompanied by profuse sweating

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30 PART | I Chinese Materia Medica

TABLE 1.4 Properties, Actions, and Application of Common Herbs That Dispel Wind-Heat (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Common Scouring Rush (mu zei) (Herba Equiseti Hiemalis)

Initially recorded in Materia Medica of the Jiayou Era (jia you ben cao). It is the dried aerial part of Equisetum hyemale L. of the Equisetaceae family. It is collected in summer and autumn, after impurities are removed, and dried under the sun or in the shade

Sweet, bitter, neutral; act on the lung and liver channels

Scatter and dissipate wind and heat, remove nebula to improve vision, and stanch bleeding

Indicated for the treatment of red eyes, epiphora induced by wind, and eyes with cloudy nebula caused by wind-heat invading upward, bleeding syndrome, such as intestinal wind (i.e., bloody stool), red dysentery, and bleeding from piles; or for the treatment of woman menstruating without ceasing in combination with other bleedingstanching herbs. Normally, 3–9 g is decocted with water as an oral dose, or made into pills or powder, or an appropriate amount is ground into powder for sprinkling externally

It is used cautiously in patients with qi and blood deficiency

Prepared Soybean (dan dou chi) (Semen Sojae Praeparatum)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the product of the fermented mature seed of Glycine max (L.) Merr. of the Leguminosae family

Bitter, acrid, cool; act on the lung and stomach channels

Release the exterior, relieve vexation, diffuse, and disperse the accumulated heat

Indicated for the treatment of externally contracted exterior pattern caused by windcold or wind-heat, common cold with fever and (or) aversion to cold, headache, externally contracted febrile disease with vexation and agitation, and oppression in the chest, deficient restlessness and insomnia. Normally, 6–12 g is decocted with water as an oral dose, ground into powder or made into pills for oral use,or an appropriate amount is used externally

It is cautiously used in patients with stomach deficiency and is easy to regurgitate

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TABLE 1.4 Properties, Actions, and Application of Common Herbs That Dispel Wind-Heat (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Pipewort Flower (gu jing cao) (Flos Eriocauli)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the dried flowering head with scape of Eriocaulon buergerianum Koern. of the Eriocaulaceae family. It is collected in autumn, the flowering head is pulled out, together with scape, and dried under the sun

Acrid, sweet, neutral; act on the liver and lung channels

Scatter and dissipate wind and heat, and remove nebula to improve vision

Indicated for the treatment of red eye with swelling and pain, photophobia, and nebula caused by wind-heat invading upward, sparrow blindness (night blindness), headache and toothache due to wind-heat, or pharyngitis and nosebleed. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder, and an appropriate amount is charred with its property retained and ground into powder for sprinkling

It is used cautiously in patients with disease of the eye due to blood deficiency

Hedge Prinsepia Nut (rui ren) (Nux Prinsepiae)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the dried matured kernel of Prinsepia uniflora Batal. or P. uniflora Batal. var. serrata Rehd. of the Rosaceae family. The matured fruit is collected during the summer and autumn; after the sarcocarp is removed, it is washed, cleaned, and dried under the sun

Sweet, slightly cold; act on the liver channel

Scatter wind and clear heat, nourish the liver to improve vision, and calm the mind

Indicated for the treatment of red eye with swelling and pain, red ulceration of palpebral margin (marginal blepharitis), blurred vision, and photophobia caused by wind-heat invading upward; or restless sleep. Normally, 5–9 g is decocted with water as an oral dose, or an appropriate amount is deoiled and ground into paste to drop the eye externally or decocted with water for washing. The dryfried one is used for calming the mind

It is not suitable for patients with eye pain that is not caused by wind-heat but by deficiency of both liver and kidney

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32 PART | I Chinese Materia Medica

2. Attached herbs (Table 1.5)

TABLE 1.5 Introduction to Attached Herbs That Dispel Wind-Heat Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Young Soybean Sprout (da dou huang juan) (Semen Sojae Germinatum)

It is the processed product of the matured seed of G. max (L.) Merr. of the Leguminosae family after it is sprouted and dried. It is soaked in water until expansion; after water is removed, it is covered with wet cloth, and showered twice a day until bud grows to 0.5–1 cm, then taken out and dried

Sweet, neutral; act on the spleen, stomach, and lung channels

Release the exterior and dispel summer heat, clear heat, and drain dampness

Indicated for the treatment of common cold due to summer heat-damp, damp-warmth in the initial stage, fever and little sweating, aversion to cold, heavy body, chest oppression and stomach cavity pĭ, aching and heavy sensation of the limbs, difficulty in micturition, and greasy tongue coating caused by damp-heat accumulated in interior. Normally, 9–15 g is decocted with water as an oral dose, or pounded to extract the juice or made into powder for oral use

It is not suited to apply together with Sargassum (hai zao) and Radix et Rhizoma Gentianae (long dan).

Flower of Kudzuvine (ge hua) (Flos Puerariae Lobatae)

It is the flower bud of P. lobata (Wild.) Ohwi or P. thomsonii Benth. of the Leguminosae family. It is collected before flower doesn’t bloom completely after autumn begins, and dried under the sun

Sweet, neutral; act on the spleen and stomach channels

Relieve alcoholism, awaken the spleen, harmonize the stomach, and stanch bleeding

Indicated for the treatment of insobriety with headache and dizziness, excessive thirst, vomiting, fullness and distention in the chest and diaphragm; also for the treatment of spitting of blood and discharging fresh blood stool. Normally, 3–15 g is decocted with water as an oral dose

It is not suitable for patients without alcoholism or the weak caused by alcohol drinking

3. Herb differentiation (Table 1.6)

TABLE 1.6 Differentiation Between Similar Efficacy Herbs That Dispel Wind-Heat Name of Medicinal Field Mint (bo he) (Herba Menthae)

Great Burdock Achene (niu bang zi) (Fructus Arctii)

Cicada Molting (chan tui) (Periostracum Cicadae)

Similarities

Differences

All three are cold and cool in nature, can scatter and dissipate wind and heat, promote eruption of papules, relieve sore throat, and are indicated for the treatment of the externally contracted wind-heat or warm disease in the initial stage with fever, slight aversion to cold, headache, thirst, red tip of the tongue with thin and yellow coating, floating and rapid pulse, initial measles without adequate eruption, rubella with itching, and swelling and pain of the throat caused by wind-heat invading upward

It has acrid, cool, and fragrant properties; is good at clearing and dissipating. It has a stronger effect of inducing sweating, so it is the most indicated for the treatment of the externally contracted wind-heat with fever and absence of sweating. It also can clear the head and eyes, soothe the liver, and move qi It has acridity to dissipate and bitterness to discharge, has cold and laxative properties, and is concurrently in charge of diffusing the lung and dispelling phlegm, so it is quite suitable for the treatment of the externally contracted wind-heat with fever, cough with inhibited expectoration. It also can dissipate the wind-heat outside and resolve heat toxin inside, and has effects of clearing heat, resolving toxins, and relieving swelling It has sweet, cold and moistening properties, can both scatter and dissipate wind and heat in the lung channel to relieve sore throat, promote eruption of papules, and relieve itching, and is good at scattering and dissipating wind and heat in the liver channel to remove nebula to improve vision, cool the liver, and extinguish wind to arrest convulsion

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TABLE 1.6 Differentiation Between Similar Efficacy Herbs That Dispel Wind-Heat (cont.) Name of Medicinal Bupleurum (chai hu) (Radix Bupleuri)

Black Cohosh Rhizome (sheng ma) (Rhizoma Cimicifugae) Kudzuvine Root (ge gen) (Radix Puerariae Lobatae)

Chrysanthemum Flower (ju hua) (Flos Chrysanthemi) Mulberry Leaf (sang ye) (Folium Mori)

Similarities

Differences

All three are acrid in flavor and cool in nature, can release the exterior and raise yang, and are indicated for the treatment of wind-heat common cold with fever and headache, and syndrome due to clear yang failing to ascend. All three can also be used for the treatment of wind-cold exterior pattern through combination with other herbs. Among them, Radix Bupleuri (chai hu) and Rhizoma Cimicifugae (sheng ma) both can raise yang and lift the sunken and treat sinking of qi and viscera prolapse. Rhizoma Cimicifugae (sheng ma) and Radix Puerariae Lobatae (ge gen) both can promote eruption of papules and treat initial measles without adequate eruption

It mainly raises the liver and gallbladder qi, is good at scattering and dissipating the pathogen in half-exterior half-interior, abating fever, soothing the liver, and resolving constraint. It is an essential medicinal for the treatment of shaoyang syndrome. It also can be commonly used for the treatment of cold damage syndrome with alternating chills and fever, fullness and discomfort in the chest and ribside, bitter taste in the mouth and dry throat, dizziness, common cold with fever, pattern of liver constraint, qi stagnation, with distending pain in the chest and hypochondrium, menstrual irregularities, and painful menstruation

Both can scatter and dissipate wind and heat, calm and subdue liver yang, clear liver heat and improve vision, treat fever, slight aversion to wind and cold, headache in the wind-heat common cold or warm disease in the initial stage, headache and dizziness caused by ascendant hyperactivity of liver yang, red eye with swelling and pain, and blurred vision due to insufficiency of liver-kidney essence and blood

It has strong effects of calming the liver, clearing liver heat, and improving vision, and also can clear heat and resolve toxins. It can be used for the treatment of sores and carbuncles with swelling due to toxin

It can mainly raise the clear yang of spleen and stomach, its effects of raising yang and lifting the sunken are stronger than that of Radix Bupleuri (chai hu). It is good at clearing heat and resolving toxins and commonly used for the treatment of various heat toxin diseases and syndromes It can mainly raise the clear yang of spleen and stomach to promote fluid production to quench thirst and arrest diarrhea, and is commonly used for the treatment of febrile disease with excessive thirst, yin deficiency wasting thirst (xia¯ o kĕ), heat dysentery and diarrhea, or diarrhea due to spleen deficiency. Meanwhile, it can release the flesh and expel heat, and can treat the externally contracted exterior pattern with fever and aversion to cold, headache and absence of sweating, painful stiff nape, and back caused by whether wind-cold or wind-heat

It has strong effects of scattering and dissipating wind and heat, and is also good at clearing lung heat and moistening dryness, and can cool the blood and stanch bleeding. It can be used for the treatment of lung heat or dryness-heat damaging the lung with cough, scanty yellow, and viscous phlegm, or dry cough with little phlegm, itching of the throat, expectoration of blood, blood spitting, and nontraumatic hemorrhage caused by blood-heat

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Chapter 2

Herbs That Clear Heat Chapter Outline Section 1 Herbs That Clear Heat and Drain Fire Outline Specific Application Knowledge of Herbs Section 2 Herbs That Clear Heat and Dry Dampness Outline Specific Application Knowledge of Herbs Section 3 Herbs That Clear Heat and Resolve Toxins

36 36 36 45 45 45 52

Outline Specific Application Knowledge of Herbs Section 4 Herbs That Clear Heat and Cool the Blood Outline Specific Application Knowledge of Herbs Section 5 Herbs That Clear Heat From Deficiency Outline Specific Application Knowledge of Herbs

52 52 80 80 80 85 85 85

ABSTRACT Chinese herbal medicinals that can mainly clear interior heat and treat interior heat patterns are called “herbs that clear heat.” Herbs that clear heat are mainly used in the treatment of warm febrile disease with interior heat pattern including high fever, excessive thirst, dampheat diarrhea and dysentery, macule caused by warm toxin, carbuncles with swelling and sore toxin, and fever due to yin deficiency. Herbs that clear heat are commonly divided into five categories: herbs that clear heat and drain fire, herbs that clear heat and dry dampness, herbs that clear heat and cool the blood, herbs that clear heat and resolve toxins, and herbs that clear deficiency-heat. Keywords: herbs that clear heat; herbs that clear heat and drain fire; herbs that clear heat and dry dampness; herbs that clear heat and resolve toxins; herbs that clear heat and cool the blood; herbs that clear heat from deficiency

Chinese herbal medicinals that can mainly clear interior heat and treat interior heat patterns are called “Herbs That Clear Heat.” Medicinals in this chapter have the properties of cold or cool, descending, and sinking inward. The interior heat is cleared through the different effects of clearing heat and draining fire, cooling the blood, resolving toxins, and clearing deficiency-heat. The meaning is exactly what is called “When there is heat, treat it with cold” in The Yellow Emperor’s Inner Classic (huang di nei jing) and “treat the heat pattern with the cold medicinal” in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). Herbs that clear heat are mainly used in the treatment of warm febrile disease with interior heat pattern including high fever, excessive thirst, damp-heat diarrhea and dysentery, macule caused by warm toxin, carbuncles with swelling and sore toxin, and fever due to yin deficiency. Due to different causes of disease, pathogenic condition, and body constitution, interior heat pattern can be divided into interior heat in qi aspect or interior heat in blood aspect, excess heat pattern or deficiency heat pattern. According to the difference of efficacy and indications, herbs that clear heat are commonly divided into five categories: (1) herbs that clear heat and drain fire, which can mainly treat excess heat in qi aspect by the action of clearing heat from qi aspect; (2) herbs that clear heat and dry dampness, which have more properties of bitterness to dry and clearing, can mainly treat dampheat diarrhea and dysentery, and jaundice by the actions of clearing heat and drying dampness; (3) herbs that clear heat and cool the blood, which mainly act on the blood aspect, can mainly treat excess heat in blood aspect by the action of clearing heat in blood aspect; (4) herbs that clear heat and resolve toxins, which mainly treat intense heat toxin, carbuncles with swelling and sores by the actions of clearing heat and resolving toxins; and (5) herbs that clear deficiency-heat, which mainly treat pathogenic heat damaging yin and fever due to yin deficiency by the actions of clearing deficiency-heat and abating steaming bone fever. When using these herbs that clear heat, the deficiency or excess of heat pattern should be distinguished. Excess heat pattern has the different patterns of heat in qi aspect, heat in nutrient and blood aspects, and dual blaze of both qi and blood, which should be respectively treated through clearing heat and draining fire, clearing heat in nutrient aspect and cooling the blood, and clearing heat in both qi and blood aspects. Deficiency heat pattern has the different patterns of pathogenic heat damaging yin, Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00002-6 Copyright © 2017 Elsevier Inc. All rights reserved.

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36 PART | I Chinese Materia Medica

fever due to yin deficiency, internal heat due to liver-kidney yin deficiency and yin deficiency which should be treated through clearing heat and nourishing yin to vent heat or enriching yin and cooling the blood to eliminate steaming bone fever. If interior heat pattern is combined with exterior pattern, they should be to release the exterior first then clear the interior heat, or combine herbs that release the exterior so as to release both the exterior and interior. If interior heat pattern is combined with accumulation and stagnation syndrome, herbs that clear heat should combine with herbs that unblock the interior or drastically purge. Most medicinals in this chapter have the properties of cold and cool, and are easy to damage spleen and stomach, so the patients with qi deficiency of spleen and stomach, less eating, thin and unformed stool should be cautious to use. Some medicinals have the properties of bitterness and cold, and are easy to transform dryness to damage yin, so the patients with heat pattern, yin damaged, or yin deficiency should be cautious to use. Herbs that clear heat are prohibited to treat conditions of exuberant yin repelling yang or true cold with false heat. The modern pharmacological research indicates the herbs that clear heat often have the antipathogeny microorganism, antitoxinum, and antipyretic effects. Some medicinals have the actions of strengthening the specificity function or nonspecificity function, antiinflammation, antitumor, antiallergic reaction, sedation, decreasing blood pressure, hepatoprotection, and cholaneresis.

SECTION 1  HERBS THAT CLEAR HEAT AND DRAIN FIRE Outline Heat is the gradual of fire, fire is the extreme of heat. Most medicinals in this section are bitter in flavor and cold in nature, or sweet in flavor and cold in nature, and have a stronger effect of clearing heat so as to treat more exuberant fire-heat pattern, so are called the “herbs that clear heat and drain fire.” They mainly clear pathogenic heat in qi aspect, and are indicated for the treatment of febrile disease with pathogen invading the qi aspect showing high fever, thirst, sweating, vexation, agitation, even coma and delirium, red tongue with yellow coating, surging, rapid and excess pulse. In addition, due to the difference of channel entry, herbs that clear heat and drain fire are indicated for the treatment of zang-fu fire-heat syndrome caused by lung heat, stomach heat, heart fire, and liver fire, respectively. When using this section’s medicinals, if intense interior heat combines with healthy qi deficiency, it should combine the herbs that supplement deficiency to reinforce healthy qi to dispel pathogen.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 2.1) TABLE 2.1 Properties, Actions, and Application of Common Herbs That Clear Heat and Drain Fire Name of Medicinal Gypsum (shi gao) (Gypsum Fibrosum)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the gypsum of the Anhydrite family of the sulfates minerals. It mainly contains aqueous calcium sulfate (CaSO4·2H2O). It is collected in whole year; after mixed stone and silt are removed, it is ground into powder or calcined for use

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Sweet, acrid, extremely cold; act on the lung and stomach channels

Clear heat and drain fire, relieve vexation and quench thirst

Indicated for the treatment of warm febrile disease with excess heat in the qi lever, with high fever, excessive thirst, dyspnea and cough due to lung heat, headache and toothache due to exuberance of stomach fire. Normally, 15–60 g of the raw one is decocted with water as an oral dose, and should be decocted first; or an appropriate amount of the calcined one is ground into powder for sprinkling or applying on the afflicted part

Caution for Use Its use is prohibited in patients with deficiency-cold of the spleen and stomach, and yin deficiency with internal heat

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TABLE 2.1 Properties, Actions, and Application of Common Herbs That Clear Heat and Drain Fire (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Calcitum (han shui shi) (Glauberitum)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the natural crystal of Nalrii Sulfas of the mirabilite family of the sulfates minerals. It is collected in whole year; after mixed stone and silt are removed, it is ground into pieces or calcined for use

Acrid, salty, cold; act on the heart, stomach, and kidney channels

Clear heat and drain fire

Indicated for the treatment of externally-contracted febrile disease (in qi aspect), with high fever, excessive thirst, mania; oral ulcer, swollen sores due to heat toxin, infantile erysipelas, and burn due to hot liquid or fire. Normally, 10–15 g is decocted with water as an oral dose, and an appropriate amount is used externally. It is used in raw or calcined to crisp for use

Its use is prohibited in patients with deficiency-cold of the spleen and stomach

Common Anemarrhena Rhizome (zhi mu) (Rhizoma Anemarrhenae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dry rhizome and root of Anemarrhena asphodeloides Bge. of the Liliaceae family. It is collected in summer and autumn; after fibrous root and sediment or the exodermis is removed, it is dried under the sun

Bitter, sweet, cold; act on the lung, stomach, and kidney channels

Clear heat and drain fire, enrich yin and moisten dryness

Indicated for the treatment of externallycontracted febrile disease with high fever and excessive thirst; dry cough or chronic cough with breathlessness caused by lung heat; steaming bone fever, tidal fever, night sweating, and vexation due to yin deficiency resulting in vigorous fire; wasting-thirst (xia¯o kĕ) due to yin deficiency with internal heat, and constipation due to yin deficiency and intestinal dryness. Normally, 6–12 g is decocted with water as an oral dose

Since it is cold, moistening, and laxative, it is not suitable for patients with thin, unformed stool due to spleen deficiency

(Continued )

38 PART | I Chinese Materia Medica

TABLE 2.1 Properties, Actions, and Application of Common Herbs That Clear Heat and Drain Fire (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Reed Rhizome (lu gen) (Rhizoma Phragmitis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the fresh or dried rhizome and root of Phragmites communis Trin. of the Poaceae family. It is collected in whole year; after bud, fibrous root, and membranaceous leaf are removed; it is dried under the sun

Sweet, cold; act on the lung and stomach channels

Clear heat and drain fire, promote fluid production to quench thirst, relieve vexation, arrest vomiting, and promote urination

Indicated for the treatment of warm febrile disease with liquid (thin fluid) damaged, accompanied by excessive thirst and vexation; cough due to lung heat, and lung abscess with expectoration of pus; vomiting or nonproductive vomiting due to stomach heat, difficult and painful heat strangury with scanty and reddish urine. Normally, 15–30 g is decocted with water as an oral dose; the dose of the fresh one should be doubled and it can be pounded to extract the juice for use

It is not suitable for patients with deficiency-cold of the spleen and stomach

Snakegourd Root (tian hua fen) (Radix Trichosanthis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Trichosanthes kirilowii Maxim. or Trichosanthes rosthornii HarIlls of the Cucurbitaceae family. It is collected in autumn and winter, and then washed clean; after the exodermis is removed; it is cut into segments or cut open into sections and dried

Sweet, slightly bitter, slightly cold; act on the lung and stomach channels

Clear heat and drain fire, promote fluid production to quench thirst, relieve swelling and expel pus

Indicated for the treatment of febrile disease with excessive thirst; dry cough with little phlegm and bloody sputum due to dryness-heat damaging the lung; wasting-thirst (xia¯o kĕ) due to internal heat and fluid consumption; sores and ulcers in the initial stage, with swelling and (or) pus due to intense heat toxin, swelling and pain of the throat due to wind-heat invading upward. Normally, 10–15 g is decocted with water as an oral dose

Its use is cautious in pregnant women, and it is not suited to combine with Radix Aconiti (chuan wu), Radix Aconiti Kusnezoffii (cao wu), and Radix Aconiti Lateralis Praeparata (fu zi) to use

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TABLE 2.1 Properties, Actions, and Application of Common Herbs That Clear Heat and Drain Fire (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Lophatherum Stem and Leaves (zhu ye) (Folium Phyllostachydis Henonis)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the leaf of Phyllostachys nigra (Lodd.) Munro var. Henonis (Mitf.) Stap ex Rendle of the Poaceae family. It is collected anytime

Sweet, acrid, bland, cold; act on the heart, stomach, and small intestine channels

Clear heat and drain fire, relieve vexation, promote fluid production, and promote urination

Indicated for the treatment of febrile disease with thin fluid consumption, with excessive thirst; or vexing heat and thirst due to externallycontracted wind-heat; sore in the mouth and tongue due to heart fire flaming upward, scanty and reddish urine, difficult and painful urination due to heart heat descending into small intestine, warm disease with loss of consciousness. and delirious speech due to heat invading the pericardium. Normally, 6–15 g is decocted with water as an oral dose; the fresh one should be used at the dose of 15–30 g

Its use is prohibited in patients with vigorous fire due to yin deficiency accompanied by steaming bone fever and tidal fever

Salvia Root (dan zhu ye) (Herba Lophatheri)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried srem and leaf of Lophatherum gracile Brongn. of the Poaceae family. Before blooming in summer, it is collected and dried under the sun

Sweet, bland, cold; act on the heart, stomach, and small intestine channels

Clear heat and drain fire, relieve vexation and quench thirst, promote urination, and relieve strangury

Indicated for the treatment of febrile disease damaging thin fluid, with vexing heat and thirst, sore in the tongue and mouth due to exuberant excess fire of the heart and/or stomach, heat strangury with scanty and reddish urine, difficulty in micturition with pain due to heart-stomach heat descending into small intestine, or dampness-heat turbid urine. Normally, 6–10 g is decocted with water as an oral dose

It is not suitable for patients with deficiency-cold of the spleen and stomach since it is cold in nature

(Continued )

40 PART | I Chinese Materia Medica

TABLE 2.1 Properties, Actions, and Application of Common Herbs That Clear Heat and Drain Fire (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Common Dayflower (ya zhi cao) (Herba Commelinae)

Initially recorded in Supplement to ‘The Materia Medica’ (ben cao shi yi). It is the dried aerial part of Commelina communis L. of the Commelinaceae family. It is collected in summer and autumn and dried under the sun

Sweet, bland, cold; act on the lung, stomach, and small intestine channels

Clear heat and drain fire, resolve toxins, promote urination, and relieve swelling

Indicated for the treatment of initial common cold due to wind-heat, or externally-contracted febrile disease with high fever and excessive thirst due to heat entering the qi aspect; swelling and pain of the throat, swollen carbuncles, sores and deeprooted boils due to heat toxin, edema with oliguresis, and heat strangury with difficult and painful urination due to damp-heat. Normally, 15–30 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in patients with deficiency or weakness of the spleen and stomach. And if use, the dosage should be decreased

Cape Jasmine Fruit (zhi zi) (Fructus Gardeniae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured fruit of Gardenia jasminoides Ellis of the Rubiaceae family. It is collected during September to November when fruit is matured and turns titian; after carpopodium and impurities are removed, it is parboiled or blanched in the aqua bulliens, taken out and dried

Bitter, cold; act on the heart, lung, and sanjiao channels

Drain fire and relieve vexation, clear heat and drain dampness, cool the blood and resolve toxins; external use: relieve swelling and pain

Indicated for the treatment of febrile disease with vexation or inquietude, or high fever, loss of consciousness, and delirious speech due to intense heat in the sanjiao; jaundice due to damp-heat, blood strangury with difficult and painful urination, blood-spitting and nontraumatic hemorrhage due to blood heat, red eye with swelling and pain, sores and ulcers due to fire toxin. External treatment: traumatic injury. Normally, 6–10 g is decocted with water as an oral dose, and an appropriate amount of the raw one is ground into powder for applying externally

It is not suitable for patients with thin, unformed stool due to deficiency of spleen and stomach since it is bitter in flavor and cold in nature and easy to damage the stomach

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TABLE 2.1 Properties, Actions, and Application of Common Herbs That Clear Heat and Drain Fire (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Common SelfHeal Fruit-Spike (xia ku cao) (Spica Prunellae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried spike of Prunella vulgaris L. of the Labiatae family. It is collected in summer when the spike turns brownish red color; after impurities are removed, it is dried under the sun

Acrid, bitter, cold; act on the liver, and gallbladder channels

Clear liver heat and drain fire, improve vision, dissipate masses, and relieve swelling

Indicated for the treatment of red eye with swelling and pain, headache, and dizziness due to liver fire flaming upward, pain in the eyeball at night due to liver yin deficiency, scrofula, goiter, mammary abscess, breast lump (hyperplasia of the mammary gland), and distending pain of the breasts. Normally, 9–15 g is decocted with water as an oral dose, or decocted to paste for oral use

Its use is cautious in patients with deficiency or weakness of the spleen and stomach

Cassia Seed (jue ming zi) (Semen Cassiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured seed of Cassia obtusifolia L. or Cassia tora L. of the Leguminosae family. The matured fruit is collected in autumn and dried under the sun, then seed is separated by beat, and impurities are removed

Sweet, bitter, salty, slightly cold; act on the liver and large intestine channels

Clear liver heat and improve vision, and moisten the intestines to promote defecation

Indicated for the treatment of red eye with swelling and pain, intolerance of light (photophobia) with excessive tearing due to liver heat, blurred vision due to due to yin deficiency of liver and kidney, headache and dizziness due to ascendant hyperactivity of liver yang, and constipation due to internal heat and intestinal dryness. Normally, 9–15 g is decocted with water as an oral dose. It shouldn’t be decocted for a long time if use for constipation

It is not suitable for patients with thin, unformed stool due to qi deficiency

(Continued )

42 PART | I Chinese Materia Medica

TABLE 2.1 Properties, Actions, and Application of Common Herbs That Clear Heat and Drain Fire (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Pale Butterfly Bush Flower (mi meng hua) (Flos Buddlejae)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the dried flower bud and inflorescence of Buddleja officinalis Maxim. of the Loganiaceae family. It is collected before blossoming in spring; after impurities are removed, it is dried under the sun

Sweet, slightly cold; act on the liver channel

Clear heat and drain fire, nourish the liver and improve vision, and remove nebula

Indicated for the treatment of red eye with swelling and pain due to liver fire flaming upward, intolerance of light (photophobia) with excessive tearing due to wind-fire invading upward, nebula generated due to liver-fire depression, blurred vision and dry eyes due to liver deficiency with heat. Normally, 9–15 g is decocted with water as an oral dose

No special contraindications

Feather Cockscomb Seed (qing xiang zi) (Semen Celosiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured seed of Celosia argentea L. of the Amaranthaceae family. When the fruit is matured in autumn, the plant or spike is collected and dried under the sun, then seed is collected, and impurities are removed

Bitter, slightly cold; act on the liver channel

Clear liver heat and drain fire, and remove nebula to improve vision

Indicated for the treatment of red eye with swelling and pain, nebula and blurred vision due to liver fire flaming upward, or blurred vision due to liver deficiency and blood heat; or blurred vision and dry eyes due to liverkidney depletion; headache and dizziness, vexation, and agitation and insomnia due to liver yang transforming into fire. Normally, 9–15 g is decocted with water as an oral dose

Its use is prohibited in patients with glaucoma because it can extend pupil

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2. Attached herbs (Table 2.2)

TABLE 2.2 Introduction to Attached Herbs That Clear Heat and Drain Fire Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Boor’s Mustard Herb (xi ming) (Herba Thlaspis Arvensis)

It is the dried aerial part of Thlaspi arvense L. of the Cruciferae family. It is collected when the fruit is matured in summer; after impurities are removed, it is dried

Acrid, slightly cold; act on the liver, stomach, and large intestine channels

Clear liver fire and improve vision, harmonize the center, drain dampness, resolve toxins, and relieve edema

Indicated for the treatment of red eye with swelling and pain, distending pain in the stomach cavity and abdomen, ribside pain, intestinal abscess, edema, morbid leukorrhea, furuncles, sores, carbuncles with swelling. Normally, 9–15 g is decocted with water as an oral dose

No special contraindications

Prepared Mirabilite (xi gua shuang) (Mirabilitum Praeparatum)

It is the product of fresh matured fruit of Citrullus lanatus (Thunb.) Matsumu. et Nakai of the Cucurbitaceae family and sodium sulfate

Salty, cold; act on the lung, stomach, and large intestine channels

Clear heat and drain fire, relieve swelling and pain

Indicated for the treatment of swelling and pain of the throat, throat bì (pharyngitis), and oral ulcer. Normally, 0.5–1.5 g is for oral taking, or an appropriate amount is blown and applied on the afflicted part

It is not suitable for patients with deficiency-cold pattern

Watermelon (xi gua) (Fructus Citrulli)

It is the fruit pulp of fresh matured fruit of Citrullus lanatus (Thunb.) Matsumu. et Nakai of the Cucurbitaceae family

Sweet, cold; act on the heart, stomach, and bladder channels

Clear heat and relieve vexation, resolve summer heat, and promote fluid production and urination

Indicated for the treatment of summer heat-heat syndrome with excessive thirst, exuberant heat injuring fluid, difficulty in micturition, throat bì (pharyngitis) and oral ulcer. Normally, an appropriate amount is for directly eating or pounded to extract the juice for drinking

It is not suitable for patients with interior cold pattern or exuberant dampness disease

Melon Seed (tian gua zi) (Semen Melo)

It is the dried matured seed of Cucumis melo L. of the Cucurbitaceae family. When the fruit is matured in summer and autumn, it is collected, washed clean, and dried under the sun

Sweet, cold; act on the lung, stomach, and large intestine channels

Clear lung heat, moisten the intestine, dissolve stasis, expel pus, cure injury, and relieve pain

Indicated for the treatment of cough due to lung heat, constipation, lung abscess, intestinal abscess, injury from falling down, and injury of sinew and bone. Normally, 9–30 g is decocted with water as an oral dose

No special contraindications

Bat Feces (ye ming sha) (Faeces Vespertilionis)

It is the dried feces of Vespertilio superans Thomas (etc.) of the Vespertilionidae family. It is advisable to be collected in summer; after impurities and silt are removed, it is rinsed and dried under the sun

Acrid, cold; act on the liver channel

Clear heat and improve vision, dissipate blood stasis and disperse accumulation

Indicated for the treatment of red eyes, subconjunctival ecchymosis due to liver heat, injury from falling down, and malnutritional stagnation. Normally, 3–9 g is decocted with water as an oral dose, and an appropriate amount is used externally

Its use is cautious in pregnant women

Pig Gall (zhu dan) (Fellis Suis)

It is the dried gallbladder of Sus scrofadomestica Brisson. of the Suidae family. It is collected any time, and washed clean, dried in the open-air, and ground into powder

Bitter, cold; act on the liver, gallbladder, lung, and large intestine channels

Clear fire and resolve toxins, moisten dryness to promote defecation, clear lung heat and dissolve phlegm

Indicated for the treatment of red eye with swelling and pain, throat bì (pharyngitis) due to liver fire flaming upward, jaundice due to liver-gallbladder damp-heat, dysentery due to large intestine damp-heat, sores and ulcers due to heat toxin, constipation due to heat accumulation, and cough due to lung heat. Normally, 0.15–0.3 g is taken infused as an oral dose

Its use is cautious in patients with deficiency-cold of the spleen and stomach

44 PART | I Chinese Materia Medica

3. Herb differentiation (Table 2.3)

TABLE 2.3 Differentiation Between Similar Efficacy Herbs That Clear Heat and Drain Fire Name of Medicinal Gypsum (shi gao) (Gypsum Fibrosum)

Similarity

Differences

Both are cold in nature, can clear heat and drain fire, and can treat warm febrile disease with excessive heat in qi aspect, high fever, excessive thirst, sweating, surging, and large pulse due to excess heat in the lung and stomach, and cough due to lung heat

It is exceedingly cold in nature, has a stronger effect of draining fire with emphasis on clearing, and is partial to clear and drain sthenic fire of the lung and stomach, and is more for the treatment of cough and panting due to lung heat, headache, and toothache due to stomach fire flaming upward. Meanwhile, if it is calcined, it can clear heat and eliminate dampness, close sore and engender flesh, and is usually used externally for ulcerated sores without tissue-regenerating for a long time, eczema, burn, and scald

Common Anemarrhena Rhizome (zhi mu) (Rhizoma Anemarrhenae)

Raw Cape Jasmine Fruit (sheng zhi zi) (Fructus Gardeniae Cruda)

It has a stronger effect of clearing heat with emphasis on enriching yin and moistening dryness, and is partial to moisten the lung and stomach dryness, and is more for the treatment of dry cough without phlegm, and wasting-thirst (xia¯o kĕ) due to yin deficiency. Meanwhile, it is good at enriching the kidney yin and subduing fire, moistening the intestines to promote defecation and can treat vigorous fire due to yin deficiency, steaming bone fever, night sweating, seminal emission, vexation, and constipation due to intestinal dryness Both can clear heat, drain fire, and relieve vexation, and treat febrile disease with vexation, blood strangury, blood-spitting, and nontraumatic hemorrhage due to blood heat, and red eye with swelling and pain, and sores due to fire toxin

Scorch-Fried Cape Jasmine Fruit (jiao zhi zi) (Fructus Gardeniae Praeparatus)

Common Self-Heal FruitSpike (xia ku cao) (Spica Prunellae)

Cassia Seed (jue ming zi) (Semen Cassiae)

Its property is more bitter and colder. It acts on qi aspect and is good at draining fire and dampness, cooling the blood and resolving toxins, and is used for the treatment of warm disease with high fever, jaundice and strangury due to damp-heat, sores and ulcers with swelling due to toxin, sprain and injury from falling down. Due to its bitter cold property, it is easy to damage the center qi (zhōng qì) and stimulate the stomach, and may cause the patients with weakness of the spleen and stomach to vomit after oral taking, but this disadvantage can be removed after it is dry-fried It acts on the blood aspect and is good at cooling the blood and stanching bleeding, clearing heat, and relieving vexation, and often used for the treatment of restlessness caused by heat constraint, and red eyes due to liver heat. Generally, if use Fructus Gardeniae (zhi zi), the patients with deficiency and weakness of the spleen and stomach should select the scorchfried one

Both act on the liver channel and can clear the liver heat, improve vision, and decrease blood pressure, and can treat red eye with swelling and pain, headache and dizziness, and hypertensive disease

It also acts on the gallbladder channel, and is especially good at clearing and draining the liver fire and can boost the liver blood, and is suitable for the treatment of red eye with swelling and pain due to liver fire flaming upward, pain in the eyeball at night due to liver yin deficiency, and headache and dizziness due to liver yang or liver fire. It also can dissipate masses and decrease blood pressure so as to treat scrofula, goiter, and high blood pressure due to ascendant hyperactivity of liver yang It also acts on the kidney and large intestine channels, has a slightly less effect of clearing the liver fire, but combines the action on enriching the kidney yin. It is suitable for the treatment of red eye with swelling and pain due to both liver fire and wind-heat, and blurred vision due to deficiency of the liver and kidney. It also can moisten the intestines to promote defecation, decrease blood pressure and reduce blood fat, and can treat the intestinal dryness and constipation due to internal heat and fluid consumption, high blood pressure due to ascendant hyperactivity of liver yang and hyperlipidemia complicated by constipation

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SECTION 2  HERBS THAT CLEAR HEAT AND DRY DAMPNESS Outline Medicinals in this section are bitter in flavor and cold in nature, besides clearing heat, have a strong action on drying dampness, and are called the “herbs that clear heat and dry dampness.” They are mainly used for the treatment of damp-heat syndrome. Because of the properties of bitter and descent so as to strongly discharge heat, medicinals in this section can clear heat and drain fire and treat zang-fu fire-heat syndrome. Due to the different parts that immersed by damp-heat, the clinical symptoms are different. Damp-warmth or summer heat-warmth with dampness, damp-heat obstructing or accumulating may cause the functional activity of qi out of smooth. The symptoms of unsurfaced fever, chest and stomach cavity pĭ and oppression, scanty reddish urine, and yellow tongue with greasy coating may be seen. If damp-heat accumulating in the spleen and stomach, ascent-descent disorders, the symptoms of distention and fullness in the stomach cavity and abdomen, vomiting, diarrhea, and dysentery may occur. If damp-heat stagnating in the large intestine, failure to conduct and transmit, the symptoms of diarrhea, dysentery and piles with swelling and pain may be seen. If damp-heat accumulating and steaming the liver and gallbladder, jaundice, reddish urine, distending pain in the hypochondrium, swelling of ear with suppuration may occur. If damp-heat pouring downward, yellow leukorrhea or heat strangury with burning pain may be seen. If multiple abscesses of joints due to damp-heat, red swelling and burning pain of joints may occur. If damp-heat immersing the skin, eczema and wet sores may be seen. The earlier-mentioned diseases and syndromes caused by damp-heat all can be treated by this section’s medicinals. Due to the great bitter-cold property and strong effect of drying dampness of this section’s medicinals, overdosage may easily damage the stomach and consume yin. The dosage should be not large. The patients with deficiency-cold of the spleen and stomach, fluid consumption, and yin impairment should be cautious to use these medicinals. If necessary, they should be used together with herbs that invigorate the stomach or herbs that nourish yin. When using this section’s medicinals to treat the zang-fu fire-heat syndrome or carbuncle-abscess with swelling and toxins, they can be combined with herbs that clear heat and drain fire and (or) herbs that clear heat and resolve toxins.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 2.4)

TABLE 2.4 Properties, Actions, and Application of Common Herbs That Clear Heat and Dry Dampness Name of Medicinal Scutellaria Root (huang qin) (Radix Scutellariae)

Source and Collection

Property, Channel Entry

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Scutellaria baicalensis Georgi of the Labiatae family. It is collected in spring and autumn; after fibrous root and sediment are removed, it is half-dried under the sun and stroked to separate the rough root bark, and then further dried under the sun

Bitter, cold; act on the lung, spleen, large intestine, small intestine, and gallbladder channels

Efficacy and Action

Clinical Application and Usage

Clear heat and dry dampness, drain fire and resolve toxins, stanch bleeding, and calm the fetus

Indicated for the treatment of dampwarmth, summer heat-damp, chest oppression with nausea and vomiting, pĭ and fullness due to damp-heat obstructing the center, jaundice with dampheat pathogen, diarrhea and dysentery due to large intestine dampheat; cough with thick phlegm due to lung heat, externally-contracted febrile disease with high fever and excessive thirst, blood-spitting and nosebleed due to blood heat, carbuncles with swelling, sore with toxins, or restless fetus. Normally, 3–10 g is decocted with water as an oral dose

Caution for Use It is not suitable for patients with deficiency-cold of the spleen and stomach since it is bitter in flavor and cold in nature and easy to damage the stomach

(Continued )

46 PART | I Chinese Materia Medica

TABLE 2.4 Properties, Actions, and Application of Common Herbs That Clear Heat and Dry Dampness (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Coptis Rhizome (huang lian) (Rhizoma Coptidis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome and root of Coptis chinensis Franch., Coptis deltoidea C.Y.Cheng et Hsiao or Coptis teeta wall. of the Ranunculaceae family. It is collected in autumn; after fibrous root and sediment are removed, it is dried and stroked to separate the remaining fibrous root

Bitter, cold; act on the heart, spleen, stomach, liver, gallbladder, and large intestine channels

Clear heat and dry dampness, drain fire, and resolve toxins

Indicated for the treatment of pĭ and fullness, vomiting and acid swallowing due to damp-heat, damp-heat diarrhea or dysentery, jaundice with damp-heat pathogen, high fever, loss of consciousness, vexation, sleeplessness, palpitation with inquietude due to exuberance of heart fire, blood-spitting and nosebleed due to blood heat, red eyes, toothache, wastingthirst (xia¯o kĕ), swollen carbuncles and furuncle; or external treatment of eczema and suppuration of ear canal. Normally, 2–5 g is decocted with water as an oral dose, and an appropriate amount is used externally

Its use is prohibited in patients with deficiency-cold of the spleen and stomach due to its extremely bitter-cold property. It is also not suitable for patients with yin deficiency and fluid consumption due to its bitter and dryness properties

Amur CorkTree Bark (huang bai) (Cortex Phellodendri Chinensis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried bark of Phellodendron chinense Schneid. of the Rutaceae family. The tree bark is peeled off after the Tomb Sweeping festival; after the rough bark is removed, it is dried under the sun

Bitter, cold; act on the kidney and bladder channels

Clear heat and dry dampness, drain fire and relieve steaming bone fever, resolve toxins and cure sores

Indicated for the treatment of abnormal vaginal discharge, heat strangury with difficult and painful sensation, diarrhea, dysentery, and jaundice due to damp-heat, foot damp qi and wĕi (atrophy) due to damp-heat, steaming bone fever, over-strained fever, night sweating, seminal emission, sores and ulcers with swelling and toxins, and eczema with itching. Normally, 3–12 g is decocted with water as an oral dose, and an appropriate amount is used externally

Its use is prohibited in patients with deficiency-cold of the spleen and stomach due to its bitter-cold property

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TABLE 2.4 Properties, Actions, and Application of Common Herbs That Clear Heat and Dry Dampness (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chinese Gentian (long dan) (Radix et Rhizoma Gentianae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root and rhizome of Gentiana manshurica Kitag., Gentiana scabra Bge., Gentiana triflora Pall., or Gentiana rigescens Franch. of the Gentianaceae family. It is collected in spring and autumn, washed clean and dried

Bitter, cold; act on the liver and gallbladder channels

Clear heat and dry dampness, drain the liver and gallbladder fire

Indicated for the treatment of jaundice with damp-heat pathogen, vulvar swelling and vaginal itching, abnormal vaginal discharge with foul smell, and eczema with itching due to damp-heat pouring downward; headache, red eyes, tinnitus, deafness, ribside pain, and bitter taste in the mouth due to the livergallbladder excess fire, and infantile convulsion with high fever due to exuberant heat in the liver channel and extreme heat producing wind. Normally, 3–6 g is decocted with water as an oral dose

It is not suitable for patients with deficiency-cold of the spleen and stomach. Its use is cautious in patients with yin deficiency and fluid consumption

Ash Bark (qin pi) (Cortex Fraxini)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried branch or trunk bark of Fraxinus rhynchophylla Hance, Fraxinus chinensis Roxb., Fraxinus szaboana Lingelsh. or Fraxinus stylosa Lingelsh. of the Oleaceae family. It is collected in spring and autumn, and dried under the sun

Bitter, astringent, cold; act on the liver, gallbladder, and large intestine channels

Clear heat and dry dampness, arrest dysentery with astringency, arrest vaginal discharge, and improve vision

Indicated for the treatment of damp-heat diarrhea or dysentery, accompanied by abdominal urgency with rectal heaviness; leukorrhea with red and white discharge, and vaginal itching due to damp-heat pouring downward; red eye with swelling and pain and nebula due to the fire from constraint in the liver channel. Normally, 6–12 g is decocted with water as an oral dose; or an appropriate amount is decocted for washing the affected area externally

Its use is prohibited in patients with deficiency-cold of the spleen and stomach

(Continued )

48 PART | I Chinese Materia Medica

TABLE 2.4 Properties, Actions, and Application of Common Herbs That Clear Heat and Dry Dampness (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Light Yellow Sophora Root (ku shen) (Radix Sophorae Flavescentis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Sophora flavescens Ait. of the Leguminosae family. It is collected in spring and autumn; after the head of root and small rootlet are removed, washed clean and dried, or cut into pieces while fresh and then dried

Bitter, cold; act on the heart, liver, stomach, large intestine, and bladder channels

Clear heat and dry dampness, kill worms, and promote urination

Indicated for the treatment of damp-heat diarrhea or dysentery, or bloody stool or bleeding from piles due to damp-heat, jaundice, and difficulty in micturition with damp-heat pathogen; leukorrhea with red and white discharge, vulvar swelling and vaginal itching due to dampheat pouring downward; eczema, itch of skin, scabies, tinea, and leprosy. External treatment: trichomonas vaginitis. Normally, 5 –10 g is decocted with water as an oral dose, or an appropriate amount is decocted for washing the afflicted part externally

Its use is prohibited in patients with deficiency-cold of the spleen and stomach. It antagonizes Radix et Rhizoma Veratri Nigri (li lu)

Dictamnus Root Bark (bai xian pi) (Cortex Dictamni)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root bark of Dictamnus dasycarpus Turcz. of the Rutaceae family. The root is collected in spring and autumn; after sediment and rough bark are removed, the root bark is peeled off and dried

Bitter, cold; act on the spleen, stomach, and bladder channels

Clear heat and dry dampness, dispel wind and resolve toxins

Indicated for the treatment of sore with dripping yellowwater, ulceration of skin, eczema, rubella, scabies and tinea due to damp-heat, jaundice with reddish urine due to accumulated dampheat, and wind-damp heat bì syndrome with redness and swelling and pain of joints. Normally, 5–10 g is decocted with water as an oral dose, or an appropriate amount is decocted for washing or ground into powder for applying the afflicted part externally

Its use is cautious in patients with deficiency-cold of the spleen and stomach

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TABLE 2.4 Properties, Actions, and Application of Common Herbs That Clear Heat and Dry Dampness (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

All-Grass of Foxtail-Like Sophora (ku dou zi) (Sophora Alopecur-oides)

Initially recorded in Handbook of Chinese Medicinal Herbs in Xinjiang (xin jiang zhong cao yao shou ce). It is the dried entire plant and seed of Sophora alopecuroides L. of the Leguminosae family. The entire plant is collected in summer, and seed is collected in spring, and dried

Bitter, cold, poisonous; act on the stomach and large intestine channels

Clear heat and dry dampness, relieve pain, and kill worms

Indicated for the treatment of diarrhea and dysentery with tenesmus due to damp-heat, pain in the stomach cavity and acid swallowing due to stomach heat, eczema, stubborn dermatitis, and leukorrhagia due to damp-heat, sore and furuncle and ulcer due to heat toxin. Normally, 1.5–3 g of the entire plant is decocted with water as an oral dose. The seeds are dry-fried and ground into powder for oral taking, 5 pills each time

The dosage for oral use should be not large since it is poisonous. And its use is cautious in patients with deficiency-cold of the spleen and stomach

Sargent Barberry Bark (san ke zhen) (Berberidis Radix)

Initially recorded in Properties of Medicinal Herbs by Category (fen lei cao yao xing). It is the dried root of Berberis soulieana Schneid., Berberis wilsonae Hemsl., Berberis poiretii Schneid., or Berberis vernae Schneid. of the Berberidaceae family. It is collected in spring and autumn; after sediment and fibrous root are removed, it is dried under the sun, or cut into pieces and dried

Bitter, cold, poisonous; act on the liver, stomach, and large intestine channels

Clear heat and dry dampness, drain fire and resolve toxins

Indicated for the treatment of dampheat diarrhea or dysentery, jaundice, and eczema due to damp-heat, carbuncles accompanied by swelling, and sore due to heat toxin, swelling and pain of the throat, red eye with swelling and pain; and suppurative inflammation of the middle ear due to fire toxin; or injury from falling down. Normally, 9–15 g is decocted with water as an oral dose, and an appropriate amount is ground into powder for applying the affected area externally

The dosage for oral use should be not large since it is poisonous. And its use is cautious in patients with deficiency-cold of the spleen and stomach

(Continued )

50 PART | I Chinese Materia Medica

TABLE 2.4 Properties, Actions, and Application of Common Herbs That Clear Heat and Dry Dampness (cont.) Name of Medicinal

Source and Collection

Manyleaf Meadowure Rhizome and Root (ma wei lian) (Radix et Rhizoma Thalictri Baicalensis)

Initially recorded in Supplement to “The Grand Compendium of Materia Medica” (ben cao gang mu shi yi). It is the rhizome and root of Thalictrum foliolosum DC., T. baicalense Turcz., or T. delavayi Franch. of the Ranunculaceae family. Its entire plant can also be as a medicinal. It is collected in autumn and winter, washed clean and cut into segments

Property, Channel Entry Bitter, cold; act on the heart, lung, liver, gallbladder, and large intestine channels

Efficacy and Action

Clinical Application and Usage

Clear heat and dry dampness, drain fire and resolve toxins

Indicated for the treatment of damp-heat diarrhea or dysentery, and jaundice with damp-heat pathogen; febrile disease with vexation and agitation and restlessness; cough due to lung heat, carbuncles and sores accompanied by swelling and pain, or red eye with swelling and pain due to fire toxin. Normally, 6–12 g of the rhizome and root or 15–30 g of the entire plant is decocted with water as an oral dose

Caution for Use Its use is cautious in patients with deficiency-cold of the spleen and stomach

2. Attached herbs (Table 2.5)

TABLE 2.5 Introduction to Attached Herbs That Clear Heat and Dry Dampness Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

False Chinese Swertia Herb (dang yao) (Swertiae Herba)

It is the dried entire plant of Swertia pseudochinensis Hara of the Gentianaceae family. It is collected in summer and autumn; after impurities are removed, it is dried under the sun

Bitter, cold; act on the liver, stomach, and large intestine channels

Clear dampheat, and invigorate the stomach

Indicated for the treatment of jaundice with damp-heat pathogen, with pain in the hypochondrium, dysentery with abdominal pain, and poor appetite. Normally, 6–12 g is decocted with water as an oral dose, or made into pills or powder. Dosage for children should be reduced accordingly. An appropriate amount is pounded to extract the juice for applying externally

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Phellodendron Bark (guan huang bai) (Cortex Phellodendri Amurensis)

It is the dried dark of Phellodendron amurense Rupr. of the Rutaceae family. The bark is peeled off; after the rough bark is removed, it is dried under the sun

Bitter, cold; act on the kidney and bladder channels

Clear heat and dry dampness, drain fire and relieve steaming bone fever, resolve toxins, and cure sores

Indicated for the treatment of diarrhea and dysentery due to damp-heat, jaundice with reddish urine, abnormal vaginal discharge with vaginal itching, heat strangury, steaming bone fever, over-strained fever, night sweating, seminal emission, sores and ulcers with swelling due to heat toxin, and eczema. Normally, 3–12 g is decocted with water as an oral dose; or an appropriate amount is decocted for washing the affected area externally

Its use is prohibited in patients with diarrhea due to spleen deficiency, eating lessening due to stomach weakness

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TABLE 2.5 Introduction to Attached Herbs That Clear Heat and Dry Dampness (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Chinese Mahonia Stem (gong lao mu) (Caulis Mahoniae)

It is the dried stem of Mahonia bealei (Fort.) Carr or Mahonia fortunei (Lindl.) Fedde of the Berberidaceae family. It is collected in whole year, cut into slices and dried

Bitter, cold; act on the liver, stomach, and large intestine channels

Clear heat and dry dampness, drain fire and resolve toxins

Clinical Application and Usage

Caution for Use

Indicated for the treatment of diarrhea and dysentery due to damp-heat, jaundice with reddish urine, red eye with swelling and pain, toothache due to stomach fire, sore and furuncle, carbuncles with swelling due to heat toxin. Normally, 9–15 g is decocted with water as an oral dose; or an appropriate amount is decocted for washing the affected area externally

Its use is prohibited in patients with deficiency-cold of constitution

3. Herb differentiation (Table 2.6)

TABLE 2.6 Differentiation Between Similar Efficacy Herbs That Clear Heat and Dry Dampness Name of Medicinal

Similarity

Differences

Scutellaria Root (huang qin) (Radix Scutellariae)

All three are bitter in flavor and cold in nature, have the main effects of clearing heat and drying dampness, draining fire and resolving toxins, and often combine with each other to treat the internal exuberance of damp-heat or intense fire toxin syndromes, such as diarrhea, dysentery, and jaundice due to damp-heat, swollen carbuncles due to heat toxin, red eye with swelling and pain, blood-spitting and nosebleed due to blood heat, and other fire-heat syndrome of zang-fu organs

It mainly acts on the lung and large intestine channels, also acts on the stomach and gallbladder channels. Its effects are partial to the upper jiao and large intestine. It is good at clearing the lung fire in the upper jiao and large intestine fire, and has a significant effect of stanching bleeding, and is especially indicated for the treatment of warm disease with heat entering the qi or nutrient-blood, cough and panting due to lung heat, dampwarmth, summer heat-damp or damp-heat obstructing the center, dampheat painful strangury and anus fistula with bloody stool. It also can clear heat and calm the fetus and treat the restless fetus due to fetus heat

Coptis Rhizome (huang lian) (Rhizoma Coptidis)

Amur Cork-Tree Bark (huang bai) (Cortex Phellodendri Chinensis)

Light Yellow Sophora Root (ku shen) (Radix Sophorae Flavescentis) Ash Bark (qin pi) (Cortex Fraxini)

It has the exceedingly bitter in flavor and cold in nature, mainly acts on the heart and stomach channels, its effects are partial to the heart and middle jiao, it is good at clearing the heart-stomach fire and eliminating damp-heat in the middle jiao. It is especially indicated for the treatment of warm disease with coma and delirium due to heat entering nutrient-blood, vexation and sleeplessness, toothache and oral ulcer due to stomach fire, vomiting and acid swallowing due to liver fire invading the stomach, pĭ and fullness due to damp-heat, and swift digestion with rapid hungering due to intense stomach fire. In addition, small amounts of Rhizoma Coptidis (huang lian) may invigorate the stomach. If it is used together with the herbs that fortify the spleen and stomach, it can treat spleen-stomach weakness Its efficacy is not as good as Rhizoma Coptidis (huang lian). It mainly acts on the kidney and bladder channels, and its effects are partial to the lower jiao, it is good at clearing ministerial fire (kidney fire), abating deficiencyheat, and eliminating the lower jiao damp-heat. It is especially indicated for the treatment of vigorous fire due to yin deficiency, steaming bone fever and tidal fever, and suppression of urine, turbid strangury, abnormal vaginal discharge, vaginal itching, swelling and pain of the foot and knee, and foot damp qi (tinea pedis) due to damp-heat in the lower jiao

Both are bitter and cold, can clear heat and dry dampness, and mainly indicated for the treatment of diarrhea and dysentery due to damp-heat, intestinal wind (i.e., bloody stool) and yellow abnormal vaginal discharge

It is good at clearing the lower jiao damp-heat, also can promote urination, so it can guide the damp-heat out from urination. And it also can kill worms to relieve itching

It is astringent and has an effect of astringing, can clear heat and dry dampness and resolve toxins, also can arrest dysentery, and arrest vaginal discharge with astringency, clear liver heat and drain fire, and remove nebula to improve vision, and are used for the treatment of red eye with swelling pain and nebula due to fire from constraint in the liver channel (Continued )

52 PART | I Chinese Materia Medica

TABLE 2.6 Differentiation Between Similar Efficacy Herbs That Clear Heat and Dry Dampness (cont.) Name of Medicinal

Similarity

Differences

Ginger Juice-Fried Coptis Rhizome (jiang huang lian)

All three can clear heat and drain dampness, drain fire and resolve toxins, and mainly treat stomach and intestine damp-heat, diarrhea and dysentery, vomiting, exuberant heat and blazing of fire pattern, high fever with vexation and agitation, carbuncles and abscesses and deep-rooted boils, sores in mouth and tongue, eczema, swelling and pain of the ear and eye

Ginger Juice-fried Rhizoma Coptidis (jiang huang lian) has alleviated the bitter-cold property of Rhizoma Coptidis (huang lian), and can clear the stomach heat, harmonize the stomach, and reinforce the effect of arresting vomiting, can mainly treat vomiting due to stomach heat, and is more used for the treatment of binding of clod and heat, damp-heat obstructing the center, disorders of the stomach downward function, pĭ and fullness with nausea and vomiting

Wine-Fried Coptis Rhizome (jiu huang lian)

Medicinal Evodia Fruit-Fried Coptis Rhizome (yu huang lian)

Wine-fried Rhizoma Coptidis (jiu huang lian) can guide the effects of Rhizoma Coptidis (huang lian) to the upper and relieve its cold property. It is good at clearing fire-heat of the head and eye in the upper jiao, and is more used for the treatment of red eye with swelling and pain, and sore in mouth and tongue Medicinal Evodia Fruit-fried Rhizoma Coptidis (yu huang lian) has inhibited the bitter-cold property of Rhizoma Coptidis (huang lian), and can mainly clear damp-heat in qi aspect, scatter the liver and gallbladder fire from constraint, and treat damp-heat obstructing and stagnating the liver and gallbladder, and liver-stomach disharmony with vomiting, epigastric upset and acid swallowing. It also can treat stagnation of pathogen inside the body, generating dampness and accumulating heat, pĭ and fullness in the chest and stomach cavity, diarrhea, or dysentery

SECTION 3  HERBS THAT CLEAR HEAT AND RESOLVE TOXINS Outline Medicinals in this section are cold or cool in nature, besides clearing heat, they are good at resolving toxins, and have the effects of clearing and resolving pathogenic fire-heat and toxins. They are mainly indicated for the treatment of swollen carbuncles and sore toxins, erysipelas, pestilent maculae, parotic swelling (mumps), swelling and pain of the throat, diarrhea due to heat toxin, insect or snake bite, cancer, burn or scald due to hot liquid or fire, and other acute febrile diseases. During the clinical medication, herbs that clear heat and resolve toxins should be specifically selected to use according to the different manifestations and the accompanied symptoms and signs from various kinds of syndromes, and/or combined together with the characteristics of the specific medicinals. The corresponding combination of medicinals should also be considered according to the requirement of patient’s condition. Like treating heat toxin in blood aspect, they can combine with herbs that clear heat and cool the blood; intense fire-heat, combine with herbs that clear heat and drain fire; complicated by pathogenic dampness, combine with herbs that drain dampness, dry dampness or remove dampness; sores and ulcers with swelling and toxins, or swelling and pain of the throat, combine with herbs that invigorate blood and relieve swelling or soften hardness and dissipate masses; red dysentery due to heat toxin, with abdominal urgency with rectal heaviness, combine with herbs that invigorate blood and move qi. This section’s medicinals can easily damage the spleen and stomach, so discontinue medication as soon as getting effect and overdose is not advisable for use.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 2.7)

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TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Japanese Honeysuckle Flower (jin yin hua) (Flos Lonicerae Japonicae)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried flower bud or with the early blossom of Lonicera japonica Thunb. of the Caprifoliaceae family. It is collected before blooming in early summer, and dried

Sweet, cold; act on the lung, heart, and stomach channels

Clear heat and resolve toxins, scatter and dissipate wind-heat, cool the blood and arrest dysentery

Indicated for the treatment of carbuncles and deep-rooted boils with redness and swelling and pain due to heat toxin; throat bì (pharyngitis), erysipelas, heat sore (herpes simplex) and miliaria; red dysentery due to heat toxin, and common cold due to externallycontracted wind-heat, or warm disease in the initial stage with fever. Normally, 6–15 g is decocted with water as an oral dose

Its use is prohibited in patients with deficiency-cold of the spleen and stomach, and sores and ulcers with clear pus due to qi deficiency

Weeping Forsythia Capsule (lian qiao) (Fructus Forsythiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried fruit of Forsythia suspensa (Thunb.) Vahl of the Oleaceae family. It is collected when the fruits are first matured but still green in autumn, after impurities are removed, steamed and dried under the sun, which calls “Green Fructus Forsythiae.” When the fruits are quite ripe, it is collected and dried under the sun, which calls “Old Fructus Forsythiae”

Bitter, slightly cold; act on the lung, heart, and small intestine channels

Clear heat and resolve toxins, relieve swelling and dissipate masses, scatter and dissipate wind-heat, clear heart heat and promote urination

Indicated for the treatment of carbuncleabscess with swelling, scrofula and phlegm nodule (superficial nodule), mammary abscess, erysipelas, common cold due to externally-contracted wind-heat, or warm disease in the initial stage with high fever, excessive thirst, coma, maculae generated due to heat invading the nutrient aspect, and difficult and painful heat strangury due to damp-heat obstructing. Normally, 6–15 g is decocted with water as an oral dose

Its use is prohibited in patients with weakness of the spleen and stomach, fever due to qi deficiency, and ulcerated carbuncleabscess with pale and clear pus

(Continued )

54 PART | I Chinese Materia Medica

TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.)

Source and Collection

Property, Channel Entry

Andrographis (chuan xin lian) (Herba Andrographis)

Initially recorded in Records of Medicinal Harvest in Lingnan (ling nan cai yao lu). It is the dried aerial part of Andrographis paniculata (Burm. f.) Nees of the Acanthaceae family. When the stem and leaves are luxuriant in autumn, it is collected and dried under the sun

Indigowoad Leaf (da qing ye) (Folium Isatidis)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried leaf of Isatis indigotica Fort. of the Cruciferae family. It is collected in 2 or 3 times in summer and autumn; after impurities are removed, it is dried under the sun

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Bitter, cold; act on the heart, lung, large intestine, and bladder channels

Clear heat and resolve toxins, cool the blood and relieve swelling, and dry dampness

Indicated for the treatment of fever due to wind-heat, warm disease in the initial stage, cough and panting due to lung heat, swelling and pain of the throat, sore in mouth and tongue, lung abscess with spitting pus, diarrhea and dysentery, difficult and painful heat strangury, and eczema with itching due to damp-heat, carbuncles and sores, and insect bite. Normally, 6–9 g is decocted with water as an oral dose, and an appropriate amount is used externally

It is not suitable for long-term use and taking too much. Its use is cautious in patients with yang deficiency and weakness of the spleen and stomach

Bitter, cold; act on the heart and stomach channels

Clear heat and resolve toxins, cool the blood, and remove maculae

Indicated for the treatment of warm disease with high fever and loss of consciousness due to heat entering nutrientblood; macules and papules generated, erysipelas, parotic swelling (mumps), and carbuncles with swelling and pain due to warm toxin; throat bì (pharyngitis) and sore in the mouth and tongue due to exuberance of heart-stomach fire. Normally, 9–15 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose; or an appropriate amount is pounded for applying the affected area externally

Its use is prohibited in patients with deficiency-cold of the spleen and stomach

Caution for Use

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TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Isatis Root (ban lan gen) (Radix Isatidis)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried root of Isatis indigotica Fort. of the Cruciferae family. It is collected in autumn; after sediment is removed, it is dried under the sun

Bitter, cold; act on the heart and stomach channels

Clear heat and resolve toxins, cool the blood and relieve sore-throat

Indicated for the treatment of fever from external contraction, warm disease in the initial stage with swelling and pain of the throat; macules and papules generated, parotic swelling (mumps), infectious sore throat with erythema (scarlatina), swollen-head infection with redness and swelling, erysipelas and carbuncles due to pestilential toxin. Normally, 9–15 g is decocted with water as an oral dose

Its use is prohibited in weak patients without excess fire and heat toxin, and cautious in patients with deficiency-cold of the spleen and stomach

Natural Indigo (qing dai) (Indigo Naturalis)

Initially recorded in Treatise on Medicinal Properties (yao xing lun). It is the dried processed powder, mass, or granule of the leaf or cauline leaf of Baphicacanthus cusia (Nees) Bremek. of the Acanthaceae family, Polygonum tinctorium Ait. of the Polygonaceae family, or Isatis indigotica Fort. of the Cruciferae family

Salty, cold; act on the liver and lung channels

Clear heat and resolve toxins, cool the blood and remove maculae, clear liver heat and drain fire, and arrest convulsion

Indicated for the treatment of maculae generated due to warm toxin; spitting of blood and nosebleed due to blood heat; chest pain, cough and expectoration of blood due to liver fire invading the lung, or cough with yellow and thick phlegm due to lung heat; sore throat and sore in the mouth and tongue, parotic swelling (mumps), and ulcers due to intense fire toxin, and infantile convulsive epilepsy due to summer heat. Normally, 1–3 g is made into pills or powder as an oral dose, and an appropriate amount is used externally

Its use is cautious in patients with stomach cold

(Continued )

56 PART | I Chinese Materia Medica

TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Cyrtomii Rhizoma (guan zhong) (Rhizoma Cyrtomii)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome with petiole residue of Dryopteris crassirhizoma Nakai of the Dryopteridaceae family. It is collected in autumn; after petiole, fibrous root, and sediment are removed, it is dried under the sun

Bitter, slightly cold, slightly poisonous; act on the liver and spleen channels

Clear heat and resolve toxins, cool the blood and stanch bleeding, and kill worms

Indicated for the treatment of epidemic common cold, windheat common cold with headache, maculae generated, parotic swelling (mumps) due to warm toxin, sores and ulcers with swelling and toxins, bleeding, especially for flooding and spotting (uterine bleeding) due to blood heat, and abdominal pain due to intestinal parasitic infestation. Normally, 5–10 g is decocted with water as an oral dose, and an appropriate amount is used externally

Avoid greasy food. Due to its slightly poisonous, the dosage should not be too large. Its use is cautious in pregnant women and patients with deficiency-cold of the spleen and stomach

Dandelion (pu gong ying) (Herba Taraxaci)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried entire plant of Taraxacum mongolicum Hand.-Mazz. or Taraxacum borealisinense Kitam. of the Compositae family, or many kinds of plants of the same family. It is collected when early blooming in spring through autumn; after impurities are removed, it is washed clean and dried under the sun

Bitter, sweet, cold; act on the liver and stomach channels

Clear heat and resolve toxins, relieve swelling and dissipate masses, promote urination and relieve strangury

Indicated for the treatment of deep-rooted boils and carbuncles with swelling, internal abscess, especially for mammary abscess (acute mastitis), lung abscess, and intestine abscess due to heat toxin, difficult and painful heat strangury, jaundice due to damp-heat, red eye with swelling and pain due to liver fire flaming upward. Normally, 10–15 g is decocted with water as an oral dose, and an appropriate amount of the fresh one is used externally

Its use is prohibited in patients with external cold due to yang deficiency, and weakness of the spleen and stomach. And overdose may cause slow diarrhea

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TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Tokyo Violet (zi hua di ding) (Herba Violae)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried entire plant of Violae yedoensis Makino of the Violaceae family. It is collected in spring and autumn; after impurities are removed, it is dried under the sun

Bitter, acrid, cold; act on the heart and liver channels

Clear heat and resolve toxins cool the blood and relieve swelling

Indicated for the treatment of deep-rooted boils with swelling, mammary abscess and intestine abscess, carbuncles of the back, erysipelas due to blood heat obstructing, and snake bite; also for the treatment of red eye with swelling and pain, and externallycontracted febrile disease due to liver heat. Normally, 15–30 g is decocted with water as an oral dose, and an appropriate amount of the fresh one is used externally

Its use is prohibited in patients with deficiency-cold of constitution

Wild Chrysanthemum Flower (ye ju hua) (Flos Chrysanthemi Indici)

Initially recorded in The Orthodox Materia Medica (ben cao zheng). It is the dried flower head of Chrysanthemum indicum L. of the Compositae family. When early blooming in autumn and winter, it is collected and dried under the sun, or steamed and dried

Bitter, acrid, slightly cold; act on the liver and heart channels

Clear heat and resolve toxins, drain fire and calm the liver

Indicated for the treatment of deeprooted boils, sores, and carbuncles with swelling, swelling and pain of the throat due to heat toxin accumulation, red eye with swelling and pain due to wind-heat invading upward, headache and dizziness due to liver fire flaming upward. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is decocted for washing or made into ointment for applying externally

Its use is cautious in pregnant women and patients with deficiency-cold of the spleen and stomach

(Continued )

58 PART | I Chinese Materia Medica

TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Paris Rhizome (chong lou) (Rhizoma Paridis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome of Paris polyphylla Smith var. yunnanensis (Franch.) Hand.-Mazz. or Paris polyphylla Smith var. chinensis (Franch.) Hara of the Liliaceae family. It is collected in autumn; after fibrous roots are removed, it is washed clean and dried under the sun

Bitter, slightly cold, slightly poisonous; act on the liver channel

Clear heat and resolve toxins, relieve swelling and relieve pain, cool the liver and arrest convulsion

Indicated for the treatment of deeprooted boils, sores, and carbuncles with swelling, swelling and pain of the throat, snake and insect bite, infantile convulsion due to extreme heat producing wind, and bleeding caused by injury from falling down, swelling and pain due to blood stasis. Normally, 3–9 g is decocted with water as an oral dose, or an appropriate amount is ground into powder for applying externally

Its use is prohibited in weak patients without excess fire and heat toxin, pregnant women, and sores and ulcers with a yin pattern

Bistort Rhizome (quan shen) (Rhizoma Bistortae)

Initially recorded in Illustrated Classic of Materia Medica (ben cao tu jing). It is the dried rhizome of Polygonum bistorta L. of the Polygonaceae family. It is collected when early sprouting in spring or when the stem and leaf will wilt in autumn; after sediment is removed, it is dried under the sun, and then fibrous root is removed

Bitter, astringent, slightly cold; act on the lung, liver, and large intestine channels

Clear heat and resolve toxins, relieve swelling, cool the blood and stanch bleeding, tranquilize the liver and extinguish wind

Indicated for the treatment of swollen carbuncles, scrofula, snake and insect bite, febrile disease with loss of consciousness, and convulsive epilepsy, red dysentery and pyretic diarrhea, bleeding, such as blood-spitting and nosebleed, or bleeding from piles due to blood heat, cough due to lung heat, sore in mouth and tongue. Normally, 5–10 g is decocted with water as an oral dose, and an appropriate amount is used externally

It is not suitable for patients without excess fire and heat toxin. And its use is prohibited in patients with sores and ulcers with a yin pattern

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TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Rhaponticum Root (lou lu) (Radix Rhapontici)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Rhaponticum uniflorum (L.) DC of the Compositae family. It is collected in spring and autumn; after fibrous root and sediment are removed, it is dried under the sun

Bitter, cold; act on the stomach channel

Clear heat and resolve toxins, relieve carbuncle and dissipate masses, unblock the channels and promote lactation, relax the sinews and unblock the vessels

Indicated for the treatment of mammary abscess (acute mastitis) with swelling and pain due to heat toxin accumulation, carbuncle-abscess and phlegmon of the dorsum, scrofula and sores due to binding constraint of phlegmfire, inhibited lactation with distending pain after childbirth due to the breast collateral obstruction, and damp bì syndrome with tendon spasm. Normally, 5–9 g is decocted with water as an oral dose

Its use is prohibited in patients with sores and ulcers collapsing due to qi deficiency, and pregnant women

Glabrous Greenbrier Rhizome (tu fu ling) (Rhizoma Smilacis Glabrae)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried root of Smilax glabra Roxb. of the Liliaceae family. It is collected in summer and autumn; after fibrous root is removed, it is washed clean and dried, or cut into pieces while fresh, and dried

Sweet, bland, neutral; act on the liver and stomach channels

Resolve toxins, eliminate dampness, and smooth joint movement

Indicated for the treatment of syphilis, and tendon spasm of limbs and pain of sinew and bone caused by mercury poisoning, heat strangury, vaginal itching, abnormal vaginal discharge, and eczema with itching due to damp-heat, swollen carbuncles and sores, scrofula, scabies, and tinea. Normally, 15–60 g is decocted with water as an oral dose, or an appropriate amount is used externally

Avoid drinking tea. Its use is cautious in patients with liver-kidney yin deficiency

(Continued )

60 PART | I Chinese Materia Medica

TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Heartleaf Houttuynia (yu xing cao) (Herba Houttuyniae)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the fresh whole plant or dried aerial part of Houttuynia cordata Thunb. of the Saururaceae family. The fresh one is collected in whole year; the dried one is collected when stem and leaf are luxuriant and spica is more in summer; after impurities are removed, it is dried under the sun

Acrid, slightly cold; act on the lung channel

Clear heat and resolve toxins, relieve carbuncle and expel pus, promote urination, and relieve strangury

Indicated for the treatment of lung abscess with expectoration of pus, panting and cough due to phlegm-heat, swollen sores and carbuncles due to heat toxin, strangury due to damp-heat, and heat dysentery. Normally, 15–25 g of the dried one or 30–50 g of the fresh one is decocted with water or pounded to extract the juice as an oral dose, or an appropriate amount is pounded for applying or decocted for fumigating and washing the afflicted part

Since it contains volatile oil, it should not be decocted for a long time. And its use is prohibited in patients with deficiency-cold pattern, or sores and ulcers with a yin pattern

Wild Buckwheat (jin qiao mai) (Rhizoma Fagopyri Dibotryis)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried rhizome of Fagopyrum dibotrys (D.Don) Hara of the Polygonaceae family. It is collected in winter; after stem and fibrous root are removed, it is dried under the sun

Slightly acrid, astringent, cool; act on the lung channel

Clear heat and resolve toxins, expel pus and dispel stasis, fortify the spleen and promote digestion

Indicated for the treatment of lung abscess with expectoration of thick fishy phlegm or pus and blood, panting and cough due to lung heat, scrofula, sores, and furuncle, and throatmoth (tonsillitis) with swelling and pain; also for the treatment of abdominal distention and eating lessening. Normally, 15–45 g is decocted with water or air tightly stewed out of water with water or yellow rice wine as an oral dose

No special contraindications

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TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sargent Gloryvine Stem (da xue teng) (Caulis Sargentodoxae)

Initially recorded in Illustrated Classic of Materia Medica (ben cao tu jing). It is the dried rattan stem of Sargentodoxa cuneata (Oliv.) Rehd.et Wils. of the Laidizabalaceae family. It is collected in autumn and winter; after lateral branch is removed, it is cut into segments and dried

Bitter, neutral; act on the large intestine and liver channels

Clear heat and resolve toxins, invigorate blood, dispel wind, and relieve pain

Indicated for the treatment of abdominal pain with intestinal abscess, sores, and ulcers due to heat toxin, injury with swelling and pain due to falling down, menstrual block and painful menstruation, and painful bì syndrome due to wind-damp. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in pregnant women

Patrinia (bai jiang cao) (Herba Patriniae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried whole plant of Patrinia scabiosaefolia Fisch.ex Link. or P. villose Juss. of the Valerianaceae family. It is collected in summer and autumn; after sediment is removed, it is washed clean and dried in the shade or under the sun and then cut into segments

Acrid, bitter, slightly cold; act on the stomach, large intestine, and liver channels

Clear heat and resolve toxins, relieve carbuncle and expel pus, dispel stasis and relieve pain

Indicated for the treatment of abdominal pain with intestinal abscess in the early stage, lung abscess with expectoration of pus and blood, swollen carbuncles and sores, postpartum abdominal pain due to static blood obstruction; leukorrhea with red and white discharge; also for the treatment of red eye with swelling and pain due to liver heat, and dysentery with red and white feces. Normally, 6–15 g is decocted with water as an oral dose, or an appropriate amount is pounded for applying externally

Its use is prohibited in patients with eating lessening and diarrhea due to weakness of the spleen and stomach

(Continued )

62 PART | I Chinese Materia Medica

TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Blackberry Lily Rhizome (she gan) (Rhizoma Belamcandae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome of Belamcanda chinensis (L) DC. of the Iridaceae family. It is collected when just sprouting in early spring or when the stem and leaves are wilted in late autumn; after fibrous root and sediment are removed, it is dried

Bitter, cold; act on the lung channel

Clear heat and resolve toxins, disperse phlegm and relieve sore throat, disperse stasis and dissipate masses

Indicated for the treatment of swelling and pain of the throat, and throat bì (pharyngitis) due to binding constraint of heat toxin and phlegm-fire, cough with counterflow qi ascent, and panting caused by excessive phlegmdrool obstructing, swollen carbuncles and sores due to heat toxin, scrofula, malaria with splenomegaly, concretions, and conglomerations (lower abdominal masses; zhēng jia˘). Normally, 3–10 g is decocted with water as an oral dose

It is not suitable for patients without excess fire or with thin, unformed stool due to spleen deficiency. Its use is prohibited or cautious in pregnant women

Euchresta Japonica (shan dou gen) (Radix et Rhizoma Sophorae Tonkinensis)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the dried root and rhizome of Sophora tonkinensis Gagnep. of the Leguminosae family. It is collected in autumn; after impurities are removed, it is washed clean and dried

Bitter, cold, poisonous; act on the lung and stomach channels

Clear heat and resolve toxins, relieve swelling and relieve sore throat, and relieve pain

Indicated for the treatment of swelling and pain of the throat, throat-moth (tonsillitis), and throat bì (pharyngitis) due to fire toxin accumulation, swelling and pain of gingiva, sore in mouth and tongue due to stomach fire flaming upward; also for cough due to lung heat, jaundice due to dampheat, swollen carbuncles and sores. Normally, 3–6 g is decocted with water as an oral dose, or an appropriate amount is used externally

Overdose may cause vomiting, diarrhea, dyspnea, and palpitation; dosage should not be too large. Its use is cautious in patients with deficiency-cold of the spleen and stomach

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TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Puffball Fruiting Body (ma bo) (Lasiosphaera seu Calvatia)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried fruiting body of Lasiosphaera fenzlii Reich., Calvatia gigantean (Batsch ex Pers.) Lloyd or Calvatia lilacina (Mont.et Berk.) Lloyd of the Lycoperdaceae family. It is collected in time when fruiting body is matured in summer and autumn; after sediment is removed, it is dried

Acrid, neutral; act on the lung channel

Clear lung heat and relieve sore-throat and stanch bleeding

Indicated for the treatment of swelling and pain of the throat, loss of voice, and cough due to wind-heat and lung fire, blood-spitting and nosebleed due to fire-heat distressing the lung. External treatment: bleeding from trauma. Normally, 2–6 g is wrapped with cloth and decocted with water as an oral dose, or made into pills or powder; or an appropriate amount is applied on the afflicted part externally

Its use is prohibited in patients with cough and loss of voice due to wind-cold lodging in the lung

Chinese White Olive (qing guo) (Fructus Canarii)

Initially recorded in Ri Hua-zi’s Materia Medica (ri hua zi ben cao). It is the dried matured fruit of Canarium album Raeusch. of the Burseraceae family. When fruit is matured in autumn, it is collected and dried

Sweet, sour, neutral; act on the lung and stomach channels

Clear heat and resolve toxins, relieve sorethroat and promote fluid production to quench thirst

Indicated for the treatment of swelling and pain of the throat due to wind-heat invading upward, excessive thirst due to summer heat, cough with sticky phlegm, vexing heat, dry throat and mouth, and loss of voice; and also for poisoning from fish and crab or insobriety. Normally, 5–10 g of the dried one or 30–50 g of the fresh one is decocted with water as an oral dose

Since it is sweet in flavor and astringent in nature, its use is cautious in patients with exterior pattern in the initial stage

(Continued )

64 PART | I Chinese Materia Medica

TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Franchet Groundcherry Fruit (jin deng long) (Calyx seu Fructus Physalis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried persistent calyx (or with fruit) of Physalis alkekengi L. var. franchetii (Mast.) Makino of the Solanaceae family. When fruit is matured and persistent calyx turns red or orange red in autumn, it is collected and dried

Bitter, cold; act on the lung channel

Clear heat and resolve toxins, relieve sorethroat and dissolve phlegm, promote urination and relieve strangury

Indicated for the treatment of sore throat, loss of voice, cough due to phlegm-heat, difficulty in micturition, and heat strangury with difficult and painful sensation. External treatment: pemphigus and eczema. Normally, 5–9 g is decocted with water as an oral dose, or an appropriate amount is pounded and applied on the afflicted part externally

Its use is prohibited in patients with diarrhea due to spleen deficiency and pregnant women

Tinospora Root (jin guo lan) (Radix Tinosporae)

Initially recorded in Supplement to ‘The Grand Compendium of Materia Medica’ (ben cao gang mu shi yi). It is the dried root tuber of Tinospora sagittata (Oliv.) Gagnep. or Tinospora capillipes Gagnep. of the Menispermaceae family. It is collected in autumn and winter; after fibrous root is removed, it is washed clean and dried under the sun

Bitter, cold; act on the lung and large intestine channels

Clear heat and resolve toxins, relieve sore throat and relieve pain

Indicated for the treatment of swelling and pain of the throat due to heat accumulated in the lung and stomach, swollen carbuncles, sores and deep-rooted boil with red swelling and pain due to heat toxin accumulation, diarrhea and dysentery with abdominal pain, and heat pain in the stomach cavity. Normally, 3–9 g is decocted with water as an oral dose, or an appropriate amount is ground into powder for blowing throat or ground with vinegar and applied on the afflicted part externally

Its use is cautious in patients with weakness of the spleen and stomach

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TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Indian Trumpet Flower Seed (mu hu die) (Semen Oroxyli)

Initially recorded in Supplement to ‘The Grand Compendium of Materia Medica’ (ben cao gang mu shi yi). It is the dried matured seed of Orozylum indicum (L.) Vent. of the Bignoniaceae family. The matured fruit is collected in autumn and winter and dried in the blazing sun until cracking of fruit; then, the seed is take out of and dried under the sun

Bitter, sweet, cool; act on the lung, liver, and stomach channels

Clear lung heat and relieve sore throat, soothe the liver, and harmonize the stomach, close sore and engender flesh

Indicated for the treatment of throat bì (pharyngitis), loss of voice, swelling and pain of the throat due to pathogenic heat damaging yin, cough due to lung heat, qistagnant pain in the liver and stomach due to liver constraint, or distending pain in the abdomen and ribside, sores and ulcers for a long time, and acute universal eczema. Normally, 1.5–3 g is decocted with water as an oral dose, or an appropriate amount is ground into powder and applied on the afflicted part externally

No special contraindications

Chinese Anemone Root (bai tou weng) (Radix Pulsatillae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Pulsatilla chinensis (Bge.) Regel of the Ranunculaceae family. It is collected in spring and autumn, after sediment is removed, it is dried

Bitter, cold; act on the stomach and large intestine channels

Clear heat and resolve toxins, cool the blood, and arrest dysentery

Indicated for the treatment of red dysentery due to heat toxin, with abdominal pain, abdominal urgency with rectal heaviness, diarrhea with pus and blood, vaginal itching and abnormal vaginal discharge, parotic swelling (mumps), scrofula, sores, and carbuncles with swelling and pain. Normally, 9–15 g of the dried one or 15–30 g of the fresh one is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is prohibited in patients with diarrhea and dysentery due to deficiency-cold

(Continued )

66 PART | I Chinese Materia Medica

TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Purslane (ma chi xian) (Herba Portulacae)

Initially recorded in Collected Commentaries on ‘Shen Nong’s Classic of the Materia Medica’ (ben cao jing ji zhu). It is the dried aerial part of Portulaca oleracea L. of the Portulacaceae family. It is collected in summer and autumn; after residual root and impurities are removed, it is washed clean, slightly steamed or scalded and dried under the sun

Sour, cold; act on the liver and large intestine channels

Clear heat and resolve toxins, cool the blood and stanch bleeding, and arrest dysentery

Indicated for the treatment of red dysentery due to heat toxin, swollen carbuncles and furuncles, eczema, erysipelas, snake and insect bite, bloody stool, flooding and spotting (uterine bleeding) or bleeding from piles. Normally, 9–15 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose, or an appropriate amount is pounded and applied on the afflicted part externally

Its use is prohibited in patients with diarrhea due to deficiency-cold of the spleen and stomach

Brucea Fruit (ya dan zi) (Fructus Bruceae)

Initially recorded in Supplement to “The Grand Compendium of Materia Medica” (ben cao gang mu shi yi). It is the dried matured fruit of Brucea javanica (L.) Merr. of the Simaroubaceae family. It is collected when fruit is matured in autumn; after impurities are removed, it is dried under the sun

Bitter, cold, slightly poisonous; act on the large intestine and liver channels

Clear heat and resolve toxins, prevent attack of malaria, arrest dysentery; external treatment: corrode wart

Indicated for the treatment of red dysentery due to heat toxin, lingering dysentery, and various malarias. External treatment: verruca vulgaris and clavus. Normally, 0.5–2 g is wrapped with flesh of the longan fruit or encapsulated for deglutition as an oral dose, or deoiled and made into pills or tablets (not be in decoction); or an appropriate amount is used externally

It is not suitable for long-term use and taking too much. Its use is prohibited or cautious in pregnant women, children, and patients with gastric bleeding, intestinal bleeding, and liver-kidney diseases

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TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Euphorbiae Humifusae (di jin cao) (Herba Euphorbiae Humifusae)

Initially recorded in Materia Medica of the Jiayou Era (jia you ben cao). It is the dried entire plant f Euphorbia humifusa willd. or Euphorbia maculata L. of the Euphorbiaceae family. It is collected in summer and autumn; after impurities are removed, it is dried under the sun

Acrid, neutral; act on the liver and large intestine channels

Clear heat and resolve toxins, cool the blood and stanch bleeding, drain dampness and relieve jaundice

Indicated for the treatment of diarrhea and dysentery due to heat toxin or dampheat, expectoration of blood, bloody urine, blood stool, flooding and spotting (uterine bleeding) due to blood heat, sores, boils and swollen carbuncles due to heat toxin, jaundice due to dampheat, and venomous snake bite. Normally, 9–20 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in patients with blood deficiency, no blood stasis, and weakness of the spleen and stomach

Chinese Cinquefoil (wei ling cai) (Herba Potentillae Chinensis)

Initially recorded in Materia Medica for Famine Relief (jiu huang ben cao). It is the dried entire plant of Potentilla chinensis Ser. of the Rosaceae family. It is collected when stem elongates in late spring; after sediment is removed, it is dried under the sun

Bitter, cold; act on the liver and large intestine channels

Clear heat and resolve toxins, cool the blood and arrest dysentery

Indicated for the treatment of red dysentery with abdominal pain, abdominal urgency with rectal heaviness, diarrhea or lingering dysentery due to heat toxin or damp-heat, bleeding from piles, flooding and spotting (uterine bleeding) due to blood heat, or bleeding from knife wound, swollen carbuncles, and sores. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount of the fresh one is pounded for applying externally

No special contraindications

(Continued )

68 PART | I Chinese Materia Medica

TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.)

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Descolor Cinquefoil (fan bai cao) (Herba Potentillae Discoloris)

Initially recorded in Materia Medica for Famine Relief (jiu huang ben cao). It is the dried entire plant of Potentilla discolor Bge. of the Rosaceae family. It is collected before blooming in summer and autumn; after sediment and impurities are removed, it is dried

Sweet, slightly bitter, neutral; act on the liver, stomach, and large intestine channels

Clear heat and resolve toxins, arrest dysentery, and stanch bleeding

Indicated for the treatment of diarrhea, heat dysentery or red dysentery due to damp-heat, swollen carbuncles and sores, blood-spiting and nosebleed, bloody stool, flooding and spotting (uterine bleeding) due to blood heat, and cough and panting due to lung heat. Normally, 9–15 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose, or an appropriate amount is pounded for applying the afflicted part

Its use is cautious in patients with cold due to yang deficiency, or deficiency-cold of the spleen and stomach

Chinese Lobelia (ban bian lian) (Herba Lobeliae Chinensis)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried entire plant of Lobelia chinensis Lour. of the Campanulaceae family. It is collected in summer; after sediment is removed, it is washed clean and dried under the sun

Acrid, neutral; act on the heart, small intestine, and lung channels

Clear heat and resolve toxins, promote urination, and relieve edema

Indicated for the treatment of swollen carbuncles, boils, and sores due to heat toxin, snake or insect bite, abdominal tympanites and edema due to water-dampness retention, jaundice due to damp-heat, and eczema. Normally, 9–15 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is prohibited in patients with edema with a pattern of deficiency

Name of Medicinal

Caution for Use

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TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Oldenlandia (bai hua she she cao) (Herba Hedyotis Diffusae)

Initially recorded in Guangxi Chinese Materia Medica (guang xi zhong yao zhi). It is the entire plant of Oldenlandia diffusa (Willd.) Roxb. of the Rubiaceae family. It is collected in summer and autumn, washed clean, or dried under the sun and cut into segments

Slightly bitter, sweet, cold; act on the stomach, large intestine, and small intestine channels

Clear heat and resolve toxins, drain dampness, and relieve strangury

Indicated for the treatment of swollen carbuncles and sores, swelling and pain of the throat, throatmoth (tonsillitis) due to heat toxin, panting and cough due to lung heat, venomous snake bite, heat strangury, difficult and painful urination due to bladder damp-heat; and also for jaundice due to dampheat, edema, dysentery, inflammatory bowel disease, or some cancer. Normally, 15–60 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is prohibited in patients with dorsal furuncle and deficiency-cold of the spleen and stomach

Common Pleione Pseudobulb (shan ci gu) (Pseudobulbus Cremastrae seu Pleiones)

Initially recorded in Supplement to “The Materia Medica” (ben cao shi yi). It is the dried pseudobulb of Cremastra appendiculata (D.Don) Makino, Pleione bulbocodioides (Franch.) Rolfe or Pleione yunnanensis Rolfe of the Orchidaceae family. It is collected in summer and autumn; after aerial parts and sediment are removed, it is separated for size, decocted with boiling water until it is quite ripe, and dried

Sweet, slightly acrid, cool; act on the liver and spleen channels

Clear heat and resolve toxins, dissolve phlegm, and dissipate masses

Indicated for the treatment of carbuncleabscess and deeprooted boils, phlegmon, scrofula and phlegm nodule, sore throat, throat bì (pharyngitis), snake and insect bite, concretions and conglomerations (zhēng jia˘), pĭ syndrome (pĭ zhèng), injury from falling down, cirrhosis of liver, and some cancers. Normally, 3–9 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is used externally

Its use is cautious in patients with deficiency of healthy qi and the weak. It is not suitable for taking too much since it is coldcool in nature

(Continued )

70 PART | I Chinese Materia Medica

TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Bear Gallbladder (xiong dan) (Fel Ursi)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried bile of Ursus arctos Linnaeus or Selenarctos thibetanus Cuvier of the Ursidae family. The bear is hunt in summer and autumn; gallbladder is taken out and dried; after membrana dermalis is removed, it is ground into fine powder for use. Now, bile is collected from the live bear by tube drain, and dried, which is called “Bear Gall Powder”

Bitter, cold; act on the liver, gallbladder, and heart channels

Clear heat and resolve toxins, extinguish wind and arrest convulsion, clear liver heat and improve vision

Indicated for the treatment of convulsive epilepsy due to extreme heat producing wind, sores and carbuncles due to heat toxin accumulation, red eye with nebula and swelling and pain, intolerance of light and excessive tearing due to liver heat, jaundice, infantile malnutrition with accumulation, and decayed tooth pain. Normally, 0.25–0.5 g is made into pills or powder as an oral dose or an appropriate amount is used externally

Its use is prohibited in patients with deficiencycold pattern (especially deficiency-cold of the spleen and stomach)

Climbing Groundsel (qian li guang) (Herba Senecionis Scandentis)

Initially recorded in Illustrated Classic of Materia Medica (ben cao tu jing). It is the dried aerial part of Senecio scandens Buch.-Ham. of the Compositae family. It is collected in whole year; after impurities are removed, it is dried in the shade

Bitter, cold; act on the lung and liver channels

Clear heat and resolve toxins, improve vision, and drain dampness

Indicated for the treatment of swollen carbuncles and sores due to heat toxin accumulation, common cold with fever, red eye with swelling and pain due to wind heat or liver fire flaming upward, diarrhea and dysentery due to large intestine damp-heat, and eczema. Normally, 9–15 g of the dried one or 30 g of the fresh one is decocted with water as an oral dose, or an appropriate amount is decocted for washing the afflicted part

Its use is cautious in patients with deficiency-cold of the spleen and stomach

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TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Ampelopsis (bai lian) (Radix Ampelopsis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root tuber of Ampelopsis japonica (Thunb.) Makino of the Vitaceae family. It is collected in spring and autumn; after sediment and rootlet are removed, it is cut into oblique pieces or longitudinal sections and dried under the sun

Bitter, slightly cold; act on the heart and stomach channels

Clear heat and resolve toxins, relieve carbuncle and dissipate masses, close sore and engender flesh, cool the blood and stanch bleeding

Indicated for the treatment of swollen carbuncles, sores and deep-rooted boils due to heat toxin accumulation, phlegmon and scrofula due to binding constraint of phlegm fire, burn and scald, and rhagades of hand and foot; also for expectoration of blood and blood-spitting due to blood heat, sprain, and contusion. Normally, 5–10 g is decocted with water as an oral dose, or an appropriate amount is decocted for washing or ground into fine powder for applying the afflicted part

It is not suitable for patients with deficiency-cold of the spleen and stomach. It could not be used together with Radix Aconiti (chuan wu), Radix Aconiti Kusnezoffii (cao wu), and Radix Aconiti Lateralis Praeparata (fu zi)

Purple Flower Holly Leaf (si ji qing) (Folium Illics Purpureae)

Initially recorded in Supplement to “The Materia Medica” (ben cao shi yi). It is the dried leaf of I1ex chinensis Sims of the Aquifoliaceae family. It is collected in autumn and winter, and dried under the sun

Bitter, astringent, cold; act on the lung, large intestine, and bladder channels

Clear heat and resolve toxins, relieve swelling and dispel stasis, cool the blood and stanch bleeding, and close sore

Indicated for the treatment of burn and scald, eczema, sores, and ulcers due to heat toxin, cough, swelling, and pain of the throat due to lung fire invading upward, diarrhea and dysentery, heat strangury, difficult and painful urination due to heat toxin invading downward, and bleeding from trauma. Normally, 15–60 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in patients with diarrhea due to deficiency-cold of the spleen and stomach

(Continued )

72 PART | I Chinese Materia Medica

TABLE 2.7 Properties, Actions, and Application of Common Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal Mung Bean (lü dou) (Semen Phaseoli Radiati)

Property, Channel Entry

Source and Collection Initially recorded in Ri Hua-zi’s Materia Medica (ri hua zi ben cao). It is the dried seed of Phaseolus radiatus L. of the Leguminosae family. It is collected when matured after autumn; after impurities are winnowed, it is washed clean, dried under the sun, and broken into pieces or ground into powder

Sweet, cold; act on the heart and stomach channels

Efficacy and Action

Clinical Application and Usage

Clear heat and resolve toxins, relieve summer heat, and promote urination

Indicated for the treatment of swollen carbuncles and sores due to heat toxin, excessive thirst, reddish urine due to summer heat, poisoning from medicine or foods, edema and difficulty in micturition. Normally, 15–30 g is decocted with water as an oral dose, or an appropriate amount is used externally

Caution for Use Its use is prohibited in patients with diarrhea due to deficiency-cold of the spleen and stomach

2. Attached herbs (Table 2.8) TABLE 2.8 Introduction to Attached Herbs That Clear Heat and Resolve Toxins Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

It is the dried stem and branch of Lonicera japonica Thunb. of the Caprifoliaceae family. It is collected in autumn and winter, and dried under the sun

Sweet, cold; act on the lung and stomach channels

Clear heat and resolve toxins, scatter wind and unblock the collaterals

Indicated for the treatment of warm disease with fever, red dysentery, swollen carbuncles and sores and ulcers due to heat toxin, heat bì due to wind-damp with red swelling, and hot pain of the joints. Normally, 9–30 g is decocted with water as an oral dose

Its use is cautious in patients with deficiency-cold of the spleen and stomach

It is the dried flower bud or with the early blossoms of Lonicera macranthoides Hand.Mazz., Lonicera hypoglauca Miq., Lonicera Confusa DC. or Lonicera fulvotomentosa Hsu et S. C. Cheng of the Caprifoliaceae family. Before blooming in summer, it is collected and dried

Sweet, cold; act on the lung, heart, and stomach channels

Clear heat and resolve toxins, scatter and dissipate wind-heat

Indicated for the treatment of swollen carbuncles and sores, deep-rooted boils, throat bì (pharyngitis), erysipelas, red dysentery due to heat toxin, common cold due to wind-heat, and warn disease with fever. Normally, 6–15 g is decocted with water as an oral dose

Its use is cautious in patients with deficiency-cold of the spleen and stomach, sores and ulcers with yin pattern

Name of Medicinal

Source and Collection

Honeysuckle Stem (ren dong teng) (Caulis Lonicerae Japonicae)

Wild Honeysuckle Flower (shan yin hua) (Flos Lonicerae)

Caution for Use

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TABLE 2.8 Introduction to Attached Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Solidago Decurense (yi zhi huang hua) (Herba Solidaginis)

It is the dried entire plant of Solidago decurrens Lour. of the Compositae family. It is collected during the flower and fruit period in autumn, after sediment is removed, and dried under the sun

Acrid, bitter, cool; act on the lung and liver channels

Clear heat and resolve toxins, scatter and dissipate windheat

Indicated for the treatment of throat bì (pharyngitis), throat-moth (tonsillitis), swelling and pain of the throat, swollen sores and deep-rooted boils, and common cold due to wind-heat. Normally, 9–15 g is decocted with water as an oral dose

Its use is cautious in pregnant women

Turpinia Ternata Leaf (shan xiang yuan ye) (Turpiniae Folium)

It is the dried leaf of Turpinia arguta Seem. of the Staphyleaceae family. It is collected when the leaves are luxuriant in summer and autumn; after impurities are removed, it is dried under the sun

Bitter, cold; act on the lung and liver channels

Clear heat and resolve toxins, relieve sore throat, relieve swelling, invigorate blood, and relieve pain

Indicated for the treatment of throat-moth (tonsillitis) and throat bì (pharyngitis), swelling and pain of the throat, swollen sores and ulcers, and injury with pain from falling down. Normally, 15–30 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Indigoplant Leaf (liao da qing ye) (Folium Polygoni Tinctorii)

It is the dried leaf of Polygonum tinctorium Ait. of the Polygonaceae family. It is collected twice when the branches and leaves are luxuriant in summer and autumn; after stem and branch and impurities are removed, it is dried

Bitter, cold; act on the heart and stomach channels

Clear heat and resolve toxins, cool the blood, and remove maculae

Indicated for the treatment of warm disease with fever, macules and papules generated, panting and cough due to lung heat, throat bì (pharyngitis), parotic swelling (mumps), erysipelas, and swollen carbuncles. Normally, 9–15 g is decocted with water as an oral dose

Its use is prohibited in patients with deficiency-cold of the spleen and stomach

Paniculate Bolbostemma (tu bei mu) (Rhizoma Bolbostematis)

It is the dried tuber of Bolbostemma paniculatum (Maxim.) Franquet of the Cucurbitaceae family. It is collected in autumn, washed clean, broken off, decocted until no white heart, taken out, and dried under the sun

Bitter, slightly cold; act on the lung and spleen channels

Resolve toxins, dissipate masses, and relieve swelling

Indicated for the treatment of mammary abscess (acute mastitis), scrofula and phlegm nodule, warts, snake and insect bite. Normally, 5–10 g is decocted with water or made into pills or powder as an oral dose or an appropriate amount is used externally

No special contraindications

Muskroot-Like Semiaquilegia Root (tian kui zi) (Radix Semiaquilegiae)

It is the dried root tuber of Semiaquilegia adoxoides (DC.) Makino of the Ranunculaceae family. It is collected in early summer, and then washed clean; after fibrous root is removed, it is dried under the sun

Sweet, bitter, cold; act on the liver and stomach channels

Clear heat and resolve toxins, relieve swelling, and dissipate masses

Indicated for the treatment of swollen carbuncles, deep-rooted boils and sores, mammary abscess (acute mastitis), scrofula, snake and insect bite. Normally, 9–15 g is decocted with water as an oral dose

Its use is prohibited in patients with deficiency-cold of the spleen and stomach

Baphicacanthus Root (nan ban lan gen) (Rhizoma et Radix Baphicacanthis Cusiae)

It is the dried rhizome and root of Baphicacanthus cusia (Nees) Bremek. of the Acanthaceae family. It is collected in summer and autumn; after spigeal stem is removed, it is washed clean and dried under the sun

Bitter, cold; act on the heart and stomach channels

Clear heat and resolve toxins, cool the blood, and remove maculae

Indicated for the treatment of warm epidemic due to seasonal noxious pathogen, fever, sore throat, maculae generated due to warm toxin, and erysipelas. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is decocted for washing or pounded for applying the afflicted part

Its use is cautious in patients with deficiency-cold of the spleen and stomach, without excess fire

(Continued )

74 PART | I Chinese Materia Medica

TABLE 2.8 Introduction to Attached Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Ciliate Bugle Herb (jin gu cao) (Herba Ajugae Ciliatae)

It is the dried entire plant of Ajuga decumbens Thunb. of the Labiatae family. It is collected when blooming in spring; after sediment is removed, it is dried under the sun

Bitter, cold; act on the lung channel

Clear heat and resolve toxins, cool the blood and relieve swelling

Indicated for the treatment of swelling and pain of the throat, expectoration of blood due to lung heat, and injury from falling down with swelling and pain. Normally, 15–30 g is decocted with water as an oral dose, or an appropriate amount is pounded for applying the afflicted part externally

Its use is prohibited in pregnant women

Japanese Flowering Fern Rhizome (zi qi guan zhong) (Rhizoma Osmundae Japonicae)

It is the dried rhizome and petiole residue of Osmunda japonica Thunb. of the Osmundaceae family. It is collected in spring and autumn, then washed clean; after fibrous root is removed, it is dried under the sun

Bitter, slightly cold, slightly poisonous; act on the lung, stomach, and liver channels

Clear heat and resolve toxins, dispel stasis and stanch bleeding, and kill worms

Indicated for the treatment of common cold due to epidemic toxin, diarrhea and dysentery, swollen carbuncles and sores due to heat toxin, blood-spitting, nosebleed, bloody stool, flooding and spotting (uterine bleeding), abnormal vaginal discharge, and abdominal pain due to parasitic infestation. Normally, 5–9 g is decocted with water as an oral dose

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Belleric Terminalia Fruit (mao he zi) (Fructus Terminaliae Billericae)

It is the dried matured fruit of Terminalia bellirica (Gaertn.) Roxb. of the Combretaceae family. It is a habitually used medicinal in Tibetan nationality, collected when fruit is matured in winter; after impurities are removed, it is dried under the sun

Sweet, astringent, neutral; act on the stomach and liver channels

Clear heat and resolve toxins, astringe and nourish the blood, and harmonize the actions of the medicinals

Indicated for the treatment of various heat patterns, diarrhea, and dysentery, yellow-water sore, liver and gallbladder diseases, and weakness after illness. Normally, 3–9 g is often made into pills or powder as an oral dose

No special contraindications

Carduus Marianus (shui fei ji) (Fructus Silybi)

It is the dried matured fruit of Silybum marianum (L.) Gaertn. of the Compositae family. When fruit is matured in autumn, the infructescence is collected, stroked to separate fruits; after impurities are removed, it is dried under the sun

Bitter, cool; act on the liver and gallbladder channels

Clear heat and resolve toxins, soothe the liver and promote gallbladder function

Indicated for the treatment of damp-heat in the liver and gallbladder, ribside pain induced by acute or chronic hepatitis, cirrhosis of liver, cholelithiasis, cholangitis, and jaundice. It is used for dispensing patent medicine, or 6–15 g is decocted with water as an oral dose

No special contraindications

Scabrous Patrinia Root (mu tou hui) (Radix Patriniae Scabrae)

It is the dried root of Patrinia heterophylla Bunge and P. scabra Bunge of the Valerianaceae family. It is collected in autumn; after stem seedling is removed, it is dried under the sun

Acrid, bitter, slightly cold; act on the heart and liver channels

Dry dampness and arrest vaginal discharge, astringe and stanch bleeding, clear heat and resolve toxins

Indicated for the treatment of leukorrhea with red and white discharge, flooding and spotting (uterine bleeding), diarrhea and dysentery, jaundice, malaria, intestinal abscess, swollen sores, and ulcers, injury form falling down. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is pounded for applying the affected area externally

Its use is cautious in patients with deficiency-cold pattern

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TABLE 2.8 Introduction to Attached Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Asiatic Moonseed Rhizome (bei dou gen) (Rhizoma Menispermi)

It is the dried rhizome of Menispermum dauricum DC. of the Menispermaceae family. It is collected in spring and autumn; after fibrous root and sediment are removed, it is dried

Bitter, cold, slightly poisonous; act on the lung, stomach, and large intestine channels

Clear heat and resolve toxins, dispel wind and relieve pain, and drain dampness

Indicated for the treatment of swelling and pain of the throat, diarrhea and dysentery due to heat toxin accumulation, cough due to lung heat, jaundice, painful bì syndrome due to dampheat, parotic swelling (mumps), piles with swelling and pain, snake and insect bite. Normally, 3–10 g is decocted with water as an oral dose

It is not suitable for patients with deficiency-cold of the spleen and stomach

Globe Thistle Root (yu zhou lou lu) (Radix Echinopsis)

It is the dried root of Echinops latifolius Tausch. or Echinops grijisii Hance of the Compositae family. It is collected in spring and autumn; after fibrous root and sediment are removed, it is dried under the sun

Bitter, cold; act on the stomach channel

Clear heat, resolve toxins, relieve carbuncle, promote lactation, relax the sinews, and unblock the vessels

Indicated for the treatment of mammary abscess (acute mastitis) with swelling and pain, carbuncle-abscess, phlegmon, scrofula and sores, inhibited lactation, and damp bì syndrome with tendon spasm. Normally, 5–10 g is decocted with water as an oral dose

Its use is cautious in pregnant women

Immature Chebula Fruit (xi qing guo) (Fructus Terminaliae Chebulae Immaturus)

It is the dried young fruit of Terminalia chebula Retz. or Terminalia chebula Retz. var. tomentella Kurt. of the Combretaceae family. It is collected in September to October, steamed and dried under the sun

Bitter, sour, astringent, neutral; act on the lung and large intestine channels

Clear heat and promote fluid production, and resolve toxins

Indicated for the treatment of diphtheria, laryngitis, throatmoth (tonsillitis) due to yin deficiency, bacillary dysentery or enteritis. Normally, 3–6 g is decocted with water as an oral dose, or kept under tongue

Its use is prohibited in patients with sore throat due to wind-fire, and interior cold pattern

Wingedtooth Laggera Herb (chou ling dan cao) (Herba Laggerae Pterodontae)

It is the dried aerial part of Laggera pterodonta (Dc.) Benth. of the Compositae family. When stem and leaf are flourishing in autumn, it is collected and dried

Acrid, bitter, cold, poisonous; act on the lung channel

Clear heat and resolve toxins, relieve cough and dispel phlegm

Indicated for the treatment of common cold due to windheat, swelling and pain of the throat, cough due to lung heat, carbuncles and sores, burn and scald, and snake bite. Normally, 9–15 g is decocted with water as an oral dose

It is not suitable for patients with deficiency-cold of the spleen and stomach

Bearded Scutellaria (ban zhi lian) (Herba Scutellariae Barbatae)

It is the dried entire plant of Scutellaria barbata D. Don of the Labiatae family. When stem and leaf are flourishing in summer and autumn, it is collected and washed clean and dried under the sun

Acrid, bitter, cold; act on the lung, liver, and kidney channels

Clear heat and resolve toxins, dissolve stasis, and promote urination

Indicated for the treatment of swollen deep-rooted boils and sores, swelling and pain of the throat, injury from falling down with pain, edema, jaundice, snake and insect bite. Normally, 15–30 g is decocted with water as an oral dose

It is not suitable for patients with blood deficiency. Its use is cautious in pregnant women

Acaulescent Pegaeophyton Root (gao shan la gen cai) (Pegaeophyti Radix et Rhizoma)

It is the dried root and rhizome of Pegaeophyton scapiflorum (Hook.f.et Thoms.) Marq. et Shaw of the Cruciferae family. It is collected in autumn; after fibrous root and sediment are removed, it is dried under the sun

Bitter, acrid, cold; act on the lung and liver channels

Clear heat and resolve toxins, clear lung heat and relieve cough, stanch bleeding, and relieve edema

Indicated for the treatment of warm disease with fever, cough due to lung heat, expectoration of blood, bleeding from trauma, and edema of the four limbs. Normally, 3–6 g is decocted with water or made into pills or powder as an oral dose and an appropriate amount is ground into powder for applying the afflicted part externally

Its use is cautious in patients with deficiency-cold of the spleen and stomach

(Continued )

76 PART | I Chinese Materia Medica

TABLE 2.8 Introduction to Attached Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Decumbent Bugle Herb (bai mao xia ku cao) (Herba Ajugae Decumbentis)

It is the dried entire plant of Ajuga decumbens Thunb. of the Labiatae family. It is collected when blooming in spring and summer; after sediment is removed, it is dried under the sun

Bitter, sweet, cold; act on the lung and liver channels

Clear heat, relieve cough and dissolve phlegm, cool the blood, relieve swelling, and resolve toxins

Indicated for the treatment of tracheitis, blood-spitting, nosebleed, red dysentery, strangury, swelling and pain of the throat, deep-rooted boils, sores, swollen carbuncles, and injury from falling down. Normally, 10–30 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose, or an appropriate amount is pounded for applying the afflicted part externally

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Ovateleaf Holly Bark (jiu bi ying) (Cortex Ilicis Rotundae)

It is the dried bark or root bark of Ilex rotunda Thunb. of the Aquifoliaceae family. It is collected in summer and autumn, and dried under the sun

Bitter, cold; act on the lung, stomach, large intestine, and liver channels

Clear heat and resolve toxins, drain dampness, and relieve pain

Indicated for the treatment of fever from summer heat-damp, swelling and pain of the throat, diarrhea and dysentery due to damp-heat, distending pain in the stomach cavity and abdomen, painful bì syndrome due to winddamp, eczema, sores and boils, and injury from falling down. Normally, 9–30 g is decocted with water as an oral dose, or an appropriate amount is decocted and concentrated for applying the afflicted part externally

It is not suitable for patients with a pattern of yin deficiency and internal heat

Mung Bean Skin (lü dou yi) (Testa Glycinis)

It is the dried seed coat of Phaseolus radiatus L. of the Leguminosae family. Mung bean is soaked in clear water, and its skin is taken out; after impurities are removed, it is dried under the sun

Sweet, cold; act on the heart and stomach channels

Clear summer heat to quench thirst, promote urination, resolve toxin, and remove nebula

Indicated for the treatment of excessive thirst due to summer heat, diarrhea, dysentery, edema, swollen carbuncles, erysipelas, and nebula generated in the eyes. Normally, 9–30 g is decocted with water or ground into powder as an oral dose; and an appropriate amount is ground into powder for applying or decocted for washing the afflicted part externally

Patients with deficiency-cold of constitution should not use it for a long-term

Black Soybean (hei dou) (Semen Sojae Nigrum)

It is the dried matued seed of Glycine max (L.) Merr. of the Leguminosae family. The matured fruit is collected in autumn and dried under the sun, stroked to separate seeds, then, impurities are removed

Sweet, neutral; act on the spleen and kidney channels

Invigorate the blood and promote urination, dispel wind and resolve toxins, fortify the spleen and boost the kidney

Indicated for the treatment of edema with distention and fullness sensation, weak foot due to wind-toxin, jaundice with puffiness, lumbar pain due to kidney deficiency, enuresis, wind bì disease with tendon spasm, postpartum convulsive disease, lockjaw, swollen carbuncles and sores, and poisoning from medicine or foods. Normally, 9–30 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is used externally

Its use is cautious in patients with abdominal distention and diarrhea due to spleen deficiency

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TABLE 2.8 Introduction to Attached Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Bunge Corydalis Herb (ku di ding) (Herba Corydalis Bungeanae)

It is the dried entire plant of Corydalis bungeana Turcz. of the Papaveraceae family. It is collected during the flower and fruit period in summer; after impurities are removed, it is dried under the sun

Bitter, cold; act on the heart, liver, and large intestine channels

Clear heat and resolve toxins, dissipate masses, and relieve swelling

Indicated for the treatment of epidemic common cold, swelling, and pain of the throat, swollen deep-rooted boils and sores, carbuncle-abscess and phlegmon, parotic swelling (mumps), and erysipelas. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is decocted for washing the afflicted part externally

Patients with deficiency-cold of constitution should not use it for a long-term

Common Picria Herb (ku xuan shen) (Herba Picriae Fel-terrae)

It is the dried entire plant of Picria fel-terrae Lour. of the Scrophulariaceae family. It is collected in autumn; after impurities are removed, it is dried under the sun

Bitter, cold; act on the lung, stomach, and liver channels

Clear heat and resolve toxins, relieve swelling and pain

Indicated for the treatment of common cold due to wind-heat, swelling and pain of the throat, throat bì (pharyngitis), parotic swelling (mumps), pain in the stomach cavity and abdomen, dysentery, injury from falling down, swollen boils, and venomous snake bite. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in patients with deficiencycold of body constitution

Chingma Abutilon Seed (qing ma zi) (Semen Abutili)

It is the dried matured seed of Abutilon theophrasti Medic. of the Malvaceae family. The matured fruit is collected in autumn and dried under the sun, stroked to separate seed, then impurities are removed

Bitter, neutral; act on the large intestine, small intestine, and bladder channels

Clear heat and resolve toxins, drain dampness, and remove nebula

Indicated for the treatment of dysentery with red and white feces, difficult and painful strangury, swollen carbuncles and sores, and eye with nebula. Normally, 6–12 g is decocted with water or made into powder as an oral dose

No special contraindications

Alpine Yarrow Herb (shi cao) (Herba Achilleae Alpinae)

It is the dried aerial part of Achillea alpina L. of the Compositae family. It is collected when blooming in summer and autumn; after impurities are removed, it is dried in the shade

Bitter, sour, neutral; act on the lung, spleen, and bladder channels

Resolve toxins and drain dampness, invigorate blood, and relieve pain

Indicated for the treatment of throat-moth (tonsillitis) and sore throat, diarrhea and dysentery, abdominalgia with intestinal abscess, difficult and painful heat strangury, abnormal vaginal discharge due to damp-heat, snake and insect bite. Normally, 15–45 g is decocted with water as an oral dose. If necessary, take two doses a day

Its use is cautious in pregnant women and the weak

Blush Red Rabdosia (dong ling cao) (Herba Rabdosiae Rubescentis)

It is the dried aerial part of Rabdosia rubescenss (Hemsl.) Hara of the Labiatae family. When stem and leaf are flourishing in summer and autumn, it is collected and dried under the sun

Bitter, sweet, slightly cold; act on the lung, stomach, and liver channels

Clear heat and resolve toxins, invigorate blood, and relieve pain

Indicated for the treatment of swelling and pain of the throat, concretions and conglomerations (zhēng jia˘), pĭ syndrome (pĭ zhèng), snake and insect bite. Normally, 3060 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in patients with aversion to cold due to deficiencycold of body constitution

(Continued )

78 PART | I Chinese Materia Medica

TABLE 2.8 Introduction to Attached Herbs That Clear Heat and Resolve Toxins (cont.)

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Coral Ardisia Root (zhu sha gen) (Radix Ardisiae Crenatae)

It is the dried root of Ardisia crenata Sims of the Myrsinaceae family. It is collected in autumn and winter, washed clean, and dried under the sun

Slightly bitter, acrid, neutral; act on the lung and liver channels

Resolve toxins and relieve swelling, invigorate blood, and relieve pain

Indicated for the treatment of swelling and pain of the throat, painful bì syndrome due to winddamp-heat, jaundice, dysentery, breast pain (mastitis), and injury from falling down. Normally, 3–9 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is cautious in pregnant women

Garden Euphorbia Herb (fei yang cao) (Herba Euporbiae Hirtae)

It is the dried entire plant of Euphorbia hirta L. of the Euphorbiaceae family. It is collected in summer and autumn, washed clean and dried under the sun

Acrid, sour, cool, slightly poisonous; act on the lung, bladder, and large intestine channels

Clear heat and resolve toxins, drain dampness and relieve itching, and promote lactation

Indicated for the treatment of lung abscess, mammary abscess, swollen deep-rooted boils and sores, ulcerative gingivitis, dysentery and diarrhea, heat strangury, bloody urine, eczema, tinea pedis, itch of skin, and postpartum hypogalactia. Normally, 6–9 g is decocted with water as an oral dose, or an appropriate amount is decocted for washing externally

Its use is cautious in pregnant women

Polygonum Perfoliatum (gang ban gui) (Polygoni Perfoliati Herba)

It is the dried aerial part of Polygonum perfoliatum L. of the Polygonaceae family. It is collected when blooming in summer, and dried under the sun

Sour, slightly cold; act on the lung and bladder channels

Clear heat and resolve toxins, promote urination to relieve edema, and relieve cough

Indicated for the treatment of swelling and pain of the throat, cough due to lung heat, infantile whooping cough, edema, scanty urine, diarrhea due to damp-heat, eczema, swollen boils, snake and insect bite. Normally, 15–30 g is decocted with water as an oral dose, or an appropriate amount is decocted for washing the affected area

Its use is cautious in pregnant women and the weak

Shorttube Lagotis Herb (hong lian) (Herba Lagotidis Brevitubae)

It is the dried entire plant of Lagotis brevituba Maxim. of the Scrophulariaceae family. It is a habitually used medicinal in Tibetan nationality, and collected when blooming in summer and autumn; after impurities are removed, it is washed clean and dried in the shade

Bitter, sweet, cold; act on the lung, heart, and liver channels

Clear heat and resolve toxins, drain dampness, calm the liver, move blood, and regulate menstruation

Indicated for the treatment of fever, excessive thirst, cough due to lung heat, headache and dizziness, jaundice due to dampheat, menstrual irregularities, and poisoning from medicine and foods. Normally, 1–6 g is decocted with water as an oral dose

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Common Fibraurea Stem (huang teng) (Caulis Fibraufeae)

It is the dried rattan of Fibraurea recisa Pierre. of the Menispermaceae family. It is collected in autumn and winter, then cut into segments and dried under the sun

Bitter, cold, act on the heart and liver channels

Clear heat and resolve toxins, drain fire and promote defecation

Indicated for the treatment of constipation, diarrhea and dysentery, swelling and pain of the throat, red eye with swelling, swollen carbuncles and sores due to exuberance of heat toxin. Normally, 30–60 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Name of Medicinal

Caution for Use

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TABLE 2.8 Introduction to Attached Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal

Source and Collection

Indian Quassia Wood (ku mu) (Ramulus et Folium Picrasmae)

It is the dried branch and leaf of Picrasma quassioides (D.Don) of the Simaroubaceae family. It is collected in summer and autumn, and then dried

Bistort Rhizome (ren gong niu huang) (Calculus Bovis Artifactus)

It is the processed product of bilein, colalin, hyodeoxycholic acid, taurine, bilirubin, cholesterol, and microelement

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Bitter, cold, slightly poisonous; act on the lung and large intestine channels

Clear heat and resolve toxins and dispel dampness

Indicated for the treatment of common cold due to wind-heat, swelling and pain of the throat, diarrhea and dysentery due to damp-heat, eczema, sores and boils, snake and insect bite. Normally, 3–4.5 g of the branch or 1–3 g of the leaf is decocted with water as an oral dose, and an appropriate amount is used externally

It should not be taken too much for oral use. Its use is cautious in pregnant women

Sweet, cool; act on the heart and liver channels

Clear heat and resolve toxins, dissolve phlegm and arrest convulsion

Indicated for the treatment of delirium and mania due to phlegm-heat, coma, acute infantile convulsion, swelling and pain of the throat, sore in mouth and tongue, swollen carbuncles, deep-rooted boils and sores. Normally, 0.15–0.35 g is used for dispensing prescription, or an appropriate amount is used for applying the afflicted part

Its use is cautious in pregnant women

Caution for Use

3. Herb differentiation (Table 2.9) TABLE 2.9 Differentiation Between Similar Efficacy Herbs That Clear Heat and Resolve Toxins Name of Medicinal Similarity

Differences

Japanese Honeysuckle Flower (jin yin hua) (Flos Lonicerae Japonicae)

Both are cold-cool in nature, act on the lung and heart channels, and can clear heat and resolve toxins, scatter and dissipate wind-heat, not only vent heat through the exterior, but also clear interior heat. They often combine with each other to treat externally-contracted wind-heat, warm disease in the initial stage, sores and ulcers due to heat toxin in order to reinforce their effects

It has a better effect of scattering and dissipating exterior heat. If it is dry-fried until charred, its effects of cooling the blood and arresting dysentery will be strengthened, and is good at treating red dysentery with pus and blood due to heat toxin. It also can be used for the treatment of swelling and pain of the throat, infantile summer carbuncles and prickly heat

All three medicinals come from the same plant: Folium Isatidis (da qing ye) is the leaf of Isatis indigotica Fort., Radix Isatidis (ban lan gen) is the root of Isatis indigotica Fort. and Indigo Naturalis (qing dai) is the processed powder of the leaf or cauline leaf of Isatis indigotica Fort. or Baphicacanthus cusia (Nees) Bremek. or Polygonum tinctorium Ait. All three can clear heat and resolve toxins, cool the blood and remove maculae

It acts on the heart and stomach channels, also act on the blood aspect, has more better effects of cooling the blood and removing maculae, and is good at treating pestilent maculae due to heat entering nutrient-blood

Weeping Forsythia Capsule (lian qiao) (Fructus Forsythiae)

Indigowoad Leaf (da qing ye) (Folium Isatidis) Isatis Root (ban lan gen) (Radix Isatidis) Natural Indigo (qing dai) (Indigo Naturalis)

It has stronger effects of clearing heart heat and resolving toxins, is good at treating abscesses (carbuncles) and dissipating masses, is a super medicinal for patient susceptible to ulcer, and can also treat scrofula and phlegm nodule. It also has the effects of clearing heart heat and promoting urination, and can be used for heat strangury, difficult and painful urination due to damp-heat accumulation

Its effects of clearing blood heat and resolving heat toxin are stronger than that of Folium Isatidis (da qing ye). It is good at resolving toxins and relieving sore throat and dissipating masses It acts on the liver and lung channels, and has better effects of clearing the liver fire and arresting convulsion, and also can drain lung heat, and treat cough with bloody sputum and chest pain due to liver fire invading the lung, and convulsive epilepsy due to summer heat

(Continued )

80 PART | I Chinese Materia Medica

TABLE 2.9 Differentiation Between Similar Efficacy Herbs That Clear Heat and Resolve Toxins (cont.) Name of Medicinal Similarity

Differences

Wild Chrysanthemum Flower (ye ju hua) (Flos Chrysanthemi Indici)

It is bitter and acrid in flavor and cold in nature, has stronger effects of clearing heat and resolving toxins than that of Flos Chrysanthemi (ju hua), and also can relieve sore throat. It is good at treating carbuncleabscess, deep-rooted boils, swelling and pain of the throat due to heat toxin accumulation. And it also can treat eczema and itch of the skin

Chrysanthemum Flower (ju hua) (Flos Chrysanthemi)

Both are bitter and acrid in flavor and slightly cold in nature, act on the liver channel, not only clear heat and resolve toxins for the treatment of swollen carbuncles, boils, and sores, and erysipelas with swelling and pain due to heat toxin accumulation, but also clear liver heat for the treatment of red eye with swelling and pain due to liver fire or wind-heat invading upward, headache and dizziness due to liver fire flaming upward

It is one of the acrid-cool medicinals that release the exterior, its effect of resolving toxins is not as good as that of Flos Chrysanthemi Indici (ye ju hua). It has better effects of scattering and dissipating wind-heat, calming the liver and improving vision, and also can boost the liver yin. So it is good at treating common cold due to wind-heat, or warm disease in the initial stage with fever and headache, blurred vision due to liver-kidney deficiency, dizziness and headache due to hyperactivity of liver yang, and convulsion due to liver heat

SECTION 4  HERBS THAT CLEAR HEAT AND COOL THE BLOOD Outline Medicinals that mainly treat patterns of heat in nutrient/blood aspect through clearing heat and cooling the blood are called “herbs that clear heat and cool the blood.” Medicinals in this section are basically bitter in flavor and cold in nature, or salty in flavor and cold in nature, and partial to acting on the blood aspect to clear heat, and mostly act on the heart and liver channels. On account of the heart governs the blood, nutrient qi communicates with the heart, and the liver stores the blood, medicinals in this section have the effects of clearing and resolving pathogenic heat in nutrient and blood aspects, and mainly treat excess heat patterns of the nutrient aspect and blood aspect, such as warm febrile disease with heat invading the nutrient aspect, heat scorching nutrient yin, and the heart spirit being harassed, symptoms of crimson tongue, fever aggravated at night, vexation and sleeplessness, thready and rapid pulse, even coma and delirium, and faintly visible macules and papules may occur; if heat invading the pericardium, symptoms of coma and delirium, tongue moving in difficulty and cold of the four limbs, and crimson tongue may be seen; if exuberant heat forcing the blood, the heart spirit being harassed, symptoms of deep purple-red tongue, blood-spitting and nosebleed, bloody urine and bloody stool, macular eruption being dark-purple, impatience and restlessness, even confusion and mania may occur. Herbs in this category can also be used for the treatment of blood-heat bleeding syndrome caused by other diseases. If treating the pattern of blazing of both qi and blood, they can combine with herbs that clear heat and drain fire to clear both qi and blood heat.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 2.10)

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TABLE 2.10 Properties, Actions, and Application of Common Herbs That Clear Heat and Cool the Blood Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Rehmannia (sheng di huang) (Radix Rehmanniae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the fresh or dried root tuber of Rehmannia glutinosa Libosch. of the Scrophulariaceae family. It is collected in autumn; after head of root, fibrous root, and sediment are removed, it is used freshly or baked until 80% is dry

Sweet, bitter, cold; act on the heart, liver, and kidney channels

Clear heat and cool the blood, nourish yin and promote fluid production

Indicated for the treatment of crimson tongue, excessive thirst due to heat entering nutrient-blood, macules and papules due to warm toxin, bloodspitting and nosebleed due to blood heat, steaming bone fever and over-strained fever due to febrile disease damaging yin, fever due to yin deficiency, thirst and constipation due to fluid consumption, and wasting-thirst (xia¯o kĕ ) due to internal heat. Normally, 10–15 g of the dried one or 20–30 g of the fresh one is decocted with water as an oral dose

It is not suitable for patients with abdominal fullness and thin, unformed stool due to spleen deficiency and dampness stagnation

Figwort Root (xuan shen) (Radix Scrophulariae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Scrophularia ningpoensis Hemsl. of the Scrophulariaceae family. It is collected when stem and leaf are wilted in winter; after rhizome, young bud and sediment are removed, it is dried under the sun or baked until 50% is dry, stacked for 3–6 days, again and again until it is dry

Sweet, bitter, salty, slightly cold; act on the lung, stomach, and kidney channels

Clear heat and cool the blood, enrich yin and subdue fire, resolve toxins and dissipate masses

Indicated for the treatment of macules and papules, crimson tongue and excessive thirst due to warm pathogen entering nutrient-blood and warm toxin, constipation, steaming bone fever and overstrained cough due to febrile disease damaging yin and fluid consumption, red eyes, sore-throat, diphtheria, swollen carbuncles, and sores. Normally, 9–15 g is decocted with water as an oral dose

It is not suitable for patients with less eating and thin, unformed stool due to deficiency-cold of the spleen and stomach. It antagonizes Radix et Rhizoma Veratri Nigri (li lu)

(Continued )

82 PART | I Chinese Materia Medica

TABLE 2.10 Properties, Actions, and Application of Common Herbs That Clear Heat and Cool the Blood (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Tree Peony Bark (mu dan pi) (Cortex Moutan)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root bark of Paeonia suffruticosa Andr. of the Ranunculaceae family. The root is collected in autumn; after rootlet and sediment are removed, root bark is peeled off and dried under the sun

Bitter, acrid, slightly cold; act on the heart, liver, and kidney channels

Clear heat and cool the blood, invigorate blood and dissolve stasis

Indicated for the treatment of macules and papules due to heat entering nutrient-blood and warm toxin, spitting of blood and nosebleed due to blood heat, fever due to yin deficiency, night fever abating at dawn, absence of sweating, steaming bone fever due to warm disease damaging yin, menstrual block and painful menstruation due to blood stagnation, injury from falling down, swollen carbuncles and sores. Normally, 6–12 g is decocted with water as an oral dose

Its use is cautious in patients with body cold due to blood deficiency or profuse menstruation and pregnant women

Red Peony Root (chi shao) (Radix Paeoniae Rubra)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the dried root of Paeonia lactiflora Pall. or Paeonia veitchii Lynch of the Ranunculaceae family. It is collected in spring and autumn; after rhizome, fibrous root and sediment are removed, it is dried under the sun

Bitter, slightly cold; act on the liver channel

Clear heat and cool the blood, dissipate blood stasis and relieve pain

Indicated for the treatment of macules and papules due to heat entering nutrientblood and warm toxin, blood-spitting and nosebleed due to blood heat, swollen sores and ulcers, red eye with swelling and pain, liver-depressed hypochondriac pain, menstrual block and painful menstruation, concretions and conglomerations (zhēng jia˘) with abdominal pain, and injury from falling down. Normally, 6–12 g is decocted with water as an oral dose

Its use is cautious in patients with carbuncleabscess broken, blood deficiency, and no blood stasis. It should not be used together with Radix et Rhizoma Veratri Nigri (li lu)

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TABLE 2.10 Properties, Actions, and Application of Common Herbs That Clear Heat and Cool the Blood (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Arnebia Root (zi cao) (Radix Arnebiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Arnebia euchroma (Royle) Johnst. or Arnebia guttata Bunge of the Boraginaceae family. It is collected in spring and autumn; after sediment is removed, it is dried

Sweet, salty, cold; act on the heart and liver channels

Clear heat and cool the blood, invigorate blood and resolve toxins, promote eruption of papules and remove macules

Indicated for the treatment of purple dark macules and papules, measles without adequate eruption due to warm disease with blood heat and exuberance of toxin, swollen carbuncles, sores and ulcers, eczema due to heat toxin, burn and scald Normally, 5–10 g is decocted with water as an oral dose, or an appropriate amount is decocted into paste or soaked in vegetable oil for applying the affected area externally

Its use is cautious in patients with diarrhea due to weakness of the stomach and intestine

Buffalo Horn (shui niu jiao) (Cornu Bubali)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the horn of Bubalus bubalis Linnaeus of the Bovidae family. It is collected, boiled with water; after horn tampon is removed, it is dried

Bitter, cold; act on the heart and liver channels

Clear heat and cool the blood, resolve toxins, and arrest convulsion

Indicated for the treatment of high fever, coma and delirium, infantile convulsion, and mania due to warm disease with heat invading the blood aspect, macules and papules generated, blood-spitting and nosebleed due to blood heat, swollen carbuncles, sores, and ulcers. Normally, 15–30 g is decocted with water as an oral dose. It should be decocted first for more than 3 h

Its use is prohibited in patients with deficiency-cold of the spleen and stomach. If overdose, epigastric discomfort, nausea, abdominal distention and poor appetite may occur

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2. Attached herbs (Table 2.11)

TABLE 2.11 Introduction to Attached Herbs That Clear Heat and Cool the Blood Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Shellac (zi cao rong) (Lacca)

It is the dried colloid substance secreted on the tree by Laccifer Lacca Kerr. of the Kerriidae family. It is collected during July to August, and placed in a cool, ventilated and dry place until dry

Bitter, cold; act on the lung and liver channels

Clear heat, cool the blood, and resolve toxins

Indicated for the treatment of measles and macules and papules without adequate eruption, swollen sores and ulcers, and eczema, uterine bleeding, and profuse menstruation. Normally, 3–10 g is decocted with water or 1.5–6 g is ground into powder as an oral dose, or an appropriate amount is used externally

Its use is cautious in pregnant women

Glabrous Sarcandra (zhong jie feng) (Herba Sarcandrae)

It is the dried entire plant of Sarcandra glabra (Thunb.) Nakai of the Chloranthaceae family. It is collected in summer and autumn; after impurities are removed, it is dried under the sun

Bitter, acrid, neutral; act on the heart and liver channels

Clear heat and cool the blood, invigorate blood and remove macules, dispel wind and unblock the collaterals

Indicated for the treatment of macules and papules generated due to blood heat, painful bì disease due to wind-damp, injury from falling down, painful menstruation, and postpartum abdominal pain due to blood stasis and stagnation. Normally, 9–30 g is decocted first with water as an oral dose, or soaked in wine, or an appropriate amount is used externally

Its use is prohibited in pregnant women and patients with vigorous fire due to yin deficiency

Emblic Leafflower Fruit (yu gan zi) (Fructus Phyllanthi)

It is the dried matured fruit of Phyllanthus emblica L. of the Euphorbiaceae family. It is a habitually used medicinal in Tibetan nationality, and collected during the winter to next year spring; after impurities are removed, it is dried under the sun

Sweet, sour, astringent, cool; act on the lung, liver, spleen, and stomach channels

Clear heat and cool the blood, promote digestion and fortify the stomach, promote fluid production and relieve cough

Indicated for the treatment of the pattern of blood heat or blood stasis, indigestion, abdominal distention, fever from common cold, cough, sore throat, diphtheria, dry mouth, and excessive thirst. Normally, 3–9 g is often made into pills or powder as an oral dose

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Halite (da qing yan) (Halitum)

It is the lake salt crystalline solid of the halides Halitum family. It mainly contains sodium chloride (NaCl). It is collected from saline lake; after impurities are removed, it is dried

Salty, cold; act on the heart, kidney, and bladder channels

Clear heat and cool the blood, improve vision, and moisten dryness

Indicated for the treatment of blood-spitting, bloody urine, swelling and pain or bleeding of the gingiva, red eye with swelling and pain, red ulcerated eyelid, and constipation. Normally, 1.2– 2.5 g is decocted with water or made into pills or powder as an oral dose or an appropriate amount is used externally

Its use is prohibited in patients with edema

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3. Herb differentiation (Table 2.12)

TABLE 2.12 Differentiation Between Similar Efficacy Herbs That Clear Heat and Cool the Blood Name of Medicinal

Similarity

Differences

Rehmannia (sheng di huang) (Radix Rehmanniae)

Both can clear heat and cool the blood, nourish yin and promote fluid production, are indicated for the treatment of the patterns of heat entering nutrientblood, febrile disease damaging yin, yin deficiency and internal heat. They often combine with each other to reinforce the effect

It has better effects of clearing heat and cooling the blood than that of Radix Scrophulariae (xuan shen), and is more used for the treatment of bleeding due to blood heat, wasting-thirst (xia¯o kĕ) due to internal heat

Both come from Radix Rehmanniae (di huang) of the Scrophulariaceae family, and are bitter and sweet in flavor, cold and moistening in nature, can clear heat and cool the blood, enrich yin and promote fluid production, and moisten the intestines to promote defecation, and treat high fever and coma due to heat entering nutrient-blood, purple black macules due to warm toxin, blood-spitting, nosebleed, bloody stool, flooding and spotting (uterine bleeding) due to blood heat, steaming bone fever and tidal fever due to invalidism damaging yin, wasting-thirst (xia¯o kĕ) due to internal heat and constipation due to yin deficiency and intestinal dryness

Fresh Rehmannia has more juice, its bitter outweighs its sweet in flavor, and has better effects of clearing heat and cooling the blood and promoting fluid production, and is more used for the treatment of patients with body fluid consumption due to exuberant heat

Figwort Root (xuan shen) (Radix Scrophulariae) Fresh Rehmannia (xian di huang) (Radix Rehmanniae Recens) Dried Rhemannia (gan di huang) (Radix Rehmanniae Recens)

It has stronger effects of draining fire and resolving toxins than that of Radix Rehmanniae (sheng di huang), and is commonly used for the treatment of swelling and pain of the throat, and scrofula due to phlegm-fire

Dried Rhemannia is moistening in nature, its sweet outweighs its bitter in flavor, and its effect of clearing heat is slightly less than that of Fresh Rehmannia, but is good at enriching yin, and more used for the treatment of yin deficiency and internal heat, steaming bone fever and tidal fever

SECTION 5  HERBS THAT CLEAR HEAT FROM DEFICIENCY Outline Medicinals in this section are basically cold and cool in nature, and partial to entering the yin level, and mainly have clearing deficiency-heat and relieving steaming bone fever as the main actions, and are indicated for the treatment of deficiencyheat syndrome with steaming bone fever, tidal fever, afternoon fever, feverish feeling in palms and soles, deficient restlessness and sleeplessness, night sweat and seminal emission, red tongue with slight coating, thready and rapid pulse caused by liver-kidney yin deficiency, and deficiency fire harassing the interior; and deficiency-heat syndrome with night fever abating at dawn, fever abated with absence of sweating, crimson tongue, thready and rapid pulse caused by pathogenic heat abated incompletely, damaging yin and consuming body fluids in later stage of warm febrile disease. Herbs in this category can also be used for the treatment of excess-heat syndrome. When using this section’s medicinals, herbs that clear heat and cool the blood, and herbs that clear heat and nourish yin are often selected to combine to treat the root and branch simultaneously.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 2.13)

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TABLE 2.13 Properties, Actions, and Application of Common Herbs That Clear Heat From Deficiency Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sweet Wormwood (qing hao) (Herba Artemisiae Annuae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried aerial part of Artemisia annua L. of the Compositae family. It is collected when flower will open in summer and autumn; after old stem is removed, it is dried in the shade

Bitter, acrid, cold; act on the liver and gallbladder channels

Clear deficiency heat, relieve steaming bone fever, resolve summer heat, prevent attack of malaria, and relieve jaundice

Indicated for the treatment of night fever abating at dawn due to warm pathogen damaging yin, fever due to yin deficiency, steaming bone fever and over-strained fever, fever and thirst due to externally-contracted summer heat, chills and fever due to malaria, and jaundice due to damp-heat. Normally, 6–12 g is decocted with water as an oral dose, but it should be added later, or the fresh is wringed to extract the juice for taking orally

Its use is prohibited in patients with diarrhea due to weakness of the spleen and stomach

Swallow-Wort Root (bai wei) (Radix et Rhizoma Cynanchi Atrati)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root and rhizome of Cynanchum atratum Bge. or Cynanchum versicolor Bge. of the Asclepiadaceae family. It is collected in spring and autumn, and then washed clean and dried

Bitter, salty, cold; act on the stomach, liver and kidney channels

Clear deficiency heat and cool the blood, promote urination and relieve strangury, resolve toxins and cure sores

Indicated for the treatment of fever due to warm pathogen damaging nutrient qi, fever due to yin deficiency, steaming bone fever and over-strained fever, postpartum fever due to blood deficiency, heat strangury, blood strangury, swollen sores and carbuncles, snake bite, swelling and pain of the throat. Normally, 5–10 g is decocted with water as an oral dose

It is not suitable for patients with eating lessening and thin, unformed stool due to deficiency-cold of the spleen and stomach

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TABLE 2.13 Properties, Actions, and Application of Common Herbs That Clear Heat From Deficiency (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chinese Wolfberry Root-Bark (di gu pi) (Cortex Lycii)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root bark of Lycium chinense Mill. or Lycium barbarum L. of the Solanaceae family. The root is collected in early spring or after autumn, and then washed clean; root bark is peeled off and dried under the sun

Sweet, cold; act on the lung, liver, and kidney channels

Cool the blood relieve steaming bone fever, clear lung heat and subdue fire, and promote fluid production to quench thirst

Indicated for the treatment of tidal fever, night sweat, and steaming bone fever due to yin deficiency, cough due to lung heat, expectoration of blood, nosebleed and bloody urine due to blood heat, and wasting-thirst (xia¯o kĕ) due to internal heat. Normally, 9–15 g is decocted with water as an oral dose

It is not suitable for patients with fever due to externally contracted windcold and thin, unformed stool due to spleen deficiency

Starwort Root (yin chai hu) (Radix Stellariae)

Initially recorded in Supplement to “The Grand Compendium of Materia Medica” (ben cao gang mu shi yi). It is the dried root of Stellaria dichotoma L. var. 1anceolata Bge. of the Caryophyllaceae family. It is collected when plant is germinated during the spring and summer or stem and leaves are wilted after autumn; after residual stem, fibrous root, and sediment are removed, it is dried under the sun

Sweet, slightly cold; act on the liver and stomach channels

Clear deficiency heat, and eliminate fever in infantile malnutrition

Indicated for the treatment of fever due to yin deficiency, steaming bone fever and over-strained fever, tidal fever, and night sweat, and infantile malnutrition with fever due to dyspeptic retention or worm accumulation. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in patients with externally contracted wind-cold and blood deficiency without fever

(Continued )

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TABLE 2.13 Properties, Actions, and Application of Common Herbs That Clear Heat From Deficiency (cont.) Name of Medicinal Figwortflower Picrorhiza Rhizome (hu huang lian) (Rhizoma Picrorhizae)

Property, Channel Entry

Source and Collection Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried rhizome of Picrorhiza scrophulariiflora Pennell of the Scrophulariaceae family. It is collected in autumn; after fibrous root and sediment are removed, it is dried under the sun

Bitter, cold; act on the liver, stomach, and large intestine channels

Efficacy and Action

Clinical Application and Usage

Withdraw deficiency heat, eliminate fever in infantile malnutrition, clear heat and dry dampness, drain fire and resolve toxins

Indicated for the treatment of steaming bone fever and tidal fever due to yin deficiency, infantile malnutrition with fever, diarrhea and dysentery, jaundice and reddish urine due to dampheat, blood-spitting, nosebleed, piles with swelling and pain, red eye with swelling and pain, swollen carbuncles and sores. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder

Caution for Use Its use is cautious in patients with deficiency-cold of the spleen and stomach, or the weak

2. Herb differentiation (Table 2.14)

TABLE 2.14 Differentiation Between Similar Efficacy Herbs That Clear Heat From Deficiency Name of Medicinal

Similarity

Differences

Starwort Root (yin chai hu) (Radix Stellariae)

Both are slightly cold in nature and have the effect of abating fever

Radix Stellariae (yin chai hu) comes from the caryophyllaceae plants. It is acrid and sweet in flavor and acts on the liver and stomach channels, and has the specialized effects of abating deficiency-heat, eliminating fever in infantile malnutrition, and can boost yin, and is indicated for the treatment of fever due to yin deficiency, steaming bone fever and tidal fever, and infatile malnutrition with fever

Bupleurum (chai hu) (Radix Bupleuri)

Figwortflower Picrorhiza Rhizome (hu huang lian) (Rhizoma Picrorhizae) Coptis Rhizome (huang lian) (Rhizoma Coptidis)

Radix Bupleuri (chai hu) comes from the umbelliferae plants. It is bitter and acrid in flavor and acts on the liver and gallbladder channels, and has the specialized effects of scattering and dissipating and abating fever, soothing the liver and resolving constraint, raising yang and lifting the sunken, and preventing attack of malaria, and is indicated for the treatment of shaoyang syndrome with cold-heat, common cold with fever, ribside pain due to liver constraint, or menstrual irregularities, chronic diarrhea and prolapse of the rectum and prolapse of the uterus due to sinking of center qi, cold and heat from malaria Both are bitter in flavor and cold in nature, can clear heat and dry dampness and resolve toxins, and treat various patterns of damp-heat and fire toxin

Rhizoma Picrorhizae (hu huang lian) comes from the scrophulariaceae plants. It is sinking and descending in nature. It also can abate deficiency-heat and eliminate fever in infantile malnutrition. It is good at treating damp-heat and fire toxin in the middle and lower jiao, steaming bone fever and tidal fever, and infantile malnutrition with fever Rhizoma Coptidis (huang lian) comes from the ranunculaceae plants, is exceedingly bitter in flavor and exceedingly cold in nature, and its efficacy is quite stronger. It is specialized in clearing heat and drying dampness, draining fire and resolving toxins, its actions is partial to the heart and middle jiao and it is good at clearing the heart fire and eliminating damp-heat. So it is more used for the treatment of severe syndromes caused by damp-heat and fire toxin

Chapter 3

Herbs That Drain Downward Chapter Outline Section 1 Herbs That Promote Defecation by Purgation Outline Specific Application Knowledge of Herbs Section 2 Herbs That Promote Defecation by Moistening Purgation

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Outline Specific Application Knowledge of Herbs Section 3 Herbs That Expel Water by Drastic Purgation Outline Specific Application Knowledge of Herbs

93 93 95 95 95

ABSTRACT Chinese herbal medicinals that induce diarrhea or moisten large intestine and promote defecation are called “Herbs that Drain Downward.” Herbs that drain downward are mainly indicated for the treatment of constipation, accumulation and stagnation in the stomach and intestine, excess heat accumulated, edema, and fluid retention with interior excess pattern. Herbs that drain downward can be divided into three categories: herbs that promote defecation by purgation, herbs that promote defecation by moistening purgation and herbs that expel water by drastic purgation. Keywords: herbs that drain downward; herbs that promote defecation by purgation; herbs that promote defecation by moistening purgation; herbs that expel water by drastic purgation

Chinese herbal medicinals that induce diarrhea or moisten large intestine and promote defecation are called “Herbs that Drain Downward.” Medicinals in this chapter have the properties of descending and sinking, mainly act on the large intestine, have the major effect of relieving constipation by purgation and can discharge the accumulation and stagnation in the stomach and intestine and dry stool. The meaning is exactly what is called “the large intestine, is an official in charge of transportation, which can transform food debris into feces” in The Yellow Emperor’s Inner Classic (huang di nei jing). They also have the effects of clearing heat and draining fire, and can clear the accumulated excess heat by purgation, which means “the upper disease is treated from the lower” or “take away the firewood under the cooking pot,” or expelling water and relieving edema, and can remove water-dampness and fluid retention along with the urine and stool. Some medicinals also have the actions of resolving toxins, invigorating blood, and dispelling stasis. Herbs that drain downward are mainly indicated for the treatment of constipation, accumulation and stagnation in the stomach and intestine, excess heat accumulated, edema, and fluid retention with interior excess pattern. Some medicinals are also indicated for swollen sores and carbuncles, and blood stasis patterns. Herbs that drain downward have a certain therapeutic effect on modern medicine’s habitual constipation, hemorrhoids constipation, acute abdomen, intestinal obstruction, adhesion of intestine, acute appendicitis, cholecystitis, pancreatitis, hepatic cirrhosis, nephritis, or exudative pleurisy respectively. According to the difference of efficacy, herbs that drain downward can be divided into three categories: (1) herbs that promote defecation by purgation; (2) herbs that promote defecation by moistening purgation; and (3) herbs that expel water by drastic purgation. When using herbs that drain downward, they should be appropriately combined with other herbs according to the accompanied symptoms and signs of interior excess pattern and patient’s constitution. If interior excess pattern is combined with exterior pathogen, which should be treated by releasing the exterior first and then purging the interior, if necessary, sharing with herbs that release the exterior to release both the exterior and interior in order to avoid inward invasion of

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exterior pathogen. If interior excess pattern is combined with healthy qi deficiency, they should be shared with herbs that supplement deficiency to treat with both attack and supplementation in order to eliminate pathogenic factor without damaging healthy qi. Medicinals in this category also often combine with herbs that move qi in order to reinforce the effects of draining and removing stagnation, or combine with herbs that clear heat if accompanied by heat accumulation, or combine with herbs that warm the interior if accompanied by cold accumulation. When using herbs that promote defecation by purgation or herbs that expel water by drastic purgation, due to their drastic actions or toxicity damaging healthy qi and the spleen and stomach easily, therefore, the old and weak and the patients with weakness of the spleen and stomach should be cautious to use. Women in menstrual period and before or after childbirth should be prohibited to use. When using these comparatively strong herbs that drain downward, they should be stopped once the intended effect is obtained in order to avoid overdose damaging the stomach qi. When using these drastic and toxic herbs that drain downward, the processing procedure and usage amount should be strictly controlled in order to avoid poisoning and to ensure medication safety. The modern pharmacological research indicates the herbs that drain downward can induce diarrhea through stimulating the intestinal mucous membrane to increase peristalsis by different mechanisms of action. In addition, most of herbs that drain downward have the effects of cholaneresis, diuresis, antiinflammation, antitumor, and antibacterium, and also can strengthen the immunologic function.

SECTION 1  HERBS THAT PROMOTE DEFECATION BY PURGATION Outline Most medicinals in this section are bitter-cold and descending and sinking in nature, act on the stomach and large intestine channels, not only have a fairly strong effect of promoting defecation by purgation but also can clear heat and drain fire, and are indicated for the treatment of constipation, dry and hard stool, and pattern of excess heat accumulation and stagnation. They often combine with herbs that move qi to strengthen the effects of purging and relieving distention and fullness. For constipation due to cold accumulation, they should combine with herbs that warm the interior. Herbs that promote defecation by purgation combining the strong actions of clearing heat and draining fire, also can be used for the treatment of high fever, unconsciousness, delirious speech and mania in the febrile disease, headache, red eyes, swelling, and pain of the throat or gingiva caused by fire-heat flaming upward, and the superior part bleeding syndrome, such as blood spitting, nosebleed, and expectoration of blood caused by intense fire-heat, respectively. To the above-mentioned syndromes with (or without) constipation, this section’s medicinals can clear excess heat or guide heat to descend. To dysentery in the initial stage, diarrhea with tenesmus, or food accumulation and stagnation, and inhibited diarrhea, appropriately combining with this section’s medicinals can remove accumulation and stagnation, and eliminate the etiological factor. To intestinal tract parasitosis, combining herbs that kill parasites can promote the discharging of polypide. According to the theory of “the six fu organs perform their functions when there is free flow,” “stagnation of qi and blood may bring about pain” and “if qi and blood is smooth, you won’t ache,” using herbs that promote defecation by purgation combining herbs that clear heat and resolve toxins, or herbs that invigorate blood and dissolve stasis to treat acute abdomen syndromes, such as cholelithiasis, ascariasis of biliary tract, acute pancreatitis, and intestinal obstruction, has obtained a better effect.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 3.1)

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TABLE 3.1 Properties, Actions, and Application of Common Herbs That Promote Defecation by Purgation Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Rhubarb Root and Rhizome (da huang) (Radix et Rhizoma Rhei)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root and rhizome of Rheum palmatum L. or Rheum tanguticum Maxim.ex Balf. or Rheum offcihale Baill. of the Polygonaceae family. It is collected when stem and leaves are withered in late autumn or before sprouting in next spring; after rootlet and exodermis are removed, it is cut into sections or segments and dried

Bitter, cold; act on the spleen, stomach, large intestine, liver and pericardium channels

Attack the accumulation by purgation, clear heat and drain fire, cool the blood and resolve toxins, expel stasis and promote menstruation flow, drain dampness, and relieve jaundice

Indicated for the treatment of constipation due to accumulated excess heat, spitting of blood, nosebleed, red eyes, swollen throat, sores and carbuncles due to heat toxin, abdominal pain with intestinal abscess, amenorrhea due to blood stasis, postpartum stasis obstructing, injury from fall, damp-heat dysentery, reddish urine, strangury and edema, burn, and scald. Normally, 5–15 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in pregnant women or women in the menstrual or lactation period, and patients with weakness of the spleen and stomach. It shouldn’t be decocted for a long time when use it for purgation

Sodium Sulfate (mang xiao) (Natrii Sulfas)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the refined crystal of Nalrii Sulfas of the mirabilite family of the sulfates minerals. It mainly contains aqueous sodium sulfate (Na2SO4·10H2O)

Salty, bitter, cold; act on the stomach and large intestine channels

Relieve constipation by purgation, moisten dryness and soften hard masses, clear fire, and relieve swelling

Indicated for the treatment of abdominal fullness with distending pain, and dry feces due to accumulated excess heat, swelling and pain of the throat, sore in mouth and tongue, red eyes, swollen carbuncles and sores, and intestinal abscess in the initial stage. External treatment: mammary abscess, and piles with sore pain. Normally, 6–12 g is taken infused with boiling water or dissolved in decoction as an oral dose, or an appropriate amount is used externally

Its use is cautious or prohibited in pregnant women or women in the lactation period. It is not suited to combine with sulfur (liu huang) or Rhizoma Sparganii (san leng) to use

Senna Leaf (fan xie ye) (Folium Sennae)

Initially recorded in New Reference of Prepared Medicines (yin pian xin can). It is the dried leaflet of Cassia angustifolia Vahl or Cassia acutifolia Delile of the Leguminosae family. It is usually collected in September and dried under the sun

Sweet, bitter, cold; act on the large intestine channel

Discharge heat and move stagnation, promote defecation, and urination

Indicated for the treatment of constipation due to heat bind, abdominal fullness with distending pain, edema or ascites with distention and fullness; also for the treatment of habitual constipation or senile constipation. Normally, 2–6 g is decocted with water as an oral dose, but should be added later, or 1.5–3 g is taken infused with warm boiled water as an oral dose

Its use is prohibited in pregnant women or women in the menstrual or lactation period

(Continued )

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TABLE 3.1 Properties, Actions, and Application of Common Herbs That Promote Defecation by Purgation (cont.) Name of Medicinal Aloe (lu hui) (Aloe)

Source and Collection Initially recorded in Treatise on Medicinal Properties (yao xing lun). It is the dried concentrated substance of leaf juice of Aloe barbadensis Miller of the Liliaceae family. Cut the leaf and collect the juice, decoct into paste, cool, and coagulate

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Bitter, cold; act on the liver, stomach, and large intestine channels

Promote defecation by purgation, clear liver heat and drain fire, kill worms, and cure infantile malnutrition

Indicated for the treatment of constipation due to heat bind, vexation and agitation, and insomnia due to vigorous heart-liver fire, convulsive epilepsy due to exuberant fire in the liver channel, and infantile malnutrition with accumulation. External treatment: tinea and sore. Normally, 1–2 g is made into pills or powder as an oral dose, or an appropriate amount is ground into powder for applying the afflicted part

Caution for Use Its use is prohibited in pregnant women, and patients with less eating and thin, unformed stool due to weakness of the spleen and stomach

2. Attached herbs (Table 3.2) TABLE 3.2 Introduction to Attached Herbs That Promote Defecation by Purgation Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Exsiccated Sodium Sulfate (xuan ming fen) (Natrii Sulfas Exsiccatus)

It is the dried white processed powder from Nalrii Sulfas losing crystal water by weathering. It mainly contains anhydrous sodium sulfate (Na2SO4)

Salty, bitter, cold; act on the stomach and large intestine channels

Promote defecation by purgation, moisten dryness and soften hard masses, clear fire, and relieve swelling

Indicated for the treatment of dry feces with abdominal fullness and distending pain due to accumulated excess heat, swelling and pain of the throat, oral ulcer and sore in tongue, swelling and pain of the gingiva, red eyes, swollen carbuncles, and erysipelas. Normally, 3–9 g is dissolved in decoction as an oral dose, or an appropriate amount is used externally

Its use is cautious in pregnant women. It should not be used with Sulfur (liu huang) or Rhizoma Sparganii (san leng)

Castor Seed (bi ma zi) (Semen Ricini)

It is the dried matured seed of Ricinus communis L. of the Euphorbiaceae family. The matured fruit is picked in autumn, and dried under the sun; after rind is removed, the seed is collected

Sweet, acrid, neutral, poisonous; act on the large intestine and lung channels

Promote defecation by purgation, relieve swelling and draw out toxin

Indicated for the treatment of dry and hard stool, swollen carbuncle-abscess, throat bì (pharyngitis) and scrofula. Normally, 2–5 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is prohibited in pregnant women and patients with intestine lubricating

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3. Herb differentiation (Table 3.3)

TABLE 3.3 Differentiation Between Similar Efficacy Herbs That Promote Defecation by Purgation Name of Medicinal Rhubarb Root and Rhizome (da huang) (Radix et Rhizoma Rhei) Sodium Sulfate (mang xiao) (Natrii Sulfas)

Wine-Fried Rhubarb Root and Rhizome (jiu da huang)

Similarity

Differences

Both are strong purgatives, have the effect of relieving constipation by purgation, and are indicated for the treatment of dry and hard stool due to accumulated excess heat, also can clear heat and relieve swelling, and treat swollen carbuncles and sores through external application

It is bitter and cold in nature, combining with other herbs, can treat constipation with various patterns, also can clear heat and drain fire, resolve toxins, stanch bleeding, invigorate blood and dispel stasis, clear damp-heat, and treat warm disease with high fever, unconsciousness, constipation due to heat bind, bleeding due to blood heat, fire pathogen flaming upward, static blood, jaundice due to damp-heat, and strangury

All three are the different processing products of Radix et Rhizoma Rhei (da huang), can promote defecation by purgation, clear heat and resolve toxins, and can treat constipation with a pattern of fire-heat

Purgation efficacy of wine-fried Radix et Rhizoma Rhei (jiu da huang) is decreased, but the effect of invigorating blood is strengthened, and it is suitable for the treatment of stagnated blood syndrome. It can guide the effects of Radix et Rhizoma Rhei (da huang) to the upper, is good at clearing excess heat in blood aspect and toxins in the upper jiao, and used for the treatment of red eyes, swollen throat, and swelling and pain of the gingiva

It is salty, bitter, and cold in nature, can drain heat to promote defecation, and is good at moistening dryness and softening hard masses, mainly treat dry and hard stool due to accumulated excess heat, and also treat swelling and pain of the throat, oral ulcer and red eyes through external application

Prepared Rhubarb Root and Rhizome (shu da huang)

Purgation efficacy of Radix et Rhizoma Rhei (da huang) is moderate after stewing. It can alleviate or eliminate the side-effect, such as abdominal pain, guide the effects of Rhubarb Root and Rhizome (da huang) to the upper or to the lower, such as the small intestine and bladder, drain fire and resolve toxins, and clear damp-heat, and is used for the treatment of sores and ulcers due to fire toxin

Charred Rhubarb Root and Rhizome (da huang tan)

After Radix et Rhizoma Rhei (da huang) is charred, the purgation efficacy becomes exceedingly poor, but it is good at cooling the blood, dissolving stasis and stanching bleeding, and indicated for the treatment of bleeding syndrome with static blood due to blood heat

SECTION 2  HERBS THAT PROMOTE DEFECATION BY MOISTENING PURGATION Outline Most medicinals in this section are plant seeds and kernels, rich in oil, sweet in flavor, and moistening in nature, act on the spleen and large intestine channels, can lubricate large intestine and promote defecation without drastic purgation, are indicated for constipation with intestinal dryness and fluid exhaustion due to old people’s fluid consumption, postpartum blood deficiency, fluid consumption in the febrile disease, and loss of blood. Medicinals in this section usually combine with other herbs according to different patient’s condition. For constipation due to exuberant heat and fluid consumption, they combine with the herbs that clear heat and nourish yin. If accompanied by qi stagnation, they combine with the herbs that move qi. For constipation due to blood deficiency, they combine with the herbs that supplement the blood.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 3.4)

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TABLE 3.4 Properties, Actions and Application of Common Herbs That Promote Defecation by Moistening Purgation Name of Medicinal

Source and Collection

Property, Efficacy and Clinical Application Channel Entry Action and Usage

Caution for Use

Hemp Seed (huo ma ren) (Fructus Cannabis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured fruit of Cannabis sativa L. of the Moraceae family. It is collected when fruit is matured in autumn; after impurities are removed, it is dried under the sun

Sweet, neutral; act on the spleen, stomach, and large intestine channels

Moisten the intestines to promote defecation, promote urination, and relieve strangury

Indicated for the treatment of the old, the weak or puerperal constipation due to (thin) fluids and blood deficiency, fluid consumption, and intestinal dryness; also for the treatment of wind edema, weak foot due to dampness and heat strangury. Normally, 10–15 g is broken into pieces and decocted with water as an oral dose, or made into pills or powder

Its use is cautious in patients with thin, unformed stool, yang wĕi (impotence), seminal emission, and abnormal vaginal discharge

Chinese Dwarf Cherry Seed (yu li ren) (Semen Pruni)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured seed of Prunus humilis Bge., Prunus japonica Thunb. or Prunus pedunculata Maxim. of the Rosaceae family. The fruit is collected when matured in summer and autumn; after sarcocarp and rind are removed, the seed is taken out and dried

Acrid, bitter, sweet, neutral; act on the spleen, large intestine, and small intestine channels

Moisten the intestines to promote defecation, lower qi, and promote urination

Indicated for the treatment of constipation with abdominal distention due to fluid consumption and intestinal dryness, food accumulation and qi stagnation; also for the treatment of postpartum constipation due to dryness-heat in the stomach and intestines; edema with distention and fullness, weak foot with puffiness, and difficulty in micturition. Normally, 6–10 g is broken into pieces and decocted with water as an oral dose, or made into pills or powder

Its use is cautious in pregnant women

Pine Nut (song zi ren) (Semen Pini Koraiensis)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the kernal of Pinus koraiensis Sieb.et Zucc of the Pinaceae family. The fruit is collected when matured, and dried under the sun; after hard rind is removed, the seed is taken out

Sweet, warm; act on the lung, liver, and large intestine channels

Moisten the intestines to promote defecation, and moisten the lung to relieve cough

Indicated for the treatment of constipation due to fluid exhaustion and intestinal dryness, and dry cough due to lung dryness. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in patients with thin, unformed stool due to spleen deficiency or damp-phlegm pattern

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2. Attached herbs (Table 3.5)

TABLE 3.5 Introduction to Attached Herbs That Promote Defecation by Moistening Purgation Name of Medicinal Linseed (ya ma zi) (Semen Lini)

Source and Collection It is the dried matured seed of Linum usitatissimum L. of the Linaceae family. When fruit is matured in autumn, the plant is collected and dried under the sun, stroked to separate the seeds; after impurities are removed, it is dried under the sun again

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sweet, neutral; act on the lung, liver, and large intestine channels

Moisten dryness to promote defecation, nourish blood, and dispel wind

Indicated for the treatment of constipation due to intestinal dryness, dry skin (xerosis cutis), itching, and baldness. Normally, 9–15 g is decocted with water as an oral dose

Its use is prohibited in patients with diarrhea

3. Herb differentiation (Table 3.6)

TABLE 3.6 Differentiation between Similar Efficacy Herbs That Promote Defecation by Moistening Purgation Name of Medicinal

Similarity

Differences

Hemp Seed (huo ma ren) (Fructus Cannabis)

Both are moistening in nature and rich in oil, can moisten the intestines to promote defecation, and indicated for the treatment of constipation due to intestinal dryness

It is oleosus, sweet in flavor, can enrich and nourish and supplement deficiency, and is usually used for the treatment of intestinal dryness due to fluid consumption and blood deficiency of the old, the weak and postpartum women

Chinese Dwarf Cherry Seed (yu li ren) (Semen Pruni)

It is moistening, bitter, and descending in nature, can move qi stagnation in the large intestine, relieve edema and promote urination without the effect of supplementing deficiency, and is more used for the treatment of constipation with qi stagnation excess pattern, also for edema with distention and fullness, and weak foot due to dampness

SECTION 3  HERBS THAT EXPEL WATER BY DRASTIC PURGATION Outline Most medicinals in this section are bitter and cold in nature, poisonous and drastic efficacy, can induce intense diarrhea after administration, can promote urination, remove the retention of fluid in the body through defecation and micturition to relieve swelling and distension, are indicated for the treatment of general edema, abdominal distension and fullness, and fluid retention with a pattern of healthy qi without deficiency. Medicinals in this section have strong effects of attacking and purging, and great side effects that are easy to damage healthy qi. So, in clinical application, the medication of this section’s medicinals should be discontinued as soon as getting effect. They should not be taken for a long time, and often combine with herbs that supplement deficiency to protect healthy qi. The weak patients should be cautious to use and pregnant women should be prohibited to use. Their processing, overdose, usage, and contraindication should be paid attention to in order to ensure the safety and effectiveness of medication.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 3.7)

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TABLE 3.7 Properties, Actions and Application of Common Herbs That Expel Water by Drastic Purgation Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Gansui Root (gan sui) (Radix Kansui)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root tuber of Euphorbia kansui T. N. Liou ex T. P. Wang of the Euphorbiaceae family. It is collected before blooming in spring or when stem and leaf are withered in late autumn, then stroked to separate the outer bark, and dried under the sun

Bitter, cold, poisonous; act on the lung, kidney, and large intestine channels

Expel fluid retention by drastic purgation, relieve swelling, and dissipate masses

Indicated for the treatment of edema with distention and fullness, retention of fluid in the chest and ribside, abdominal tympanites, phlegm rheum, accumulations and gatherings (abdominal masses; jī jù), cough and panting due to qi counterflow, difficulty in urination and defecation, epilepsy due to windphlegm, swollen carbuncles, and sores. Normally, 0.5–1.5 g is made into pills or powder after processing as an oral dose, or an appropriate amount is used externally

Use of the raw one is prohibited in pregnant women and the weak. It is not suited to combine with Radix et Rhizoma Glycyrrhizae (gan cao) to use. It should be processed with vinegar for taking orally in order to decrease toxicity

Euphorbia Root (jing da ji) (Radix Euphorbiae Pekinensis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Euphorbia pekinensis Rupr. of the Euphorbiaceae family. It is collected in autumn and winter, then washed clean and dried under the sun

Bitter, cold, poisonous; act on the lung, spleen, and kidney channels

Expel fluid retention by drastic purgation, relieve swelling, and dissipate masses

Indicated for the treatment of edema with distention and fullness, accumulated fluid in the chest and abdomen, abdominal tympanites, phlegm rheum, accumulations and gatherings (jī jù), cough and panting due to qi counterflow, swollen carbuncles and sores due to heat toxin, scrofula, and phlegm nodule. Normally, 1.5–3 g is decocted with water as an oral dose, or 1 g is made into pills or powder as an oral dose or an appropriate amount is used externally

Use of the raw one is prohibited in pregnant women and the weak. It is not suited to combine with Radix et Rhizoma Glycyrrhizae (gan cao) to use. It should be processed with vinegar for taking orally in order to decrease toxicity

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TABLE 3.7 Properties, Actions and Application of Common Herbs That Expel Water by Drastic Purgation (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Lilac Daphne Flower Bud (yuan hua) (Flos Genkwa)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried flower bud of Daphne genkwa Sieb. et Zucc. of the Thymelaeaceae family. It is collected before blooming in spring; after impurities are removed, it is dried

Bitter, acrid, warm, poisonous; act on the lung, spleen, and kidney channels

Expel fluid retention by drastic purgation, dispel phlegm and relieve cough; external treatment: kill worms and cure sores

Indicated for the treatment of dyspnea with cough, referred pain in the chest and ribside, pĭ below the heart, edema and abdominal tympanites due to retention of fluid in the chest and ribside, cough phlegm and panting due to qi counterflow. External treatment: scabies, tinea and favus, swollen carbuncles, and chilblain. Normally, 1.5–3 g is decocted with water or 0.6 g is made into pills or powder as an oral dose or an appropriate amount is used externally

Its use is prohibited in pregnant women. It is not suited to combine with Radix et Rhizoma Glycyrrhizae (gan cao) to use. It should be processed with vinegar for taking orally in order to decrease toxicity

Pokeberry Root (shang lu) (Radix Phytolaccae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Phytolacca acinosa Roxb. or Phytolacca americana L. of the Phytolaccaceae family. It is collected from autumn to next spring; after fibrous root and sediment are removed, it is cut into pieces and dried under the sun or in the shade

Bitter, cold, poisonous; act on the lung, spleen, kidney, and large intestine channels

Expel water and relieve swelling, promote urination and defecation; external treatment: resolve toxins and dissipate masses

Indicated for the treatment of edema, abdominal tympanites, constipation, difficulty in micturition with an excess pattern of water-dampness and distention and fullness. External treatment: sores and ulcers, and swollen carbuncles in the initial stage. Normally, 3–9 g is decocted with water as an oral dose, or an appropriate amount is decocted for fumigating and washing externally

Its use is prohibited in pregnant women. It should be processed with vinegar for taking orally in order to decrease toxicity

(Continued )

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TABLE 3.7 Properties, Actions and Application of Common Herbs That Expel Water by Drastic Purgation (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Pharbitidis Seed (qian niu zi) (Semen Pharbitidis)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried matured seed of Pharbitis nil (L.) Choisy or Pharbitis purpurea (L.) Voigt. of the Convolvulaceae family. When the fruit is matured and before the rind is broken, the plant is collected and dried under the sun, and then stroked to separate the seeds

Bitter, cold, poisonous; act on the lung, kidney, and large intestine channels

Expel water, promote urination and defecation, disperse phlegm and clear up rheum (fluid retention), kill worms and remove accumulation

Indicated for the treatment of edema with distention and fullness, abdominal tympanites, difficulty in defecation and micturition, accumulated phlegm rheum, panting and cough due to lung qi obstructing, abdominal pain due to worm accumulation. Normally, 3–6 g is decocted with water as an oral dose, or made into pills or powder for taking orally with 1.5–3 g each time

Its use is prohibited in pregnant women. Its medicinal nature will be alleviated if it is dry-fried, and not suited to combine with Fructus Crotonis (ba dou) or Semen Crotonis Pulveratum (ba dou shuang)

Croton Seed (ba dou) (Fructus Crotonis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured fruit of Croton tiglium L. of the Euphorbiaceae family. It is collected when matured in autumn, then piled for 2–3 days, spread out and dried

Acrid, heat, extremely poisonous; act on the stomach and large intestine channels

Dredge the cold accumulation by drastic purgation, expel water and relieve edema, dispel phlegm, and relieve sore throat; external treatment: erode sores

Indicated for the treatment of constipation due to cold accumulation, ascites, abdominal tympanites, throat bì (pharyngitis) with phlegm obstructing, swollen carbuncles with pus formed but not ulcerated, ulcers, scabies, tinea, warts, and nevus. Normally, 0.1–0.3 g is made into pills or powder as an oral dose each time, or an appropriate amount is ground into powder for applying the affected area

Its use is prohibited in pregnant women and the weak. It is not suited to combine with Semen Pharbitidis (qian niu zi) to use, and is usually made into Semen Crotonis Pulveratum (ba dou shuang) for use

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TABLE 3.7 Properties, Actions and Application of Common Herbs That Expel Water by Drastic Purgation (cont.) Name of Medicinal Caper Euphorbia Seed (qian jin zi) (Semen Euphorbiae)

Source and Collection Initially recorded in Materia Medica of Sichuan (shu ban cao). It is the dried matured seed of Euphorbia lathyris L. of the Euphorbiaceae family. The fruit is collected when matured in summer and autumn; after impurities are removed, it is dried

Property, Channel Entry

Efficacy and Action

Acrid, warm, poisonous; act on the liver, kidney, and large intestine channels

Expel fluid retention by drastic purgation, break up blood stasis, and resolve masses; external treatment: cure tinea and erode warts

Clinical Application and Usage

Caution for Use

Indicated for the treatment of edema, abdominal tympanites, difficulty in defecation and micturition, phlegm rheum, concretions and conglomerations (zhēng jia˘), and menstrual block due to blood stasis, or used externally for the treatment of stubborn dermatitis and cutaneous tubercle. Normally, 1–2 g of the decorticated and deoiled one is often made into pills or powder as an oral dose, or an appropriate amount is pounded for applying the afflicted part externally

Its use is prohibited in pregnant women, the weak and patients with thin, unformed stool

2. Attached herbs (Table 3.8)

TABLE 3.8 Introduction to Attached Herbs That Expel Water by Drastic Purgation Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Lowdaphne Stringbush Flower Bud (huang yuan hua) (Flos Wikstroemiae Chamaedaphnes)

It is the dried flower bud of Wikstroemia chamaedaphne Meissn. of the Thymelaceae family. It is collected in early autumn, and dried in the shade or by baking

Acrid, warm, slightly poisonous; act on the lung and large intestine channels

Expel water by drastic purgation, and clear up phlegm

Indicated for the treatment of edema, abdominal distention and fullness, phlegm rheum, cough, and panting with counterflow qi ascent, also used for infectious hepatitis, schizophrenia, and epilepsy. Normally, 1.5–3 g is ground into powder as an oral dose, or 3–6 g is decocted with water as an oral dose

Its use is prohibited in the weak, ulcer, and pregnant women. It antagonizes Radix et Rhizoma Glycyrrhizae (gan cao)

(Continued )

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TABLE 3.8 Introduction to Attached Herbs That Expel Water by Drastic Purgation (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Knoxia Root (hong da ji) (Radix Knoxiae)

It is the dried root tuber of Knoxia valerianiodes Thorel et Pitard of the Rubiaceae family. It is collected in autumn and winter; after fibrous root is removed, it is washed clean, slightly scalded in boiling water, and dried

Bitter, cold, mild poisonous; act on the lung, spleen, and kidney channels

Expel water and fluid retention, relieve swelling, and dissipate masses

Indicated for the treatment of edema with distention and fullness, accumulated water in the chest and abdomen, accumulated phlegm rheum, cough and panting due to qi counterflow, difficulty in defecation and micturition, swollen carbuncles and sores, scrofula, and phlegm nodule. Normally, 1.5–3 g is made into pills or powder as an oral dose with 1 g each time, or an appropriate amount is used externally

Its use is prohibited in pregnant women. It should be processed with vinegar for taking orally in order to decrease toxicity

Defatted Croton Seed Powder (ba dou shuang) (Semen Crotonis Pulveratum)

It is the dried processed product of matured fruit of Euphorbia lathyris L. of the Euphorbiaceae family. Grind the fruit kernel, package with oil-absorbing sheets, heat and slightly bake, and crush to remove the oil and fat

Acrid, heat, extremely poisonous; act on the stomach and large intestine channels

Warm the intestine and promote defecation, resolve stagnation and break up masses, expel water, and relieve edema

Indicated for the treatment of constipation due to colddampness accumulation, concretions, and conglomerations (zhe¯ngjia˘ ), abdominal edema, and exuberant phlegm-drool obstructing. Normally, 0.1–0.3 g is made into pills or powder as an oral dose

Its use is prohibited in pregnant women. It is not suited to combine with Semen Pharbitidis (qian niu zi) to use

Caper Euphorbia Seed Powder (qian jin zi shuang) (Semen Euphorbiae Pulveratum)

It is the processed product of matured seed of Euphorbia lathyris L. of the Euphorbiaceae family. Take Semen Euphorbiae (qian jin zi), decorticate and clean the kernel, and make into frostlike powder

Acrid, warm, poisonous; act on the liver, kidney, and large intestine channels

Expel fluid retention by drastic purgation, break up blood stasis and resolve masses; external treatment: cure tinea and erode warts

Indicated for the treatment of difficulty in defecation and micturition, edema, phlegm rheum, indigestion with distention and fullness, and menstrual block due to blood stasis. External treatment: stubborn dermatitis, and cutaneous tubercle. Normally, 0.5–1 g is often made into pills or powder as an oral dose or an appropriate amount is used externally

Its use is prohibited in pregnant women, the weak and patients with thin, unformed stool

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3. Herb differentiation (Table 3.9) TABLE 3.9 Differentiation Between Similar Efficacy Herbs That Expel Water by Drastic Purgation Name of Medicinal

Similarity

Differences

Gansui Root (gan sui) (Radix Kansui)

All three are bitter in flavor and purgative in nature, belong to the herbs expel water by drastic purgation, can drastically expel fluid retention and water, and are often used for the treatment of edema with distention and fullness, abdominal tympanites, and retention of fluid in the chest and ribside with an excess pattern. All three are poisonous, not suited to use together with Radix et Rhizoma Glycyrrhizae (gan cao), and should be processed with vinegar in order to decrease toxicity for oral taking

It has a strongest effect of expelling water by drastic purgation among the three herbs, is good at expelling the water-dampness in the channel. It can expel phlegm-drool and can treat epilepsy due to wind phlegm

Both has a strong effect of promoting defecation by drastic purgation, and can treat constipation due to accumulation and stagnation

It is acrid and heat in nature, and has strong poisonous, and its effect is drastic, and it is indicated for the treatment of constipation due to cold accumulation with an acute syndrome. It can expel water, relieve edema, and dispel phlegm, and treat edema and abdominal tympanites caused by excess pathogen, and cold excess chest bind syndrome due to exuberant phlegm-drool obstructing

Euphorbia Root (jing da ji) (Radix Euphorbiae Pekinensis)

Lilac Daphne Flower Bud (yuan hua) (Flos Genkwa)

Croton Seed (ba dou) (Fructus Crotonis)

Rhubarb Root and Rhizome (da huang) (Radix et Rhizoma Rhei)

It has a stronger effect of expelling fluid retention by drastic purgation than that of Flos Genkwa (yuan hua), is good at expelling the water-dampness in zang-fu organs. It is cold and discharging (heat) in nature, also has a stronger effect of eliminating toxins than that of Radix Kansui (gan sui), and used for the treatment of swollen carbuncles due to heat toxin It has an inferior effect of expelling water by drastic purgation among the three herbs, but it has the most intense toxicity, is good at expelling the water and fluid retention in the chest and lung, dispelling phlegm, and relieving cough. It is also warm in nature, can kill worms and cure tinea for the treatment of sore heat and stubborn dermatitis

It is bitter in flavor and cold in nature, and mainly used for the treatment of constipation due to excess heat bind. It also can drain fire and resolve toxins, cool the blood and stanch bleeding, invigorate blood, and dispel stasis, and treat red eyes, toothache and oral ulcer caused by intense fire toxin, blood spitting, nosebleed, carbuncles and sores due to blood heat, and menstrual block caused by blood stasis

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Chapter 4

Herbs That Expel Wind and Damp Chapter Outline Section 1 Herbs That Expel Wind-Cold-Damp Outline Specific Application Knowledge of Herbs Section 2 Herbs That Expel Wind-Damp-Heat Outline Specific Application Knowledge of Herbs

104 104 104 116 116 116

Section 3 Herbs That Expel Wind-Damp and Strengthen the Sinew and Bone Outline Specific Application Knowledge of Herbs

123 123 123

ABSTRACT Chinese herbal medicinals that dispel or eliminate wind-cold-damp and treat wind-cold-damp bì syndrome are called “Herbs that Expel Wind and Damp.” They are mainly indicated for the treatment of wind-damp bì syndrome with pain in the limbs, swelling, and inconvenience of the joints, and spasms of the sinews. Herbs that expel wind and damp can be divided into three categories: herbs that expel wind-cold-damp, herbs that expel wind-damp-heat, and herbs that expel wind-damp and strengthen the sinew and bone. Keywords: herbs that expel wind and damp; herbs that expel wind-cold-damp; herbs that expel wind-damp-heat; herbs that expel wind-damp and strengthen the sinew and bone; dispel wind and eliminate dampness; dispel wind and quicken the collaterals; dispel wind-damp and relieve pain

Chinese herbal medicinals that dispel or eliminate wind-cold-damp and treat wind-cold-damp bì syndrome are called “Herbs That Expel Wind and Damp.” Medicinals in this chapter are more acrid and bitter, warm or cool in nature, can expel wind-damp that remained in the muscles, channels and collaterals, sinews and bones; some medicinals also have the effects of dissipating cold, relaxing the sinews, unblocking the collaterals, relieving pain, or supplementing the liver and kidney, and strengthening the sinew and bone. They are mainly indicated for the treatment of wind-damp bì syndrome with pain in the limbs, swelling and inconvenience of the joints, and spasms of the sinews. Some medicinals are also indicated for the treatment of soreness and weakness of waist and knees, and flaccid lower limbs. Herbs that expel wind and damp have a certain therapeutic effect on modern medicine’s rheumatism, rheumatoid arthritis, sciatica, scapulohumeral periarthritis, lubar intervertebral disc protrusion, cervical spondylosis, hyperostosis, wound, fracture pain, lumbar muscle strain, sequela of cerebrovascular diseases, urticaria, itch of skin, or scabies and tinea, respectively. Herbs that expel wind and damp can be divided into three categories: (1) herbs that expel wind-cold-damp; (2) herbs that expel wind-damp-heat; and (3) herbs that expel wind-damp and strengthen the sinew and bone according to the difference of their properties and actions. When using herbs that expel wind and damp, doctors should appropriately combine other medicinals according to the patterns of bì syndrome, the positions invaded by wind-damp, and the course of disease or syndrome. For the windprevalent migratory bì syndrome, doctors should select “Herbs That Expel Wind and Damp” especially that are good at expelling wind to combine with medicinals that invigorate blood and nourish nutrient qi; for the dampness-prevalent fixed bì syndrome, should select “Herbs That Expel Wind and Damp” especially that are warm and dry to combine with medicinals that fortify the spleen and percolate dampness; for the cold-prevalent painful bì syndrome, should select “Herbs That Expel Wind and Damp” especially that are strong warm in nature to combine with medicinals that unblock yang and warm the channels; for the heat bì syndrome caused by inward penetration of external pathogen to transform into heat or constraint for a long time to transform into heat, should select “Herbs That Expel Wind and Damp” especially that are cold and cool in nature to combine with medicinals that cool the blood, clear heat and resolve toxins; if bì syndrome in the initial stage with exterior pathogen, should combine with herbs that release the exterior to dissipate wind and overcome dampness; Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00004-X Copyright © 2017 Elsevier Inc. All rights reserved.

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if inward penetration of pathogen, should combine with herbs that invigorate blood and unblock the collaterals; if complicated by turbid phlegm or static blood, should combine with herbs that dispel phlegm or dissipate stasis; if weakness due to chronic disease, liver-kidney insufficiency, and decrease in disease resistance, should select herbs that expel wind-damp and strengthen the sinew and bone to combine with medicinals that supplement the liver and kidney, boost qi and blood in order to reinforce healthy qi and dispel pathogen. Bì syndromes belong to chronic disease. In order to take medicine conveniently, many medicinals in this category can be made into wine preparation, pills, or powder. Wine also can strengthen the effects of herbs that expel wind and damp. They also can be made into preparation for applying externally. Herbs that expel wind and damp are acrid, warm, and dry in nature, which is easy to damage yin and consume blood, the patients with yin-blood (blood and body fluids) depletion should be cautious to use. The modern pharmacological research indicates the herbs that expel wind and damp generally have the effects of antiinflammation, analgesia, and sedation at different levels, and are often used for the treatment of rheumatic arthritis, rheumatoid arthritis, ankylosing spondylitis, sciatica, fibrositis, scapulohumeral periarthritis, lumbar muscle strain, hyperosteogeny, injury from fall, neuralgia, hemiparalysis, and some skin diseases.

SECTION 1  HERBS THAT EXPEL WIND-COLD-DAMP Outline Medicinals in this section are most acrid-bitter in flavor and warm in nature, and act on the liver, spleen, and kidney channels. The acrid medicinals can dissipate and dispel wind, and bitter medicinals can dry dampness, warm, and unblock and dispel cold. They have better effects of dispelling wind, eliminating dampness, dissipating cold, relieving pain, and unblocking the collaterals; especially relieving pain is the protruded action. They are indicated for the treatment of wind-cold-damp bì syndrome with limbs’ joint pain, spasms of the sinews, fixed pain, and pain aggravated when encountering cold. Medicinals in this section also can be used for the treatment of wind-damp-heat bì syndrome through combining with other herbs.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 4.1) TABLE 4.1 Properties, Actions, and Application of Common Herbs That Expel Wind-Cold-Damp Name of Medicinal Double Teeth Pubescent Angelica Root (du huo) (Radix Angelicae Pubescentis)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Angelica pubescens Maxim. f. biserrata Shan et Yuan of the Umbelliferae family. It is collected when sprouting in early spring or stem and leaf are withered in autumn; after fibrous root and sediment are removed, it is baked to damp-dry, piled for 2–3 days until become soft, and baked again to full dry

Property, Channel Entry Acrid, bitter, slightly warm; act on the kidney, bladder channels

Efficacy and Action

Clinical Application and Usage

Dispel wind and eliminate dampness, unblock bì syndrome and relieve pain, release the exterior

Indicated for the treatment of recent or chronic bì syndrome, pain in the waist and knees, joint pain of the legs and feet caused by wind-cold- damp, headache, heaviness of the head and body pain caused by externally-contracted wind-cold complicated by damp, or headache due to latent wind in the shaoyin kidney channel; also for itch of skin. Normally, 3–10 g is decocted with water as an oral dose, or an appropriate amount is used externally

Caution for Use Its use is cautious in patients with yin deficiency and blood dryness

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TABLE 4.1 Properties, Actions, and Application of Common Herbs That Expel Wind-Cold-Damp (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chinese Clematis Root (wei ling xian) (Radix et Rhizoma Clematidis)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried root and rhizome of Clematis chinensis Osbeck, Clematis hexapetala Pall. or Clematis manshuria Rupr. of the Ranunculaceae family. It is collected in autumn; after sediment is removed, it is dried under the sun

Acrid, salty, warm; act on the bladder channel

Dispel wind-damp, unblock the channels and collaterals, relieve pain, and remove bone sticking

Indicated for the treatment of painful bì syndrome caused by wind-damp, with numbness of the limbs, spasms of the sinews, inconvenient flexing and stretching, or pain in the waist and back caused by wind-cold, also for bone sticking in the throat, injury pain from fall, headache, toothache, or pain in the stomach cavity. Normally, 6–10 g is decocted with water as an oral dose, or an appropriate amount is used externally

Due to its acrid and dispersing properties, its use should be cautious in patients with weakness of qi and blood

Common Monkshood Mother Root (chuan wu) (Radix Aconiti)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried mother root of Aconitum carmichaelii Debx. of the Ranunculaceae family. It is collected during the last third of June to the first 10 days of August; after daughter root and sediment are removed, it is dried under the sun

Acrid, bitter, heat, extremely poisonous; act on the heart, liver, kidney, and spleen channels

Dispel wind and eliminate dampness, warm the channels, and relieve pain

Indicated for the treatment of bì syndrome due to wind-cold-damp, with joint pain and inconvenient flexing and stretching, cold pain in the epigastrium and abdomen due to interior exuberant yin cold, cold shàn pain (cold hernia pain), injury from falling down, or as an anesthetic. Normally, after processing, 1.5–3 g is decocted first with water as an oral dose, or an appropriate amount is used externally

Its use is prohibited in pregnant women, and it is not suite to use with Radix Ampelopsis (bai lian), Rhizoma Pinelliae (ban xia), Fructus Trichosanthis (gua lou), Bulbus Fritillaria (bei mu), and Rhizoma Bletillae (bai ji)

(Continued )

106 PART | I Chinese Materia Medica

TABLE 4.1 Properties, Actions, and Application of Common Herbs That Expel Wind-Cold-Damp (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Agkistrodon (qi she) (Agkistrodon)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the dried dody of Agkistrodon acutus (Güenther) of the Viperidae family. It is caught in summer and autumn, split abdomen; after internal organs are removed, it is washed clean, prop open abdomen by bamboo pieces, coiled up like disc, dried, and last bamboo pieces are removed

Sweet, salty, warm, poisonous; act on the liver channel

Dispel wind, unblock the collaterals, and arrest convulsion

Indicated for the treatment of obstinate bì syndrome due to wind-damp, numbness and spasm, wind-strike with hemiplegia (half-body paralysis), twisted mouth and squint eye, (infantile) convulsion, tetanus, leprosy, scabies and tinea; also for the treatment of scrofula, syphilis and ulcer. Normally, 3–9 g is decocted with water as an oral dose, or 1–1.5 g is ground into powder as an oral dose, 2-3 times a day

Its use is prohibited in patients with yin deficiency and internal heat. For oral taking, overdose should be avoided

Black-Tail Snake (wu shao she) (Zaocys)

Initially recorded in Treatise on Medicinal Properties (yao xing lun). It is the dried body of Zaocys dhumnades (Cantor) of the Colubridae family. It is caught in summer and autumn, split abdomen or peel off the skin, remain the head and tail; after internal organs are removed, it is coiled up like disc, and dried

Sweet, neutral; act on the liver channel

Dispel wind, unblock the collaterals and arrest convulsion

Indicated for the treatment of obstinate bì syndrome due to wind-damp, numbness and spasm, wind-strike with twisted mouth and squint eye, hemiplegia (half-body paralysis), convulsion, tetanus, leprosy, scabies and tinea; also for the treatment of scrofula and ulcer. Normally, 6–12 g is decocted with water as an oral dose, 2–3 g is ground into powder as an oral dose, or made into pills or steeped in wine, or an appropriate amount is used externally

Its use is cautious in patients with blood deficiency generating wind

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TABLE 4.1 Properties, Actions, and Application of Common Herbs That Expel Wind-Cold-Damp (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chinese Quince Fruit (mu gua) (Fructus Chaenomelis)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried nearly matured fruit of Chaenomeles speciosa (Sweet) Nakai of the Rosaceae family. When fruit turns green yellow in summer and autumn, it is collected and scalded in boiling water until exocarp turns gray, ripped half, and dried under the sun

Sour, warm; act on the liver, spleen and stomach channels

Relax the sinews and quicken the collaterals, harmonize the stomach, and remove dampness

Indicated for the treatment of painful bì syndrome with spasms of the sinews, soreness and heaviness of the waist, and knee joint due to wind-damp, abdominal pain, vomiting, diarrhea and spasm pain of the muscle due to dampness obstructing in the middle jiao, weak foot with edema due to winddamp, dyspepsia, and thirst due to fluid consumption. Normally, 6–9 g is decocted with water as an oral dose

Its use is prohibited in patients with internal constraint heat, scanty and reddish urine, and not suitable for patients with weakness of waist and knee due to essence and blood deficiency, and kidney yin insufficiency

Silkworm Feces (can sha) (Faeces Bombycis)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried feces of Bombyx mori Linnaeus of the Bombycidae family. It is collected during June to August and dried under the sun, and then earth and broken bits are winnowed

Sweet, acrid, warm; act on the liver, spleen and stomach channels

Dispel wind-damp, harmonize the stomach and remove dampness, invigorate blood and unblock the channels

Indicated for the treatment of painful bì syndrome due to wind-damp, abdominal pain, vomiting, diarrhea and spasm pain of the muscle due to dampturbidity obstructing in the middle jiao, rubella and eczema; also for menstrual block, flooding and spotting (uterine bleeding). Normally, 5–15 g is wrapped with carbasus and decocted with water as an oral dose, or made into pills or powder, or an appropriate amount is used externally

Its use is prohibited in patients with bematoas-thenic myospasm and the limbs are unable to move voluntarily

(Continued )

108 PART | I Chinese Materia Medica

TABLE 4.1 Properties, Actions, and Application of Common Common Herbs That Expel Wind-Cold-Damp (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Common Clubmoss (shen jin cao) (Herba Lycopodii)

Initially recorded in Supplement to ‘The Materia Medica’ (ben cao shi yi). It is the dried entire plant of Lycopodium japonicum Thunb. of the Lycopodiaceae family. It is collected when stem and leaf are flourishing in summer and autumn; after impurities are removed, it is dried under the sun

Slightly bitter, acrid, warm; act on the liver, spleen and kidney channels

Dispel wind and eliminate dampness, relax the sinews, and quicken the collaterals, invigorate blood and relieve pain

Indicated for the treatment of bì syndrome due to wind-cold-damp, aching pain of joints with inconvenient flexing and stretching, weakness of the four limbs and numbness of the skin, injury with blood stasis and swelling from falling down. Normally, 3–12 g is decocted with water as an oral dose, or steeped with in wine for taking orally, or an appropriate amount is pounded for applying the afflicted part externally

Its use is prohibited in patients with excessive bleeding or pregnant women

Aristolochia Mollissima (xun gu feng) (Herba Aristolochiae Mollissimae)

Initially recorded in Illustrated Reference of Botanical Nomenclature (zhi wu ming shi tu kao). It is the rhizome or entire plant of Aristolochia mollissima Hance of the Aristolochiaceae family. It is collected in summer and autumn, then dried under the sun and cut into segments

Acrid, bitter, neutral; act on the liver channel

Dispel wind-damp, invigorate blood, unblock the collaterals, and relieve pain

Indicated for the treatment of painful bì syndrome due to wind-damp, with numbness of the limbs, spasms of the sinews, inconvenient flexing and stretching of the joints, injury from falling down, with swelling and pain due to blood stasis and qi stagnation; also for the treatment of stomachache, toothache, and swollen carbuncles. Normally, 10–15 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is prohibited in patients with yin deficiency and internal heat or pregnant women. If overdose, side effects, such as nausea, vomiting, dizziness, and headache may occur

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TABLE 4.1 Properties, Actions, and Application of Common Herbs That Expel Wind-Cold-Damp (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Pine Nodular Branch (song jie) (Lignum Pini Nodi)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried tuberculiform knot or branch knot of Pinus tabulieformis Carr. or Pinus massoniana Lamb. of the Pinaceae family. It is collected in whole year, then sawed into pieces and dried in the shade

Bitter, acrid, warm; act on the liver and kidney channels

Dispel wind and eliminate dampness, relax the sinews and unblock the collaterals, invigorate blood and relieve pain

Indicated for the treatment of winddamp painful bì syndrome with a pattern of exuberant cold-damp, pain of multiple joints, low back pain, spasms of the muscle, foot bì or wĕi (atrophy), and injury with blood stasis and swelling and pain from falling down. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is steeped in wine or dry-fried and ground into powder for applying the afflicted part externally

Its use is cautious in patients with yin deficiency and blood dryness

Kadsura Pepper Stem (hai feng teng) (Caulis Piperis Kadsurae)

Initially recorded in Renewed Materia Medica (ben cao zai xin). It is the dried rattan stem of Piper kadsura (Choisy) Ohwi of the Piperaceae family. It is collected in summer and autumn; after root and leaf are removed, it is dried under the sun

Acrid, bitter, slightly warm; act on the liver and kidney channels

Dispel wind- damp, unblock the channels and collaterals, rectify qi and relieve bì pain

Indicated for the treatment of bì syndrome due to wind-cold-damp, with limb and joint pain, spasms of the sinews, inconvenient flexing and stretching of the joint, cold pain in the stomach cavity and abdomen, and injury with blood stasis and swelling and pain from falling down; also for the treatment of edema. Normally, 6–12 g is decocted with water as an oral dose, or steeped in wine, and an appropriate amount is used externally

Its use is cautious in patients with vigorous fire due to yin deficiency, and prohibited in patients with heart diseases or pregnant women

(Continued )

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TABLE 4.1 Properties, Actions, and Application of Common Herbs That Expel Wind-Cold-Damp (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Orientvine Stem (qing feng teng) (Caulis Sinomenii)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried rattan stem of Sinomenium acutum (Thunb.) Rehd. et Wils. or Sinomenium acutum (Thunb.) Rehd. et wils. var. cinereum Rehd. et wils. of the Menispermaceae family. It is collected in late autumn and early winter, then cut into pieces and dried under the sun

Bitter, acrid, neutral; act on the liver and spleen channels

Dispel wind- damp, unblock the channels and collaterals, and promote urination

Indicated for the treatment of painful bì syndrome due to wind-damp, with swelling and distention of the joints, or numbness due to winddamp, crane-like arthropathy, paralysis, itch of the skin, edema, and weak foot with swelling due to dampness. Normally, 6–12 g is decocted with water as an oral dose, or steeped in wine, or an appropriate amount of the fresh one is pounded for applying or decocted for washing externally

Its use is cautious in patients with deficiency- cold of the spleen and stomach

Obtuseleaf Erycibe Stem (ding gong teng) (Caulis Erycibes)

Initially recorded in Chinese Pharmacopoeia (zhong hua ren min gong he guo yao dian). It is the dried rattan stem of Erycibe 0btusifolia Benth. or Erycibe schmidtii Craib of the Convolvulaceae family. It is collected in whole year, then cut into segments or pieces and dried under the sun

Acrid, warm, slightly poisonous; act on the liver, spleen, and stomach channels

Dispel wind and eliminate dampness, and relieve swelling and pain

Indicated for the treatment of bì syndrome due to wind-cold-damp, with hemiplegia (half-body paralysis), numbness of the foot and hand, soreness of the waist and leg, and injury with blood stasis and swelling and pain from falling down. Normally, 3–6 g is decocted with water as an oral dose, or made into wine preparation for oral taking or applying the afflicted part externally

Due to its strong effect of inducing sweating, its use is cautious in the weak, and prohibited in pregnant women

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TABLE 4.1 Properties, Actions, and Application of Common Herbs That Expel Wind-Cold-Damp (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Tripterygium Hypoglaucum Root (kun ming shan hai tang) (Radix Tripterygium Hypoglaucum)

Initially recorded in Materia Medica of South Yunnan (dian nan ben cao). It is the dried root or entire plant of Tripterygium hypoglaucum (Levl.) Hutch. of the Celastraceae family. The entire plant is collected in whole year; the root is collected in autumn and washed clean, then cut into pieces and dried under the sun

Bitter, acrid, warm, extremely poisonous; act on the liver, spleen, and kidney channels

Dispel winddamp, dispel stasis and unblock the collaterals, promote reunion of fractured tendon and bone, stanch bleeding, resolve toxins, and kill worms

Indicated for the treatment of wind-cold-damp bì syndrome for a long time, with swelling and pain of the joints, pain in the sinew and bone, injury from falling down, and bone fracture with swelling and pain; also for the treatment of excessive bleeding after childbirth, cancer, and stubborn dermatitis. Normally, 6–15 g of the root or 20–30 g of the stem and branch is decocted first with water as an oral dose, or steeped in wine, or an appropriate amount is used externally

Its use is prohibited in the weak or pregnant women

Shortstalk Monkshood Root (xue shang yi zhi hao) (Radix Aconiti Brachypodi)

Initially recorded in Scientific Folk Medicinals (ke xue de min jian yao cao). It is the dried root tuber of Aconitum brachypodum Diels, A. brachypodum Diels var. laxiflorum Fletcher et Lauener, A. brachypodum Diels var. crispulum W. T. Wang, A. nagarum Stapf var. lasiandrum W. T. Wang., A. nagarum Stapf var. heterotrichum Fletcher et Lauener, A. Pendulum Busch. or A. Flavum Hand.Mazz. of the Ranunculaceae family. It is collected in late summer and early autumn, and dried under the sun; after soaked in water or processed with urina hominis, it is rinsed clean and cut into pieces for use

Bitter, acrid, warm, extremely poisonous; act on the liver channel

Dispel wind- damp, invigorate blood, and relieve pain

Indicated for the treatment of various kinds of pain patterns, such as painful bì (cold bì) syndrome due to wind-damp, neuralgia, toothache, injury pain from fall, after operation pain, and carcinoma pain; swollen sores and ulcers, insect toxin, poisonous snake bite, and bee bite. Normally, 0.02–0.04 g is ground into powder as an oral dose, or an appropriate amount is used externally

For oral use, it should be processed and the dosage should be strictly controlled. And its use is prohibited in pregnant women, the old, the weak, infant, and patients with heart diseases or peptic ulcers

(Continued )

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TABLE 4.1 Properties, Actions, and Application of Common Herbs That Expel Wind-Cold-Damp (cont.) Name of Medicinal Sweetgum Fruit (lu lu tong) (Fructus Liquidambaris)

Property, Channel Entry

Source and Collection Initially recorded in Supplement to “The Grand Compendium of Materia Medica” (ben cao gang mu shi yi). It is the dried matured infructescence of Liquidambar formosana Hance of the Hamamelidaceae family. It is collected when fruit is matured; after impurities are removed, it is dried

Bitter, neutral; act on the liver and kidney channels

Efficacy and Action

Clinical Application and Usage

Dispel wind and quicken the collaterals, promote urination, promote menstruation flow

Indicated for the treatment of painful bì syndrome of joints, numbness and tendon spasm, wind-strike with hemiplegia (halfbody paralysis), injury from falling down, edema with distention and fullness, scant breast milk, inhibited lactation, and menstrual block. Normally, 5–10 g is decocted with water as an oral dose, or an appropriate amount is used externally

Caution for Use Its use is prohibited in pregnant women and patients with profuse menstruation

2. Attached herbs (Table 4.2) TABLE 4.2 Introduction to Attached Herbs That Expel Wind-Cold-Damp Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application Usage

Caution for Use

Difengpi Bark (di feng pi) (Cortex Illicii)

It is the dried tree bark of Illicium difengpi K. I. B. et K. I. M. of the Magnoliaceae family. It is collected in spring and autumn, dried under the sun or at low temperature

Slightly acrid, astringent, warm, slightly poisonous; act on the bladder and kidney channels

Dispel wind and eliminate dampness, move qi, and relieve pain

Indicated for the treatment of painful bì syndrome due to winddamp, low back pain caused by overstrain, and insect bite. Normally, 6–9 g is decocted with water as an oral dose, or an appropriate amount is decocted for washing or applying externally

Its use is cautious in pregnant women

Multibanded Krati (jin qian bai hua she) (Bungarus Parvus)

It is the dried body of young snake of Bungarus multinftus Blyth of the Elapidae family. It is caught in summer and autumn, and split abdomen; after internal organs are removed and bloodstain is wiped, it is soaked in alcohol, coiled up like disc and dried

Sweet, salty, warm, poisonous; act on the liver and spleen channels

Dispel wind, unblock the collaterals, and arrest convulsion

Indicated for the treatment of obstinate bì syndrome due to wind-damp, numbness and spasm, wind-strike with twisted mouth and squint eye, hemiplegia (half-body paralysis), convulsion, tetanus, leprosy, scabies, and tinea. Normally, 2–5 g is ground into powder for oral taking with 1–1.5 g each time

Its use is prohibited in patients with yin and blood deficiency, or internal heat producing wind

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TABLE 4.2 Introduction to Attached Herbs That Expel Wind-Cold-Damp (cont.)

Source and Collection

Property, Channel Entry

Kusnezoff Monkshood Root (cao wu) (Radix Aconiti Kusnezoffii)

It is the dried root tuber of Aconitum kusnezoffii Reichb. of the Ranunculaceae family. It is collected when stem and leaf are withered in autumn; after fibrous root and sediment are removed, it is dried under the sun

Acrid, bitter, heat, extremely poisonous; act on the heart, liver, kidney, and spleen channels

Prepared Kusnezoff Monkshood Root (zhi cao wu) (Radix Aconiti Kusnezoffii Praeparata)

It is the processed product of root tuber of Aconitum kusnezoffii Reichb. of the Ranunculaceae family. It is soaked and rinsed with cool water until slightly peppery flavor can be tasted, then put in the decoction of Radix et Rhizoma Glycyrrhizae (gan cao) and Black Soybean (hei dou) to boil out until no white heart; after gruffs are removed, it is sun to half dry, moistened, cut into pieces, and dried under the sun

Snake Slough (she tui) (Periostracum Serpentis)

Radde Anemone (liang tou jian) (Rhizoma Anemones Raddeanae)

Name of Medicinal

Efficacy and Action

Clinical Application Usage

Caution for Use

Dispel wind and eliminate dampness, dissipate cold, warm the channels, relieve pain, eliminate phlegm, and relieve swelling

Indicated for the treatment of windcold-damp bì syndrome, joint pain, cold pain in the epigastrium and abdomen, numbness and spasm, wind-strike with hemiplegia (halfbody paralysis), cold shàn pain (cold hernia pain), headache due to head wind, tetanus, injury pain from falling down, phlegmatic mass, throat bì (pharyngitis), carbuncle-abscess, deep-rooted boils, scrofula, or as an anesthetic. Normally, after processing, 3–6 g is decocted first with water for 1–2 h as an oral dose, or made into pills or powder, and an appropriate amount is used with vinegar externally

Its use is prohibited in pregnant women, and it is not suited to use with Rhizoma Pinelliae (ban xia), Radix Ampelopsis (bai lian), Fructus Trichosanthis (gua lou), Bulbus Fritillaria (bei mu), and Rhizoma Bletillae (bai ji). Don’t eat the raw one

Acrid, bitter, heat, poisonous; act on the heart, liver, kidney, and spleen channels

Dispel wind and eliminate dampness, warm the channels, and relieve pain

Indicated for the treatment of bì syndrome caused by wind-colddamp, with joint pain, cold pain in the epigastrium and abdomen, cold shàn pain (cold hernia pain), or as an anesthetic. Normally, 1.5–3 g is decocted first or for a long time with water as an oral dose

It is not suited to use with Rhizoma Pinelliae (ban xia), Radix Ampelopsis (bai lian), Fructus Trichosanthis (gua lou), Bulbus Fritillaria (bei mu), and Rhizoma Bletillae (bai ji)

It is the dried exuviated epidermis of Elaphe taeniura Cope, Elaphe carinata (Guenther) or Zaocys dhumnades (Cantor) of the Colubridae family. It is collected in late spring and early summer or early winter; after sediment is removed, it is dried

Salty, sweet, neutral; act on the liver channel

Dispel wind, arrest convulsion, remove nebula, relieve swelling, kill worms, and resolve toxins

Indicated for the treatment of infantile convulsive epilepsy, acute throat troubles, swollen and rigid tongue, oral ulcer, sublingual swelling, nebula cataract, boils, swollen carbuncles, scrofula, mumps, anus fistula, scabies, or tinea. Normally, 3–6 g is decocted with water as an oral dose, or 1.5–3 g is ground into powder as an oral dose, or an appropriate amount is used externally

Its use is prohibited in pregnant women

It is the dried rhizome of Anemone raddeana Regel of the Ranunculaceae family. It is collected in summer; after fibrous root is removed, it is washed cleaned, and dried

Acrid, heat, poisonous; act on the spleen channel

Dispel wind-damp and relieve carbuncle with swelling

Indicated for the treatment of bì syndrome caused by wind-colddamp, with spasm of the limbs, bone joint pain, and swollen carbuncles with ulceration. Normally, 1–3 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is prohibited in pregnant women

(Continued )

114 PART | I Chinese Materia Medica

TABLE 4.2 Introduction to Attached Herbs That Expel Wind-Cold-Damp (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application Usage

Caution for Use

Tuniclike Psammosilene Root (jin tie suo) (Radix Psammosilenes Tunicoidis)

It is the dried root of Psammosilene tunicoides W. C. Wu et C. Y. Wu of the Caryophyllaceae family. It is collected in autumn; after outer bark and impurities are removed, it is dried under the sun

Bitter, acrid, warm, slightly poisonous; act on the liver channel

Dispel wind and eliminate dampness, dissipate stasis and relieve pain, resolve toxins, and relieve swelling

Indicated for the treatment of painful bì syndrome caused by wind-damp, cold pain in the stomach cavity, injury from falling down and bleeding wound. External treatment: sores and furuncle, snake, and insect bite. Normally, 0.1–0.3 g is made into pills or powder as an oral dose or an appropriate amount is used externally

Its use is cautious in pregnant women

Yellow Azalea Flower (nao yang hua) (Flos Rhododendri Mollis)

It is the dried flower of Rhododendron molle G. Don of the Ericaceae family. When blooming initially in April and May, it is collected and dried under the sun or in the shade

Acrid, warm, extremely poisonous; act on the liver channel

Dispel wind and eliminate dampness, dissipate stasis, and stop pain

Indicated for the treatment of painful bì syndrome caused by wind-damp, hemilateral headache (migraine) or general headache, swelling and pain from falling down, and stubborn dermatitis. Normally, 0.6–1.5 g is steeped in wine or made into pills or powder as an oral dose, or an appropriate amount is decocted with water for washing externally

It is not suitable for taking too much or for a long time. Its use is prohibited in the weak and pregnant women

Paniculate Swallowwort Root (xu chang qing) (Radix et Rhizoma Cynanchi Paniculati)

It is the dried root and rhizome of Cynanchum paniculatum (Bge.) Kitag. of the Asclepiadaceae family. It is collected in autumn; after impurities are removed, it is dried in the shade

Acrid, warm; act on the liver and stomach channels

Dispel wind and remove dampness, move qi, and invigorate blood, relieve pain and alleviate itching, resolve toxins, and relieve swelling

Indicated for the treatment of painful bì syndrome caused by wind-damp, stomachache or with distention and fullness, toothache, low back pain, injury pain from falling down, rubella, and eczema. Normally, 3–12 g is decocted later with water as an oral dose, or 1–3 g is ground into power as an oral dose, or made into pills or steeped in wine for taking orally

Its use is cautious in the weak and pregnant women

Tuberculate Speranskia Herb (tou gu cao) (Herba Speranskiae Tuberculatae)

It is the entire plant of Speranskia tuberculata (Bunge) Baill. of the Euphorbiaceae family. It is collected when blooming and bearing fruit during May to June; after impurities are removed, it is dried under the sun

Acrid, warm; act on the liver and kidney channels

Dispel wind and remove dampness, relax the sinews, and invigorate blood, dissipate stasis and relieve swelling, resolve toxins, and relieve pain

Indicated for the treatment of painful bì syndrome caused by wind-damp, with spasms of the sinew and bone, weak foot due to cold-damp, sprain of waist, half-body paralysis, menstrual block, scrotum eczema, swollen sores, and furuncle. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is decocted with water for fumigating and washing, or pounded for applying externally

Its use is prohibited in pregnant women

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3. Herb differentiation (Table 4.3) TABLE 4.3 Differentiation between Similar Efficacy Herbs That Expel Wind-Cold-Damp Name of Medicinal

Similarity

Differences

Double Teeth Pubescent Angelica Root (du huo) (Radix Angelicae Pubescentis)

Both can dispel wind-damp, relieve pain, and release the exterior, are indicated for the treatment of bì syndrome caused by windcold-damp, exterior pattern of wind-cold complicated by dampness, and headache. For bì syndrome with general pain due to wind-cold-damp, both herbs often combine with each other to reinforce their effects

Its property is more moderate, the effect of dispersing is less than that of Rhizoma et Radix Notopterygii (qiang huo), and it is more used for the treatment of wind-cold-damp bì syndrome in lower half of the body, and shaoyin headache. It also can remove the latent wind in the shaoyin kidney channel, and treat the latent-wind headache (headache, dizziness, pain involving the tooth and cheek, pain generating after encountering wind). It also can disperse the fire from constraint and treat the sore pain of gingiva due to wind-fire

Notoptetygium Root (qiang huo) (Rhizoma et Radix Notopterygii)

Multibanded Krati (jin qian bai hua she) (Bungarus Parvus) Agkistrodon (qi she) (Agkistrodon)

Black-Tail Snake (wu shao she) (Zaocys)

Chinese Quince Fruit (mu gua) (Fructus Chaenomelis)

Silkworm Feces (can sha) (Faeces Bombycis)

Its property is partial to dryness, the effect of dispersing is stronger than that of Radix Angelicae Pubescentis (du huo), and it is more used for the treatment of wind-cold-damp bì syndrome with pain in the upper half of the body, and also can treat headache caused by externally-contracted wind-cold All three are the exclusive medicinals that expel wind-damp, have the moving and scurrying properties, can dispel wind, unblock the collaterals and arrest convulsion, and are suitable for the treatment of the patterns of internal or external wind-toxin congestion and stagnation, especially good at treating bì syndrome for a long time due to pathogen invading deeply, with spasms of the sinews, limbs numbness, wind-strike with twisted mouth and squint eye, hemiplegia (half-body paralysis), numbing wind (leprosy), stubborn dermatitis, infantile convulsion, and itch of skin

Its property and efficacy are similar to that of Agkistrodon (qi she), but are stronger than that of Agkistrodon (qi she) and Zaocys (wu shao she)

Both can dispel wind and eliminate dampness, relax the sinews and quicken the collaterals, and harmonize the stomach. Both are warm in nature, and good at harmonizing the center and removing dampness, can treat bì syndrome with spasms due to damp, vomiting and diarrhea, abdominal pain, and spasm of muscle due to damp-turbidity obstructing the center and ascent-descent disorder, both herbs often combine with each other to reinforce their effects

It not only can eliminate dampness and harmonize the stomach, but also has the effects of relaxing the sinews and quickening the collaterals, is good at calming the liver abd relaxing the sinews, is an essential medicinal for the treatment of painful bì syndrome with spasms of the sinews due to wind-damp, and spasm and pain of the sinews due to blood deficiency and hyperactivity of liver. It also can treat weak foot with swelling and pain, discomfort surging into the heart, and indigestion

It is poisonous and has a stronger efficacy, and is an essential medicinal that treats obstinate bì syndrome. Its efficacy of treating scabies and tinea are less than that of Zaocys (wu shao she) It has the effects of dispelling wind and unblocking the collaterals, eliminating dampness and killing worms, its effects are similar to that of Agkistrodon (qi she), but its effects are more moderate and no poison. It is good at dispelling wind of sinews and skin

Its effects are more moderate, and it not only can eliminate dampness, but also is good at dispelling wind, can treat the wind-damp bì syndrome regardless of preponderance of wind or damp. It also can dispel wind and relieve itching, and treat rubella with itching all over the body

116 PART | I Chinese Materia Medica

SECTION 2  HERBS THAT EXPEL WIND-DAMP-HEAT Outline Medicinals in this section are most acrid-bitter in flavor and cold in nature, and act on the liver, spleen, and kidney channels. The acrid medicinals have the effects of moving and dispersing, the bitter medicinals have the effects of descending and draining, the cold medicinals have the effect of clearing heat. Medicinals in this section have satisfactory actions of dispelling wind and eliminating dampness, unblocking the collaterals and relieving pain, clearing heat and relieving swelling, and are indicated for the treatment of wind-damp-heat bì syndrome with red swelling and pain of the joints. Medicinals in this section also can be used for the treatment of wind-cold-damp bì syndrome through combining with other herbs.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 4.4) TABLE 4.4 Properties, Actions, and Application of Common Herbs That Expel Wind-Damp-Heat Name of Medicinal Large Leaf Gentian Root (qin jiao) (Radix Gentianae Macrophyllae)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Gentiana macrophylla Pall., Gentiana straminea Maxim., Gentiana crasicaulis Duthie ex Burk. or Gentiana dahurica Fisch. of the Gentianaceae family. It is collected in spring and autumn; after sediment is removed, it is sun to soften, then piled up until red yellow or gray yellow formed, and dried under the sun; or after black bark is kneaded while fresh and dried under the sun for Dahuria Gentian Root

Property, Channel Entry Acrid, bitter, neutral; act on the stomach, liver, and gallbladder channels

Efficacy and Action

Clinical Application and Usage

Dispel wind-damp, unblock the collaterals and relieve bì pain, abate deficiency heat, clear damp-heat, and relieve jaundice

Indicated for the treatment of painful bì syndrome, spasms of the sinews and soreness of the bone joints caused by wind-damp with regardless of cold or heat pattern, a short or long course, wind-strike with hemiplegia (half-body paralysis), twisted mouth and squint eye, and aphasia with stiff tongue, steaming bone fever or tidal fever, infantile malnutrition fever with accumulation, and jaundice due to damp- heat accumulated in interior; also for the treatment of piles. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder, and an appropriate amount is used externally

Caution for Use Its use is cautious in the thin and weak, and patients with profuse urine, thin, and unformed stool

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TABLE 4.4 Properties, Actions, and Application of Common Herbs That Expel Wind-Damp-Heat (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Four Stamen Stephania Root (fang ji) (Radix Stephaniae Tetrandrae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Stephania tetrandra S. Moore of the Menispermaceae family. It is collected in autumn, then washed clean; after thick bark is removed, it is under sun until 50% is dry, cut into segments (or slivered the large one again), and dried

Bitter, acrid, cold; act on the bladder and lung channels

Dispel wind-damp and relieve pain, promote urination, and relieve edema

Indicated for the treatment of painful bì syndrome with a pattern of exuberance of damp-heat, soreness and heaviness of the limbs, red swelling pain of the joints, or damp-heat body pain, edema of the lower limbs, weak foot and shin with swelling and pain due to damp-heat obstructing the channels and collaterals, difficulty in micturition, eczema and sores, scabies and tinea due to damp-heat; also for the treatment of hypertensive disease. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder

Because its extremely bitter and cold properties that is easy to damage the stomach qi, its use is cautious in patients with anorexia and yin deficiency and the weakling, and prohibited in patients with yin deficiency without damp-heat

Mulberry Twig (sang zhi) (Ramulus Mori)

Initially recorded in Illustrated Classic of Materia Medica (ben cao tu jing). It is the dried twig of Morus alba L. of the Moraceae family. It is collected in late spring and early summer; after leaf is removed, it is dried under the sun, or cut into pieces while fresh and dried under the sun

Slightly bitter, neutral; act on the liver channel

Dispel winddamp, smooth joint movement, promote urination, dispel wind, and relieve itching

Indicated for the treatment of bì syndrome caused by wind-damp with regardless of cold or heat pattern, a short or long course, especially for wind-dampheat bì syndrome with soreness and numbness of the shoulder, arms and joints; also for edema, skin rash and pruritus. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is used externally

No special contraindications

(Continued )

118 PART | I Chinese Materia Medica

TABLE 4.4 Properties, Actions, and Application of Common Herbs That Expel Wind-Damp-Heat (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Siegesbeckia (xi xian cao) (Herba Siegesbeckiae)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried aerial part of Siegesbeckia orientalis L., Siegesbeckia pubescens Makino or Siegesbeckia glabrescens Makino of the Compositae family. It is collected before blooming or in flowering phase in summer and autumn; after impurities are removed, it is dried under the sun

Acrid, bitter, cold; act on the liver and kidney channels

Dispel winddamp, smooth joint movement, and resolve toxins

Indicated for the treatment of painful bì syndrome due to wind-damp, with weak sinew and bone, soreness and weakness of waist and knees, palsy of the four limbs, or wind-strike with hemiplegia (half-body paralysis), twisted mouth and squint eye, rubella, eczema, sores and carbuncles with red swelling and hot pain; also for the treatment of hypertensive disease. Normally, 9–12 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in patients without wind-damp. When overdose or using the raw, vomiting is easy to occur

Clerodendron Leaf (chou wu tong ye) (Folium Clerodendri)

Initially recorded in Illustrated Classic of Materia Medica (ben cao tu jing). It is the dried twig and leaf of Clerodendron trichotomum Thunb. of the Verbenaceae family. It is collected before blooming in summer, then dried under the sun and cut into segments

Acrid, bitter, sweet, cool; act on the liver channel

Dispel winddamp, unblock the channels and collaterals, and calm the liver

Indicated for the treatment of painful bì syndrome due to wind-damp, with numbness of the four limbs, hemiplegia (half-body paralysis), rubella with eczema and itch of the skin; headache and dizziness due to hyperactivity of liver yang. Now, it is often used for hypertensive disease. Normally, 5–15 g is decocted with water as an oral dose, or ground into powder for oral taking with 3 g each time, or an appropriate amount is used externally

When using for high blood pressure, it should not be decocted for a long time

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TABLE 4.4 Properties, Actions, and Application of Common Herbs That Expel Wind-Damp-Heat (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Erythrina Bark (hai tong pi) (Cortex Erythrinae)

Initially recorded in Materia Medica from the [Southern] Seaboard Area (hai yao ben cao). It is the dried trunk bark or root bark of Erythrina variegata L. or E. arborescens Roxb. of the Leguminosae family. It is collected in summer and autumn, then dried under the sun and cut into slivers

Bitter, acrid, neutral; act on the liver channel

Dispel winddamp, unblock the collaterals and relieve pain, kill worms, and alleviate itching

Indicated for the treatment of painful bì syndrome due to wind-damp, with spasms of the limbs, soreness and weakness of waist and knees, or palsy and numbness; especially for the treatment of painful bì syndrome of the lower limb joints, scabies, tinea, and eczema with itching. Normally, 5–15 g is decocted with water as an oral dose, or steeped in water for taking orally, or an appropriate amount is used externally

Its use is cautious in patients with blood deficiency. It is not suitable for patients with low back pain without a pattern of wind-damp

Chinese Star Jasmine Stem (luo shi teng) (Caulis Trachelospermi)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rattan stem of Trachelospermum jasminoides (Lindl.) Lem. of the Apocynaceae family. It is collected during winter to next spring; after impurities are removed, it is dried under the sun

Bitter, slightly cold; act on the heart, liver and kidney channels

Dispel wind and unblock the collaterals, cool the blood and relieve swelling

Indicated for the treatment of heat bì syndrome due to wind-damp, with spasms of the sinews, soreness and weakness of waist and knees; throat bì (pharyngitis) and swollen carbuncles caused by heat toxin congestion, and injury with blood stasis and swelling and pain from falling down. Normally, 6–12 g is decocted with water as an oral dose, or an appropriate amount of the fresh one is pounded for applying externally

Its use is prohibited in patients with aversion to cold due to yang deficiency, thin, and unformed stool

(Continued )

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TABLE 4.4 Properties, Actions, and Application of Common Herbs That Expel Wind-Damp-Heat (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Tripterygium Root (lei gong teng) (Radix Tripterygii Wilfordii)

Initially recorded in Supplement to “The Grand Compendium of Materia Medica” (ben cao gang mu shi yi). It is the dried root or radicular xylem of Tripterygium wilfordii Hook. F. of the Celastraceae family. It is collected in autumn; after soil is removed, it is dried under the sun, or decorticated, dried and cut into thick pieces

Bitter, acrid, cold, extremely poisonous; act on the liver and kidney channels

Dispel winddamp, invigorate blood and unblock the collaterals, relieve swelling and pain, kill worms, and resolve toxins

Indicated for the treatment of obstinate bì syndrome due to wind-damp, especially for red swelling hot pain with morning stiffness, even arthrentasis; leprosy, stubborn dermatitis, eczema, scabies, and swollen furuncle due to heat toxin. Normally, 10–25 g is decocted with water with mild flame for 1–2 h as an oral dose, and dosage of the one with root bark should be decreased, or ground into powder for oral taking with 1.5–4.5 g every day; or an appropriate amount is used externally

Its use is prohibited in pregnant women and cautious in patients with structural diseases of internal organs and leucopenia

Common Heron’s Bill (lao guan cao) (Herba Erodii Stephaniani)

Initially recorded in Materia Medica for Famine Relief (jiu huang ben cao). It is the dried aerial part of Erodium stephanianum Willd., Geranium wilfordii Maxim. or G. carolinianum L. of the Geraniaceae family. When fruit is nearly matured in summer and autumn, it is collected and dried under the sun and cut into segments

Acrid, bitter, neutral; act on the liver, kidney and spleen channels

Dispel winddamp, unblock the collaterals, clear heat toxin, and arrest diarrhea and dysentery

Indicated for the treatment of painful bì syndrome due to wind-damp, with numbness, spasms, soreness of sinew and bone, diarrhea, and dysentery due to damp-heat or heat toxin, sores and ulcers, carbuncles and furuncle, eczema, burn, and scald due to accumulated damp toxin. Normally, 9–15 g is decocted with water as an oral dose, or decocted into paste or steeped in wine for taking orally, or an appropriate amount is used externally

No special contraindications

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TABLE 4.4 Properties, Actions, and Application of Common Herbs That Expel Wind-Damp-Heat (cont.) Name of Medicinal

Source and Collection

Japanese Dioscorea Rhizome (chuan shan long) (Rhizoma Dioscoreae Nipponicae)

Initially recorded in Medicinal Herbal of Northeast (dong bei yao yong zhi wu zhi). It is the dried rhizome of Diosocorea nipponica Makino of the Dioscoreaceae family. It is collected in spring and autumn, and then washed clean; after fibrous root and outer bark are removed, it is dried under the sun

Luffa Vegetable Sponge (si gua luo) (Retinervus Luffae Fructus)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried vascular bundle of matured fruit of Luffa cylindrica (L.) Roem. of the Cucurbitaceae family. When fruit is matured, rind turns yellow, and the interior is withered in summer and autumn, it is collected; after rind and sarcocarp are removed, it is washed clean; after seed is removed, it is dried under the sun

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Bitter, slight cold; act on the liver, kidney and lung channels

Dispel wind and remove dampness, relax the sinews and unblock the collaterals, invigorate blood and relieve pain, relieve cough and panting

Indicated for the treatment of painful bì syndrome due to wind-damp, with joint swelling, low back and leg pain, numbness of the limbs, injury from falling down, cough and panting due to phlegm-heat, chest bì syndrome, carbuncles, and more used for the treatment of heat bì syndrome. Normally, 9–15 g is decocted with water as an oral dose, or made into wine preparation for using, or an appropriate amount is used externally

When it is processed to crush to pieces, pay attention to protect in order to avoid anaphylactic response

Sweet, neutral; act on the lung, stomach and liver channels

Dispel wind, unblock the collaterals, invigorate blood, and promote lactation

Indicated for the treatment of painful bì syndrome due to wind-damp, spasms of the sinews, distending pain in the chest and hypochondrium due to qi stagnation and blood stasis, inhibited lactation, mammary abscess (acute mastitis) with swelling pain; also for the treatment of injury from falling down and chest bì syndrome. Normally, 5–12 g is decocted with water as an oral dose, or an appropriate amount is used externally

No special contraindications

Caution for Use

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2. Attached herbs (Table 4.5) TABLE 4.5 Introduction to Attached Herbs That Expel Wind-Damp-Heat Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Chinese Stauntonvine Stem and Leaf (ye mu gua) (Caulis et Folium Stauntoniae Chinensis)

It is the dried stem and branch with leaf of Stauntonia chinensis DC. of the Laidizabalaceae family. It is collected in whole year, then washed clean, cut into segments, and dried

Slightly bitter, neutral; act on the liver and stomach channels

Dispel wind and relieve pain, relax the sinews, and quicken the collaterals

Indicated for the treatment of painful bì syndrome caused by wind-damp, low back pain or leg pain, headache, toothache, painful menstruation, and injury pain from falling down. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in pregnant women

China Greenbrier (ba qia) (Rhizoma Smilacis Chinae)

It is the dried rhizome of Smilax china L. of the Liliaceae family. It is collected during the late autumn to the next spring; after soil and fibrous root are removed, it is washed clean and dried under the sun; or cut into pieces while fresh and dried

Sweet, sour, neutral; act on the liver and kidney channels

Dispel wind and drain dampness, resolve toxins and carbuncles

Indicated for the treatment of painful bì syndrome caused by wind-damp, turbid strangury, abnormal vaginal discharge, diarrhea, dysentery, swollen carbuncles and sores, stubborn dermatitis, scald and burn. Normally, 10–30 g is decocted with water as an oral dose, or steeped in wine, made into pills or powder for taking orally

It is prohibited to use together with tea and vinegar

Clinical Application and Usage

Caution for Use

3. Herb differentiation (Table 4.6) TABLE 4.6 Differentiation Between Similar Efficacy Herbs That Expel Wind-Damp-Heat Name of Medicinal

Similarity

Differences

Stephania Tetrandra (han fang ji) (Radix Stephaniae Tetrandrae)

Both are bitter-acrid in flavor and cold in nature, act on the bladder and lung channels, and can dispel wind-damp and promote urination

It mainly governs the water pathogen, has strong effects of promoting urination and relieving edema, and is more used for the treatment of edema. If patients with the syndrome is partial to the inferior part, and preponderance of dampness over wind, Radix Stephaniae Tetrandrae (han fang ji) is often selected to use

Southern Fangji Root (mu fang ji) (Radix Cocculi Trilobi)

Chinese Star Jasmine Stem (luo shi teng) (Caulis Trachelospermi) Kadsura Pepper Stem (hai feng teng) (Caulis Piperis Kadsurae)

It mainly governs wind pathogen, has better effects of diffusing and unblocking, expelling wind-damp and relieving pain, and is more for treating painful bì syndrome. If patients with the syndrome are partial to the superior part and preponderance of wind over dampness, Radix Cocculi Trilobi (mu fang ji) is often selected to use Both are the herbs that expel wind-damp, can dispel wind and unblock the collaterals, and are commonly used for the treatment of inconvenient flexing and stretching of the joints and hypertonicity of the sinews caused by wind-damp, and injury from falling down

It is slightly cold in nature, and suitable for the treatment of patients with painful bì syndrome due to wind-damp, complicated by heat syndrome. It also can cool the blood and relieve swelling, and treat swollen sores and throat bì (pharyngitis) due to heat toxin, and injury from falling down with swelling and blood stasis It is partial to the warm property, and suitable for the treatment of patients with bì syndrome accompanied by more obvious wind-cold-damp, joint pain, spasms of the sinews, inhibited flexing and stretching, and no heat syndrome

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SECTION 3  HERBS THAT EXPEL WIND-DAMP AND STRENGTHEN THE SINEW AND BONE Outline Medicinals in this section mainly act on the liver and kidney channels, and not only can dispel wind and dampness, but also have definite effects of supplementing the liver and kidney, and strengthening the sinew and bone, and are mainly indicated for the treatment of wind-damp bì syndrome lasting for a long time, liver and kidney deficiency, soreness and weakness of waist and knees, and weakness or flaccidity of feet. If wind-damp invading the body for a long time, the liver and kidney are easy to be damaged; on the contrary, deficiency of liver and kidney, the wind-cold-damp pathogen is easy to attack the waist and knees again, so the herbs in this section have the actions of reinforcing healthy qi to dispel pathogen and treating both the root and branch simultaneously. They also can be used for the treatment of lumbago, bone wĕi (atrophy) with weakness or flaccidity due to deficiency of the kidney.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 4.7)

TABLE 4.7 Properties, Actions and Application of Common Herbs That Expel Wind-Damp and Strengthen the Sinew and Bone Name of Medicinal Eleutherococcus Root Bark (wu jia pi) (Cortex Acanthopanacis)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root bark of Acanthopanax gracilistylus W. W. Smith of the Araliaceae family. The root is collected in summer and autumn, then washed clean; the root bark is peeled off and dried under the sun

Property, Channel Entry Acrid, bitter, warm; act on the liver and kidney channels

Efficacy and Action

Clinical Application and Usage

Dispel wind and remove dampness, supplement and boost the liver and kidney, strengthen the sinew and bone, promote urination, and relieve edema

Indicated for the treatment of bì syndrome caused by wind-damp, with pain in the waist and knees, spasms of the sinews, especially for the old and weak due to chronic disease; flaccid sinews and bones due to deficiency of liver and kidney, infantile walk retardation, lack of strength, edema, and weak foot with swelling and pain due to obstruction of wind-cold-damp. Normally, 5–10 g is decocted with water as an oral dose, or steeped in wine, made into pills or powder for taking orally

Caution for Use Its use is cautious in patients with vigorous fire due to yin deficiency

(Continued )

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TABLE 4.7 Properties, Actions and Application of Common Herbs That Expel Wind-Damp and Strengthen the Sinew and Bone (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chinese Taxillus (sang ji sheng) (Herba Taxilli)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried stem and branch with leaf of Taxillus chinensis (DC.) Danser of the Loranthaceae family. It is collected during winter to next spring; after big stem is removed, it is cut into segments and dried, or steamed and dried

Bitter, sweet, neutral; act on the liver and kidney channels

Dispel wind-damp, supplement the liver and kidney, strengthen the sinew and bone, and calm the fetus

Indicated for the treatment of painful bì syndrome caused by winddamp, especially for soreness and weakness of waist and knees, and weak sinew and bone due to bì syndrome lasting for a long time and damaging the liver and kidney; uterine bleeding, profuse menstruation, vaginal bleeding (painless spotting) during pregnancy, restless fetus, and dizziness; also for the treatment of hypertensive disease. Normally, 9–15 g is decocted with water as an oral dose

No special contraindications

Chain Fern (gou ji) (Rhizoma Cibotii)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome of Cibotium barometz (L.) J. Sm. of the Dicksoniaceae family. It is collected in autumn and winter; after sediment is removed, it is dried; or after hard root, leafstalk, and golden yellow floss are removed, it is cut into thick pieces and dried, or steamed and sun until 60%–70% is dry

Bitter, sweet, warm; act on the liver and kidney channels

Dispel wind-damp, supplement the liver and kidney, and strengthen the waist and knee

Indicated for the treatment of painful bì syndrome caused by wind-damp, especially for low back pain and stiff spine with inability to bend over due to deficiency of the liver and kidney complicated by windcold-damp, soreness and weakness of waist and knees, lack of strength of the lower limbs due to liver-kidney depletion, enuresis due to kidney deficiency and leukorrhagia due to deficiency-cold of the chong and ren mai. Normally, 6–12 g is decocted with water as an oral dose

Its use is cautious in patients with kidney deficiency with fever, difficulty in micturition or short inhibited voiding of deepcolored urine

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TABLE 4.7 Properties, Actions and Application of Common Herbs That Expel Wind-Damp and Strengthen the Sinew and Bone (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Homalomena Rhizome (qian nian jian) (Rhizoma Homalomenae)

Initially recorded in Supplement to “The Grand Compendium of Materia Medica” (ben cao gang mu shi yi). It is the dried rhizome of Homalomena occulta (Lour.) Schott of the Araceae family. It is collected in spring and autumn, washed clean; after outer bark is removed, it is dried under the sun

Bitter, acrid, warm; act on the liver and kidney channels

Dispel winddamp, and strengthen the sinew and bone

Indicated for the treatment of bì syndrome caused by wind-cold-damp, especially for the old with cold pain in the waist and knees, spasms and numbness of the lower limbs, and flaccid sinews and bones. Normally, 5–10 g is decocted with water as an oral dose, or steeped in wine for taking orally

Its use is cautious in patients with yin deficiency and internal heat

Snow Lotus (xue lian hua) (Herba Saussureae Lanicepsis)

Initially recorded in Supplement to “The Grand Compendium of Materia Medica” (ben cao gang mu shi yi). It is the whole plant with flower of Saussurea laniceps Hand.-Mazz., S. Gnaphaloides (Royle) Sch.-Bip. or S. Medusa Maxim. of the Compositae family. It is collected before blooming During June to July; after soil is removed, it is dried in the open-air and cut into segments

Sweet, slightly bitter, warm; act on the liver and kidney channels

Dispel winddamp, and strengthen the sinew and bone, supplement the kidney yang, regulate menstruation, and stanch bleeding

Indicated for the treatment of bì syndrome caused by wind-damp, especially for bì syndrome with preponderance of cold-damp, weakness of waist and knees due to wind-damp lasting for a long time and the liver-kidney deficiency, yang wĕi (impotence), flaccid sinews and bones due to kidney deficiency, menstrual irregularities or block, painful menstruation, uterine bleeding and morbid leukorrhea. Normally, 6–12 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is prohibited in pregnant women. If overdosage, great dripping sweating may occur

(Continued )

126 PART | I Chinese Materia Medica

TABLE 4.7 Properties, Actions and Application of Common Herbs That Expel Wind-Damp and Strengthen the Sinew and Bone  (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Pyrola (lu xian cao) (Herba Pyrolae)

Initially recorded in Materia Medica of South Yunnan (dian nan ben cao). It is the dried entire plant of Pyrola calliantha H. Andres or Pyrola decorata H. Andres of the Pyrolaceae family. It is collected in whole year; after impurities are removed, it is dried until leaf becomes soft, piled up until leaf turns purple brown, and dried under the sun

Sweet, bitter, warm; act on the liver and kidney channels

Dispel winddamp, and strengthen the sinew and bone, stanch bleeding, and relieve cough

Indicated for the treatment of painful bì syndrome caused by wind-damp, low back pain due to kidney deficiency, flaccid waist and knees, profuse menstruation, flooding and spotting (uterine bleeding), expectoration of blood, bleeding wound, chronic cough due to lung deficiency or deficiency-type panting due to failure of the kidney to grasp qi. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is cautious in pregnant women

Chinese Photinia Leaf (shi nan ye) (Folium Photiniae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried leaf of Photinia serrulata Lindl. of the Rosaceae family. It is collected in whole year, then dried under the sun and cut into slivers

Acrid, bitter, neutral, slightly poisonous; act on the liver and kidney channels

Dispel wind- damp, unblock the channels and collaterals, and boost the kidney qi

Indicated for the treatment of bì syndrome caused by wind-damp, especially for wind-damp lasting for a long time with soreness and weakness of the waist feet due to kidney deficiency, recurrent headache or hemilateral headache (migraine), and rubella with itching. Normally, 10–15 g is decocted with water as an oral dose, or an appropriate amount is used externally

Its use is prohibited in patients with vigorous fire due to yin deficiency

Herbs That Expel Wind and Damp Chapter | 4

127

2. Attached herbs (Table 4.8) TABLE 4.8 Introduction to Attached Herbs That Expel Wind-Damp and Strengthen the Sinew and Bone Name of Medicinal

Source and Collection

Property, Channel Entry

Tianshan Mountain Snow Lotus (tian shan xue lian) (Herba Saussureae Involucratae)

It is the dried aerial part of Saussurea involucrata (Kar. et Kir.) Sch.-Bip. of the Compositae family. It is a habitually used medicinal in Uygur nationality, collected when blooming in summer and autumn, and dried in the shade

Uighur medicine: secondary order damp-heat in nature; TCM: slightly bitter, warm

Uighur medicine: supplement the kidney and invigorate blood, strengthen the sinew and bone, nourish nerve, and regulate abnormal body fluids; TCM: warm the kidney and assist yang, dispel wind, and overcome dampness, unblock the channels, and invigorate blood

Indicated for rheumatic arthritis, joint pain, cough due to lung cold, cold pain in the lower abdomen and kidney region, and profuse abnormal vaginal discharge. Normally, 3–6 g is decocted with water as an oral dose, or steeped in wine, or an appropriate amount is used externally

Its use is prohibited in pregnant women

Colored Mistletoe (hu ji sheng) (Herba Visci)

It is the dried stem and branch with leaf of Viscum coloratum (Komar.) Nakai of the Loranthaceae family. It is collected during winter to next spring, after big stem is removed, cut into segments and dried, or steamed and dried

Bitter, neutral; act on the liver and kidney channels

Dispel wind-damp, supplement the liver and kidney, strengthen the sinew and bone, and calm the fetus

Indicated for the treatment of painful bì syndrome due to winddamp, soreness and weakness of the waist and knees, or weakness of sinew and bone, flooding and spotting (uterine bleeding), profuse menstruation, vaginal bleeding (painless spotting) during pregnancy, restless fetus, and dizziness. Normally, 9–15 g is decocted with water as an oral dose

No special contraindications

Efficacy and Action

Clinical Application and Usage

Caution for Use

3. Herb differentiation (Table 4.9)

TABLE 4.9 Differentiation Between Similar Efficacy Herbs That Expel Wind-Damp and Strengthen the Sinew and Bone Name of Medicinal

Similarity

Differences

Eleutherococcus Root Bark (wu jia pi) (Cortex Acanthopanacis)

Both can expel wind and eliminate dampness, strengthen the sinew and bone, and treat painful bì syndrome due to wind-damp, spasms of the limbs, inconvenient flexing and stretching of the joint, soreness and weakness of waist and knees, and infantile walk retardation

It is acrid and bitter in flavor and warm in nature. It can promote urination and relieve edema, and treat edema of skin and weak foot due to dampness; also can dispel wind and eliminate dampness and relieve itching, and treat male scrotum eczema with itching, female vaginal itching, and morbid leukorrhea

Chinese Taxillus (sang ji sheng) (Herba Taxilli)

It is bitter and sweet in flavor and neutral in nature, has stronger effects of supplementing and boosting the liver and kidney than that of Eleutherococcus Root Bark (wu jia pi), can strengthen the sinew and bone, mainly treat wind-damp bì syndrome with liver-kidney insufficiency and nutrient-blood depletion, with weak sinew and bone, soreness and weakness of waist and knees; also can consolidate the chong and ren mai and calm the fetus, and treat restless fetus and vaginal bleeding (painless spotting) during pregnancy due to liver-kidney insufficiency and insecurity of the chong and ren mai

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Chapter 5

Herbs That Transform Dampness Chapter Outline Specific Application Knowledge of Herbs

130

ABSTRACT Chinese herbal medicinals that are fragrant in flavor, warm and dry in nature, and have the major effects of transforming dampness and activating the spleen are called “Herbs That Transform Dampness.” Herbs that transform dampness are mainly indicated for the treatment of pĭ and fullness in the stomach cavity and abdomen, vomiting and acid regurgitation, thin and unformed stool, less eating and fatigue, sweet taste in the mouth with more drool, white and greasy tongue coating caused by damp-turbidity obstructed in interior, damp encumbering the spleen, transportation, and transformation disorder. Keywords: herbs that transform dampness; dry dampness and fortify the spleen; remove dampness and move qi

Chinese herbal medicinals that are fragrant in flavor, warm and dry in nature, and have the major effects of transforming dampness and activating the spleen are called “Herbs That Transform Dampness.” The spleen likes dryness and dislikes dampness, “earth (spleen) likes warm and is fond of fragrance.” Medicinals in this chapter are acrid, fragrant, warm and dry, and mainly act on the spleen and stomach channels, can promote the spleen-stomach transportation and transformation, and eliminate dampturbidity, which are called by the predecessor as “awaken the spleen” or “awaken the spleen and remove dampness.” Meanwhile, the acrid property can show the effect of moving qi; the fragrant property can show the effect of unblocking qi; both can promote the qi movement in the middle jiao to remove the syndrome of qi stagnation in the spleen-stomach caused by damp-turbidity. In addition, some medicinals also can remove pathogenic qi in four seasons depended on its acrid-fragrant, and warm-dry properties, and have the effects of resolving summer heat, dispelling filth, opening the orifices and preventing attack of malaria. Herbs that transform dampness are mainly indicated for the treatment of pĭ and fullness in the stomach cavity and abdomen, vomiting and acid regurgitation, thin and unformed stool, less eating and fatigue, sweet taste in the mouth with more drool, white and greasy tongue coating caused by damp-turbidity obstructed in interior, damp encumbering the spleen, transportation, and transformation disorder. Moreover, they have the effect of resolving summer heat with aromatics, and can treat syndrome of damp-warmth, summer heat-damp in the initial stage, or damp-heat accumulated in interior, accompanied by unsurfaced fever, distention and oppression in the chest and stomach cavity. Some medicinals can be used for the treatment of pestilence or epidemic, and malignant malaria. Aromatic medicinals that remove dampness have a certain therapeutic effect on chronic gastroenteritis, gastroneurosis, gastrointestinal type cold, acute gastroenteritis, and typhus abdominalis in modern medicine, respectively. When using herbs that transform dampness, doctors should appropriately combine other medicinals, according to the different conditions of damp encumbrance and the accompanied symptoms and signs. For patients with distention, fullness, pĭ and oppression in the stomach cavity and abdomen caused by dampness obstruction and qi stagnation, they often combine with herbs that move qi; for patients with cold pain in the stomach cavity and abdomen due to dampness obstruction and partial to cold-damp, they can combine with herbs that warm the center and dispel cold; for patients with pĭ in the stomach cavity, poor appetite and digestion, mental fatigue, and lack of power, they commonly combine with herbs that supplement qi and fortify the spleen; for patients with damp-warmth, damp-heat, or summer heat-damp syndrome, they often combine with herbs that clear heat and dry dampness, resolve summer heat or drain dampness. Herbs that transform dampness are fragrant in flavor, and most of them contain volatile oil, so they are generally made into powder for oral taking in order to play a better efficacy. If used for decoctions, they should be added at the end, and Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00005-1 Copyright © 2017 Elsevier Inc. All rights reserved.

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130 PART | I Chinese Materia Medica

should not be decocted for a long time in order to avoid the loss of volatile effective constituents and decrease of therapeutic effect. Most of medicinals in this category belong to the ones that are acrid, warm, fragrant and dry, and easy to consume qi and damage yin, so patients with yin deficiency and blood dryness or qi deficiency should be cautious to use. The modern pharmacological research indicates most of the herbs that transform dampness can stimulate the olfactory sensation, gustatory sensation, and gastric mucosa, and accordingly promote gastric secretion, excite the peristalsis of intestinal canal, and quicken the gastrointestinal propulsive motility to strengthen appetite, promote digestion, and discharge the accumulation of gas in the intestinal tract.

SPECIFIC APPLICATION KNOWLEDGE OF HERBS 1. Primary herbs (Table 5.1)

TABLE 5.1 Properties, Actions, and Application of Common Herbs That Transform Dampness Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Cablin Patchouli (guang huo xiang) (Herba Pogostemonis)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried aerial part of Pogostemon cablin (Blanco) Benth. of the Labiatae family. When branch and leaf are flourishing, it is collected and dried under the sun, and sealed to moisten at night repeatedly until it is dry

Acrid, slightly warm; act on the spleen, stomach, and lung channels

Aromatic medicinals remove turbidity, harmonize the center and arrest vomiting, release the exterior and resolve summer- heat

Indicated for the treatment of pĭ and oppression in the stomach cavity and abdomen, and vomiting due to dampturbidity obstructing in the middle jiao, summer heat-damp attacking the exterior or damp-warmth in the initial stage with fever, fatigue, chest oppression, cold-damp blocking summer heat with abdominal pain, vomiting, diarrhea, and headache. Normally, 5–10 g is decocted with water as an oral dose; dose of the fresh one should be doubled

It is not suitable for patients with yin deficiency and blood dryness

Eupatorium (pei lan) (Herba Eupatorii)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried aerial part of Eupatorium fortunei Turcz. of the Compositae family. It is collected twice in summer and autumn, respectively; after impurities are removed, it is dried under the sun

Acrid, neutral; act on the spleen, stomach, and lung channels

Aromatic medicinals remove dampness, awaken the spleen and increase appetite, release the exterior, and resolve summer- heat

Indicated for the treatment of stomach cavity pĭ with nausea and vomiting due to damp-turbidity obstructing in the middle jiao, sweet taste and greasy sensation in the mouth, bad breath, drooling, summer heat-damp attacking the exterior or dampwarmth in the initial stage with fever, fatigue and chest oppression. Normally, 5–10 g is decocted with water as an oral dose; the fresh one should be doubled at the dose

Its use is cautious in patients with yin deficiency and blood dryness, and qi deficiency

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TABLE 5.1 Properties, Actions, and Application of Common Herbs That Transform Dampness (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Atractylodes Rhizome (cang zhu) (Rhizoma Atractylodis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizoma of Atractylodes lancea (Thunb.) DC. or Atractylodes chinensis (DC.) Koidz. of the Compositae family. It is collected in spring and autumn; after sediment is removed, it is dried under the sun and stroked to separate fibrous root

Acrid, bitter, warm; act on the spleen, stomach, and liver channels

Dry dampness and fortify the spleen, dispel wind and dissipate cold, and improve vision

Indicated for the treatment of distention and fullness in the stomach cavity and abdomen, and diarrhea due to dampness obstructing in the middle jiao, edema and weak foot due to dampness, painful bì syndrome caused by wind-damp, common cold due to wind-cold, night blindness, blurred vision, and dry eyes. Normally, 3–9 g is decocted with water as an oral dose

Its use is prohibited in patients with yin deficiency and internal heat, and profuse sweating due to qi deficiency

Magnolia Bark (hou po) (Cortex Magnoliae Officinalis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried trunk bark, root bark and branch bark of Magnolia officinalis Rehd. et Wils. or Magnolia officinalis Rehd. et Wils. var. biloba Rehd. et Wils. of the Magnoliaceae family. The bark is peeled off during April to June; root and branch bark is directly dried in the shade; trunk bark is slightly decocted with boiling water, then piled in the shady and wet place until the inner surface turns purple brown, then steamed to soften, taken out, coiled like tube and dried

Bitter, acrid, warm; act on the spleen, stomach, lung, and large intestine channels

Dry dampness and disperse phlegm, lower qi and relieve abdominal fullness

Indicated for the treatment of distention and fullness in the stomach, vomiting and diarrhea due to dampness stagnation damaging the center, abdominal distention, and constipation due to food accumulation and qi stagnation, cough and panting due to phlegm rheum obstructing the lung; also used for the treatment of plum-stone qi (globus hystericus) due to binding of phlegm and qi. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder

Its use is cautious in patients with qi deficiency and fluid consumption or pregnant women

(Continued)

132 PART | I Chinese Materia Medica

TABLE 5.1 Properties, Actions, and Application of Common Herbs That Transform Dampness (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Villous Amomum Fruit (sha ren) (Fructus Amomi)

Initially recorded in Treatise on Medicinal Properties (yao xing lun). It is the dried matured fruit of Amomum villosum Lour., Amomum villosum Lour. var. xanthioides T.L.Wu et Senjen or Amomum longiligularg T.L. wu of the Zingiberaceae family. It is collected when matured in summer and autumn, and dried under the sun or at low temperature

Acrid, warm; act on the spleen, stomach, and kidney channels

Remove dampness and increase appetite, warm the spleen and arrest diarrhea, rectify qi and calm the fetus

Indicated for the treatment of stomach cavity pĭ without hunger due to dampturbidity obstructing in the middle jiao or qi stagnation in the spleen and stomach, especially for which induced by qi stagnation due to cold-damp, vomiting and diarrhea due to deficiency-cold of the spleen-stomach, pernicious vomiting during pregnancy and restless fetus due to qi stagnation. Normally, 3–6 g is added later and decocted with water as an oral dose

Its use is cautious in patients with yin deficiency and blood dryness

Round Cardamon (bai dou kou) (Fructus Amomi Kravanh)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried matured fruit of Amomum kravanh Pierre ex Gagnep. or Amomum compactum Soland ex Maton of the Zingiberaceae family. When fruit turns yellow from green in autumn, it is collected and dried under the sun

Acrid, warm; act on the lung, spleen, and stomach channels

Remove dampness and move qi, warm the center and arrest vomiting, increase appetite and promote digestion

Indicated for the treatment of no desire to eat due to dampturbidity obstructing in the middle jiao, damp-warmth in the initial stage with chest oppression and no hunger, vomiting due to stomach cold and dampness obstruction and qi stagnation with distending pain in the chest and abdomen, and food accumulation. Normally, 3–6 g is added later and decocted with water as an oral dose

Its use is cautious in patients with yin deficiency and blood dryness

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TABLE 5.1 Properties, Actions, and Application of Common Herbs That Transform Dampness (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Katsumadai (cao dou kou) (Semen Alpiniae Katsumadai)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the dried near matured seed of Alpinia katsumadai Hayata of the Zingiberaceae family. The fruit is collected in summer and autumn, then dried under the sun until 90% is dry, or slightly scalded by water, dried under the sun until 50% is dry, then removed the seed vessel; seed mass is taken out and dried under the sun

Acrid, warm; act on the spleen and stomach channels

Dry dampness and move qi, warm the center and arrest vomiting

Indicated for the treatment of distention, fullness, and cold pain in the stomach cavity and abdomen caused by colddamp obstructing in the middle jiao, belching and vomiting, and no pleasure in eating due to colddamp, diarrhea, and dysentery with abdominal pain caused by exuberant cold-damp in the middle jiao. Normally, 3–6 g is added later and decocted with water as an oral dose, or is better to be made into powder for taking

Its use is cautious in patients with yin deficiency and blood dryness

Tsaoko Fruit (cao guo) (Fructus Tsaoko)

Initially recorded in Principles of Correct Diet (yin shan zheng yao). It is the dried matured fruit of Amomum tsao-ko Crevost et Lemaire of the Zingiberaceae family. It is collected when fruit is matured in autumn; after impurities are removed, it is dried under the sun or at low temperature

Acrid, warm; act on the spleen and stomach channels

Dry dampness and warm the center, prevent attack of malaria and dispel phlegm

Indicated for the treatment of distending pain in the stomach cavity and abdomen, pĭ and fullness and vomiting, diarrhea, turbid greasy coating due to internal obstruction of exuberant cold-damp, malaria with chills and fever, and pestilence with fever. Normally, 3–6 g is decocted with water as an oral dose

Its use is cautious in patients with yin deficiency and blood dryness

134 PART | I Chinese Materia Medica

2. Attached herbs (Table 5.2) TABLE 5.2 Introduction to Attached Herbs That Transform Dampness Name of Medicinal

Source and Collection

Property, Channel Entry

Magnolia Flower (hou po hua) (Flos Magnoliae Officinalis)

It is the dried flower bud of Magnolia officinalis Rehd.et Wils. or Magnolia officinalis Rehd. et Wils. var. biloba Rehd. et Wils. of the Magnoliaceae family. Before blooming in spring, it is collected, steamed in the food steamer until gas rising for about 10 min, and dried under the sun or at low temperature

Bitter, slightly bitter, slightly warm; act on the spleen, stomach, and lung channels

Aromatic medicinals remove dampness, rectify qi to loosen the center, and resolve constraint

Indicated for the treatment of pĭ and fullness and distention in the chest and stomach cavity due to qi stagnation in the liver and stomach, no pleasure in eating due to dampness obstruction and qi stagnation in the spleen and stomach, or for common cold with cough and chest oppression. Normally, 3–9 g is decocted with water as an oral dose

Its use is prohibited in patients with yin deficiency and fluid dryness or fluid consumption

Villous Amomum Pericarp (sha ren qiao) (Pericarpium Amomi)

It is the nut shell of Amomum villosum Lour., Amomum villosum Lour. var. xanthioides T.L.Wu et Senjen or Amomum longiligularg T.L. wu of the Zingiberaceae family. When matured in summer and autumn, it is collected and dried

Acrid, warm; act on the spleen and stomach channels

Remove dampness and move qi, warm the center and arrest vomiting

Indicated for the treatment of distending pain in the stomach cavity and abdomen, vomiting, and less eating due to qi stagnation in the spleen and stomach. Normally, 3–6 g is added later and decocted with water as an oral dose

Its use is cautious in patients with yin deficiency and fever

Round Cardamon Husk (bai dou kou qiao) (Pericarpium Amomi Kravanh)

It is the nut shell of Amomum kravanh Pierre ex Gagnep. or Amomum compactum Soland ex Maton of the Zingiberaceae family. When fruit turns yellow from green in autumn, it is collected and dried

Acrid, slightly warm; act on the spleen and stomach channels

Remove dampness and move qi, warm the center and arrest vomiting

Indicated for the treatment of pĭ and fullness in the stomach cavity and abdomen, no pleasure in eating, and vomiting due to dampness obstruction and qi stagnation. Normally, 3–5 g is added later and decocted with water as an oral dose

Its use is cautious in patients with yin deficiency and fever

Efficacy and Action

Clinical Application and Usage Caution for Use

Herbs That Transform Dampness Chapter | 5

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3. Herb differentiation (Table 5.3) TABLE 5.3 Differentiation Between Similar Efficacy Herbs That Transform Dampness Name of Medicinal

Similarity

Differences

Eupatorium (pei lan) (Herba Eupatorii)

Both are acrid-fragrant in flavor, can remove dampness, resolve summer heat and release the exterior so as to treat syndromes due to dampness obstructing in the middle jiao, externally-contracted summer heat-damp and damp-warmth in the initial stage. Both often combine with each other to use

It is neutral in nature, the effect of releasing the exterior is less than that of Herba Pogostemonis (guang huo xiang), is good at removing internal dampness and dispelling filth, and can treat sweet taste and greasy sensation in the mouth, bad breath, drooling and bad breath due to dampheat in the spleen channel

Cablin Patchouli (guang huo xiang) (Herba Pogostemonis)

Magnolia Bark (hou po) (Cortex Magnoliae Officinalis)

Atractylodes Rhizome (cang zhu) (Rhizoma Atractylodis)

Aromatic Madder (xiang ru) (Herba Moslae) Eupatorium (pei lan) (Herba Eupatorii) Villous Amomum Fruit (sha ren) (Fructus Amomi)

Round Cardamon (bai dou kou) (Fructus Amomi Kravanh)

It is acrid, slightly warm but not dry-heat in nature, is an essential aromatic medicinal that remove damp-turbidity. It has a stronger effect of releasing the exterior, and is more used for externally-contracted exterior pattern. It also can remove dampness and harmonize the center and arrest vomiting, and is suitable for the treatment of nausea and vomiting due to dampness obstructing in the middle jiao Both are aromatic medicinals that remove dampness, are acrid-bitter in flavor and warm in nature, can dry dampness and activate spleen, often combine with each other to treat the syndrome due to dampness obstructing in the middle jiao with distention and fullness in the stomach cavity and abdomen, poor appetite, nausea and vomiting, fatigue, and turbid greasy tongue coating

Its effect of drying dampness is less than that of Rhizoma Atractylodis (cang zhu). It can move qi and disperse food accumulation so as to treat distention and fullness in the stomach cavity and abdomen caused by dampness obstruction and food accumulation syndrome. It is an essential medicinal that eliminates distention and fullness. It also has the effects of lowering qi and relieving panting

Both can remove dampness with aromatic property, resolve summer heat and release the exterior, and treat pĭ and fullness in the stomach cavity and abdomen, vomiting and diarrhea due to catching cold or drinking cold drinks in summer

Its effects of inducing sweating and releasing the exterior are stronger than that of Herba Eupatorii (pei lan). It also can harmonize the center and remove dampness, and promote urination

Both are miracle medicinals that awaken the spleen and increase appetite, can remove dampness and move qi, warm the center and arrest vomiting, and arrest diarrhea, and often combine with each other to treat the patterns of dampness obstructing in the middle jiao and qi stagnation in the spleen and stomach

Its warm and dry properties and the effects of removing dampness and moving qi are stronger than that of Fructus Amomi Kravanh (bai dou kou), and it is partial to the middle and lower jiao. It is more for warming the spleen and good at arresting diarrhea, and often used for the treatment of the more severe syndrome due to cold-damp coagulating and obstructing in the middle jiao

It is an essential medicinal to treat the syndrome due to dampness obstructing in the middle jiao, can both dry dampness and fortify the spleen, is often used for the treatment of phlegm-rheum, edema and morbid leukorrhea due to exuberance of spleen-dampness; also can dispel wind-damp, induce sweating and improve vision so as to treat bì syndrome due to wind-colddamp, externally-contracted wind-cold complicated by dampness, night blindness and blurred vision

It is aromatic in nature and good at dispelling filth. It can effectively treat splenic pure heat (pí da¯n) syndrome with sweet and greasy taste in the mouth, excessive drool, and foul breath due to damp-heat in the spleen channel

Its effects of removing dampness and moving qi are partial to the middle and upper jiao. It is often used for the treatment of damp-warmth in the initial stage with pĭ and oppression, is more for warming the stomach and good at arresting vomiting. It is also suitable for the treatment of the mild syndrome due to cold-damp encumbered in interior

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Chapter 6

Herbs That Promote Urination and Percolate Dampness Chapter Outline Section 1 Herbs That Promote Urination to Relieve Edema Outline Specific Application Knowledge of Herbs Section 2 Herbs That Promote Urination and Relieve Strangury Outline Specific Application Knowledge of Herbs

138 138 138

Section 3 Herbs That Clear Damp-Heat and Relieve Jaundice Outline Specific Application Knowledge of Herbs

152 152 152

145 145 145

ABSTRACT Chinese herbal medicinals that free and regulate the waterways, percolate and drain water-dampness, and mainly treat syndrome of internal stagnation of water-dampness are called “Herbs That Promote Urination and Percolate Dampness.” Herbs that promote urination and percolate dampness are mainly indicated for the treatment of various kinds of syndromes or patterns, such as difficulty in urination, edema, diarrhea, phlegm-rheum, strangury, jaundice, eczema, and abnormal vaginal discharge caused by water-dampness. They are divided into three categories: herbs that promote urination to relieve edema, herbs that promote urination and relieve strangury, and herbs that clear damp-heat and relieve jaundice. Keywords: herbs that promote urination and percolate dampness; herbs that promote urination to relieve edema; herbs that promote urination and relieve strangury; herbs that clear damp-heat and relieve jaundice

Chinese herbal medicinals that free and regulate the waterways, percolate and drain water-dampness, and mainly treat syndrome of internal stagnation of water-dampness are called “Herbs That Promote Urination and Percolate Dampness.” Most medicinals in this chapter are sweet and bland, and act on the bladder and small intestine channels, are partial to descending in action tendency, and have the effects of promoting urination to alleviate edema, promoting urination to relieve strangury, and draining dampness to relieve jaundice. Herbs that promote urination and percolate dampness are mainly indicated for the treatment of various kinds of syndromes or patterns, such as difficulty in urination, edema, diarrhea, phlegm-rheum, strangury, jaundice, eczema, and abnormal vaginal discharge caused by water-dampness. When using herbs that promote urination and percolate dampness, doctors should appropriately combine the correlated medicinals according to the different diseases or syndromes. For sudden edema with the exterior pattern, they can combine with herbs that diffuse the lung and release the exterior; for edema for a long time due to spleen-kidney yang deficiency, they can combine with herbs that warm and supplement the spleen and kidney; for damp-heat combined pathogen, they can combine with herbs that clear heat; for cold accompanying dampness, they can combine with herbs that warm the interior and dispel cold; for bloody urine caused by heat damaging the collaterals, they can combine with herbs that cool the blood and stanch bleeding; and for diarrhea, phlegm-rheum, damp-warmth or jaundice, they can combine with herbs that fortify the spleen, aromatic medicinals that remove dampness, or herbs that clear heat and dry dampness. In addition, “qi flow

Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00006-3 Copyright © 2017 Elsevier Inc. All rights reserved.

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138 PART | I Chinese Materia Medica

promotes water transportation,” “qi stagnation aggravates water retention,” so herbs that promote urination and percolate dampness also often combine with herbs that move qi in order to improve the efficacy. Because herbs that promote urination and percolate dampness are easy to consume and injury fluid, patients with yin depletion and less fluid, or seminal emission and enuresis caused by kidney deficiency, should be cautious or prohibited to use. Some medicinals have a stronger effect of dredging stasis, the pregnant women should be cautious to use. Herbs that promote urination and percolate dampness can be divided into three categories: (1) herbs that promote urination to relieve edema, (2) herbs that promote urination and relieve strangury, and (3) herbs that clear damp-heat and relieve jaundice according to the action characteristics of medicinals and different clinical applications. The modern pharmacological research indicates most of the herbs that promote urination and percolate dampness have the actions of diuresis, antipathogen, cholaneresis, hepatoprotection, blood pressure release, and antineoplasms. Some medicinals also can lower blood sugar, blood fat, or regulate immunologic function.

SECTION 1  HERBS THAT PROMOTE URINATION TO RELIEVE EDEMA Outline Medicinals in this section are sweet, bland in flavor, and neutral, slightly cold in nature. The bland property can show the percolating and diuretic effects. After administration, urination becomes smooth and edema subsidises. So, they have the effects of promoting urination and alleviating edema, and are indicated for the treatment of edema, difficulty in urination, diarrhea, and phlegm-rheum due to internal stagnation of water-dampness. When using this section’s medicinals, doctors can select other herbs to do appropriate combination according to the etiology and disease mechanism of different syndromes.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 6.1)

TABLE 6.1 Properties, Actions, and Application of Common Herbs That Promote Urination to Relieve Edema Name of Medicinal Poria (fu ling) (Poria)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried sclerotium of Poria cocos (Schw.) Wolf of the Polyporaceae family. It is collected during July to September; after sediment is removed, it is piled up and watered, spread out and dried until the surface is dry, then watered again, repeated several times until folds occur and most of the internal moisture is lost, and dried in the shade

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sweet, bland, neutral; act on the heart, lung, spleen, and kidney channels

Promote urination and percolate dampness, fortify the spleen, and harmonize the stomach, and tranquilize the heart

Indicated for the treatment of various kinds of edema with distention and fullness, difficulty in micturition, oliguresis, dizziness, and palpitation due to phlegmrheum, less eating, fatigue, thin and unformed stool, and diarrhea due to spleen deficiency, uneasiness, palpitation, insomnia, and forgetfulness due to deficiency of both the heart and spleen. Normally, 10–15 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in patients with spontaneous seminal emission due to deficiencycold

TABLE 6.1 Properties, Actions, and Application of Common Herbs That Promote Urination to Relieve Edema (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Coix Seed (yi yi ren) (Semen Coicis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured kernal of Coix lacryma-jobi L. var. mayuen. (Roman.) Stapf of the Poaceae family. The matured plant is cut in autumn, then dried under the sun, stroked to separate fruit, and dried again; after outer rind, tawny seed coat and impurities are removed, kernal is collected

Sweet, bland, cool; act on the spleen, stomach, and lung channels

Promote urination and percolate dampness, fortify the spleen and arrest diarrhea, eliminate bì, evacuate pus, resolve toxins, and dissipate masses

Indicated for the treatment of edema, difficulty in micturition, weak foot with puffiness, or diarrhea due to spleen deficiency and exuberant damp, chronic bì syndrome due to (wind) damp, with spasms of the sinews, inconvenient flexing and stretching, lung abscess, intestinal abscess, excrescence, and some cancers. Normally, 9–30 g is decocted with water as an oral dose, or made into pills or powder

Its use is cautious in pregnant women and body fluid insufficiency

Polyporus (zhu ling) (Polyporus)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried sclerotium of Polyporus umbellatus (Pers.) Fries of the Polyporaceae family. It is collected in spring and autumn; after impurities are removed, it is dried

Sweet, bland, neutral; act on the kidney and bladder channels

Promote urination, relieve edema, and percolate dampness

Indicated for the treatment of various kinds of edema with distention and fullness, difficulty in micturition caused by internal stagnation of water-dampness, diarrhea due to colddamp in stomach, strangury and turbidity, and morbid leukorrhea. Normally, 6–12 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in patients without waterdampness

Water Plantain Rhizome (ze xie) (Rhizoma Alismatis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried tuber of Alisma orientale (Sam.) Juzep. of the Alismataceae family. When stem and leaf are withered in winter, it is collected and washed clean, and dried; after fibrous root and thick bark are removed, it is moistened thoroughly, cut into pieces and dried under the sun

Sweet, bland, cold; act on the kidney and bladder channels

Promote urination and percolate dampness, discharge heat, remove turbidity, and reduce blood fat

Indicated for the treatment of difficulty in micturition, edema with distention, and fullness caused by internal stagnation of water-dampness, incessant diarrhea due to cold damaging the spleen and stomach, dizziness due to phlegm-rheum stagnation, oliguresis, heat strangury, and painful urination, hyperlipidemia, seminal emission, and tidal fever due to hyperactivity of kidney fire. Normally, 6–10 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in patients with spontaneous seminal emission due to deficiencycold

(Continued)

140 PART | I Chinese Materia Medica TABLE 6.1 Properties, Actions, and Application of Common Herbs That Promote Urination to Relieve Edema (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chinese Waxgourd Peel (dong gua pi) (Exocarpium Benincasae)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the dried outer pericarp of Benincasa hispida (Thunb.) Cogn. of the Cucurbitaceae family. The fruit is collected when matured in late summer and early autumn. When eating wax gourd, outer pericarp is peeled, washed clean and cut into mass or wide sliver, and dried under the sun

Sweet, cool; act on the spleen and small intestine channels

Promote urination and relieve edema, clear heat, and resolve summer heat

Indicated for the treatment of edema with distention and fullness, difficulty in micturition, summer heat-heat syndrome, or thirst, scanty and reddish urine due to summer heat-heat; also for the treatment of diarrhea and swollen carbuncles. Normally, 9–30 g is decocted with water as an oral dose, or an appropriate amount is decocted with water for washing externally

Its use is cautious in patients with puffiness caused by malnutrition

Cornsilk (yu mi xu) (Stigma Maydis)

Initially recorded in Materia Medica of South Yunnan (dian nan ben cao). It is the dried style and stigma of Zea mays L. of the Poaceae family. It is often collected when peeling the corn after autumn; after impurities are removed, it is dried under the sun

Sweet, neutral; act on the bladder, liver and gallbladder channels

Promote urination, relieve edema, discharge heat, drain dampness, and relieve jaundice

Indicated for the treatment of edema, difficulty in micturition, or edema due to spleen deficiency, especially for scanty and reddish urine, painful urination caused by bladder damp-heat, or high blood pressure, stony strangury, cholelithiasis, and jaundice. Normally, 30–60 g is decocted with water as an oral dose; the fresh one should be doubled at the dose. And an appropriate amount is used externally

Corn stigma should be removed when eating corn. It is not used except as a medicinal

Bottle Gourd (hu lu) (Fructus Lagenariae)

Initially recorded in Ri Hua-zi’s Materia Medica (ri hua zi ben cao). It is the dried pericarp of Lagenaria siceraria (Molina) Standl. var. depressa (Ser.) Hara of the Cucurbitaceae family. It is collected in autumn, and broken into pieces; after pulp of fruit and seed are removed, it is dried under the sun

Sweet, bland, neutral; act on the lung and kidney channels

Promote urination and relieve edema, relieve strangury, drain dampness, and relieve jaundice, dissipate masses

Indicated for the treatment of facial edema, abdominal edema, difficulty in micturition, heat strangury and blood strangury, jaundice, wasting-thirst (xia¯o keˇ ), and swollen carbuncles. Normally, 15–30 g is decocted with water as an oral dose; the fresh should be doubled at the dose. Or it is carbonized by calcining with function preserved and ground into powder

Its use is prohibited in patients with deficiencycold of the spleen and stomach

Herbs That Promote Urination and Percolate Dampness Chapter | 6 141 TABLE 6.1 Properties, Actions, and Application of Common Herbs That Promote Urination to Relieve Edema (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chinese Silkvine Root-Bark (xiang jia pi) (Cortex Periplocae)

Initially recorded in Records of Chinese Medicinals (zhong yao zhi). It is the dried root bark of Periploca sepium Bge. of the Asclepiadaceae family. The root is collected in spring and autumn; root bark is peeled and dried under the sun

Acrid, bitter, warm, poisonous; act on the liver, kidney, and heart channels

Promote urination and relieve edema, dispel winddamp, and strengthen the sinew and bone

Indicated for the treatment of edema of lower limbs, palpitation and short breath, difficulty in micturition, bì syndrome due to wind-cold-damp blocking, spasms of the joints with pain, soreness and weakness of waist and knees, infantile flaccid sinews and bones, and walk retardation. Normally, 3–6 g is decocted with water as an oral dose, or steeped in wine or made into pills or powder; or an appropriate amount is decocted with water for washing externally

Due to its toxicity, for oral taking, overdose should be avoided. Its use is prohibited in patients with blood heat or ascendant hyperactivity of liver yang

Raisin Tree Seed (zhi ju zi) (Semen Hoveniae)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the fruit with fleshy carpopodium or seed of Hovenia dulcis Thunb. of the Rhamnaceae family. When fruit is matured during October to November, the fruit with carpopodium is collected dried under the sun or ground the rind down; the seed is sieved; after impurities are removed, it is dried under the sun

Sweet, sour, neutral; act on the spleen channel

Promote urination and relieve edema, relieve alcoholism, quench thirst and relieve vexation, and arrest vomiting

Indicated for the treatment of edema and difficulty in micturition caused by internal stagnation of water-dampness, drunkenness symptoms, such as vexing heat and excessive thirst and vomiting, or consumption with blood spitting caused by insobriety, difficulty in defecation and micturition. Normally, 10–15 g is decocted with water as an oral dose, or soaked in wine for taking orally

Its use is prohibited in patients with deficiencycold of the spleen and stomach

Sun Spurge (ze qi) (Herba Euphoribiae Helioscopiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried entire plant of Euphorbia helioscopia L. of the Euphorbiaceae family. It is collected when blooming during April to May; after root and sediment are removed, it is dried under the sun

Acrid, bitter, slightly cold, poisonous; act on the large intestine, small intestine, and lung channels

Promote urination and relieve edema, dissolve phlegm and relieve cough, resolve toxins and dissipate masses, and kill worms

Indicated for the treatment of general edema, abdominal edema with distention and fullness, panting and cough due to phlegmrheum or lung heat, bacillary dysentery, scrofula, tinea, and sores. Normally, 5–10 g is decocted with water as an oral dose, or boiled to a paste, or made into pills or powder, or an appropriate amount is decocted with water for washing externally

Its use is cautious in pregnant women and patients with deficiencycold of the spleen and stomach. It is not suitable for long-term use and taking too much

(Continued)

142 PART | I Chinese Materia Medica

TABLE 6.1 Properties, Actions, and Application of Common Herbs That Promote Urination to Relieve Edema (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chinese Mole Cricket (lou gu) (Gryllotalpa)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried polypide of Gryllotalpa unispina Saussure or G. Africana palisot et Besurois. of the Gryllotalpidae family. It is caught in summer and autumn, and scalded to die; after wing and foot are removed, it is dried under the sun or baked to tawny

Salty, cold; act on the large intestine and small intestine channels

Promote urination and relieve edema, and relieve strangury

Indicated for the treatment of facial edema, abdominal edema, and difficulty in micturition with an excess pattern, strangury, especially for painful stony strangury, scrofula, swollen carbuncles, or ulcers. Normally, 6–9 g is decocted with water as an oral dose, or ground into powder for taking orally with 3–5 g each time, or an appropriate amount is ground into powder for applying externally

Its use is prohibited in patients with qi deficiency, the weak and pregnant women

Shepherd’s Purse (ji cai) (Herba Capsellae)

Initially recorded in Important Formulas Worth a Thousand Gold Pieces (qian jin fang). It is the dried entire plant with root of Capsella bursapastoris (L.) Medle. of the Cruciferae family. It is collected during March to May, then washed clean, cut into segments, and dried under the sun

Sweet, cool; act on the liver, stomach and bladder channels

Promote urination and relieve edema, improve vision, calm the liver, and stanch bleeding

Indicated for the treatment of edema caused by internal stagnation of water-dampness, red eye or dry eye with pain due to liver heat, or with nebula, bloody stool or urine, profuse uterine bleeding, and profuse menstruation due to blood heat, dysentery with red and white feces, strangury and chyluria. Normally, 15–30 g is decocted with water as an oral dose; the fresh should be doubled at the dose; or made into pills or powder. Or an appropriate amount is pounded to extract the juice for putting drops in eyes

It is not suitable for patients with deficiencycold of constitution. Its use is cautious in patients with thin, unformed stool

Herbs That Promote Urination and Percolate Dampness Chapter | 6

143

2. Attached herbs (Table 6.2) TABLE 6.2 Introduction to Attached Herbs That Promote Urination to Relieve Edema Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Poria Exodermis (fu ling pi) (Cutis Poriae)

It is the dried black outer coating of sclerotium of Poria cocos (Schw.) Wolf of the Polyporaceae family. The sclerotium is collected during July to September; its outer coating is peeled and dried in the shade

Sweet, bland, neutral; act on the lung, spleen, and kidney channels

Promote urination and relieve edema

Indicated for the treatment of edema with abdominal distention, difficulty in micturition, and especially for cutaneous edema. Normally, 15–30 g is decocted with water as an oral dose

No special contraindications

Sweet-Scented Oleander Leaf or Bark (jia zhu tao) (Folium seu Cortex Nerii Indici)

It is the dried leaf or bark of Nerium indicum Mill. of the Apocynaceae family. It is collected in the four seasons; after impurities are removed, the leaf or bark is dried under the sun or applied while fresh

Acrid, warm, poisonous; act on the heart, lung, and kidney channels

Warm yang and promote urination, dispel phlegm and calm panting, dissipate stasis and relieve pain, arrest convulsion, and extinguish wind

Indicated for the treatment of palpitation due to decline of heart-kidney yang and water pathogen attacking the heart, panting due to wind-cold attacking the lung, swollen pain due to injury from fall, menstrual block, and epilepsy. Normally, 0.3–0.9 g is decocted with water as an oral dose, or 0.1–3 g is ground into powder for oral use or for applying externally

It is not suitable for long-term use and taking too much. Its use is prohibited in pregnant women and cautious in patients with yin deficiency resulting in vigorous fire

Chinese Lizardtail Herb (san bai cao) (Herba Saururi)

It is the dried aerial part of Saururus chinensis (Lour.) Baill. of the Saururaceae family. It is collected in whole year, then washed clean, and dried under the sun

Sweet, acrid, cold; act on the lung and bladder channels

Promote urination and relieve edema, clear heat and resolve toxins

Indicated for the treatment of edema, difficult and painful urination, or continuous, dribbling urination, morbid leukorrhea; external treatment: swollen sores and ulcers, and eczema. Normally, 15–30 g is decocted with water as an oral dose

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Chinese Waxgourd Seed (dong gua zi) (Semen Benincasae)

It is the dried seed of Benincasa hispida (Thunb.) Cogn. of the Cucurbitaceae family. The matured seed is collected when eating wax gourd, then washed clean, and dried under the sun

Sweet, slightly cold; act on the lung and large intestine channels

Moisten the lung, dissolve phlegm, relieve carbuncle, and promote urination

Indicated for the treatment of cough It is not suitable due to phlegm-heat, lung abscess, for taking for a intestinal abscess, strangury, long-time use edema, piles, and rosacea. Normally, 10–15 g is decocted with water as an oral dose

Adzuki Bean (chi xiao dou) (Semen Phaseoli)

It is the dried matured seed of Vigna umbellata Ohwi et Ohashi or Vigna angularis Ohwi et Ohashi of the Leguminosae family. When fruit is matured but not split in autumn, the entire plant is collected and dried under the sun, then stroked to separate the seed; after impurities are removed, seed is dried under the sun again

Sweet, sour, neutral; act on the heart and small intestine channels

Promote urination and relieve edema, relieve jaundice, resolve toxins, and evacuate pus

Indicated for the treatment of edema with distention and fullness, weak foot with puffiness, jaundice, reddish urine, winddamp-heat bì syndrome, strangury, bloody stool, swollen carbuncles and sores, and abdominal pain with intestinal abscess. Normally, 9–30 g is decocted with water as an oral dose, or an appropriate amount is ground into powder for applying externally

Its use is cautious in patients with yin deficiency and fluid consumption

Common Bombax Flower (mu mian hua) (Flos Bombacis)

It is the dried flower of Gossampinus malabarica (DC.) Merr. of the Bombacaceae family. It is collected in full bloom in spring; after impurities are removed, it is dried under the sun

Sweet, bland, cool; act on the large intestine channel

Clear heat and drain dampness, resolve toxins, and stanch bleeding

Indicated for the treatment of diarrhea, dysentery, eczema and sores, hemorrhoids, and profuse uterine bleeding. Normally, 6–9 g is decocted with water as an oral dose

No special contraindications

(Continued)

144 PART | I Chinese Materia Medica

TABLE 6.2 Introduction to Attached Herbs That Promote Urination to Relieve Edema (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Cluster Mallow Fruit (dong kui guo) (Fructus Malvae Verticillatae)

It is the dried matured fruit of Malva verticillata L. of the Malvaceae family. It is a habitually used medicinal in Mongolia nationality, collected when matured in summer and autumn; after impurities are removed, it is dried in the shade

Sweet, astringent, cool

Clear heat and promote urination, and relieve edema

Indicated for the treatment of suppression of urine, edema, thirst, heat strangury, blood strangury or strangury during pregnancy (urinary tract infection). Normally, 3–9 g is decocted with water as an oral dose

Its use is prohibited in patients with loose stool due to spleen deficiency, and cautious in pregnant women

Broad Bean (can dou) (Semen et Flos Viciae Fabae)

It is the dried seed of Vicia faba L. of the Leguminosae family. When bean pod is matured and become black in summer, the whole plant is collected and dried; the seed is stroked to separate and dried under the sun

Sweet, neutral; act on the spleen and stomach channels

Fortify the spleen and promote urination, resolve toxins, and relieve edema

Indicated for the treatment of gé shí (the syndromes that patients feel bloated in the chest and have difficulty in swallowing), edema and sores. Normally, 30–60 g is decocted with water as an oral dose

Overdose should be avoided. Its use is prohibited in the allergic patients

3. Herb differentiation (Table 6.3) TABLE 6.3 Differentiation Between Similar Efficacy Herbs That Promote Urination to Relieve Edema Name of Medicinal

Similarity

Differences

Poria (fu ling) (Poria)

Both are sweet and bland in flavor, and act on the spleen channel, can promote urination and relieve edema, percolate dampness and fortify the spleen, and treat the syndrome of exuberant damp due to spleen deficiency, such as edema and damp diarrhea. Both often combine with each other to reinforce their effects in clinic

It is neutral in nature. Its effect of dispelling pathogen is not intense and effect of reinforcing healthy qi is not powerful. It is an essential medicinal to promote urination and percolate dampness, and can be used for the treatment of edema with a pattern of cold or heat, deficiency, or excess. Its effect of fortifying the spleen is stronger than that of Semen Coicis (yi yi ren). It can treat dizziness and palpitation caused by phlegm-rheum. It also acts on the heart and kidney channels, can supplement, and boost the heart and spleen, tranquillize the heart and calm the mind, and can be used for the treatment of severe palpitation, insomina, and profuse dreaming due to deficiency of both the heart and spleen.

Coix Seed (yi yi ren) (Semen Coicis)

Polyporus (zhu ling) (Polyporus) Water Plantain Rhizome (ze xie) (Rhizoma Alismatis)

Its effects are moderate, and large dose is often selected to apply. It is cold in nature and can clear heat and evacuate pus, acts on the lung and stomach channels, and is commonly used for lung wĕi (atrophy), lung abscess and intestinal abscess. It is also good at dispelling the pathogenic dampness in the sinew and bone, and especially suitable for the treatment of bì syndrome due to wind-damp-heat, with hypertonicity of the sinews Both are the commonly used herbs that promote urination and relieve edema, sweet and bland in flavor, and act on the kidney and bladder channels, can treat edema, difficulty in micturition, diarrhea, morbid leukorrhea, and stranguria with turbid discharge

It is neutral in nature, has a simple effect of promoting urination, which is stronger than that of Rhizoma Alismatis (ze xie), and mainly indicated for the treatment of the diseases or syndromes caused by waterdampness. It is cold in nature and can discharge heat. It is good at discharging the kidney heat or bladder heat, and especially suitable for the treatment of lower jiao damp-heat. It also can be used for the treatment of dizziness due to phlegm-rheum, seminal emission, night sweat, steaming bone fever or tidal fever caused by kidney yin insufficiency, and exuberance of ministerial fire

Herbs That Promote Urination and Percolate Dampness Chapter | 6

145

TABLE 6.3 Differentiation Between Similar Efficacy Herbs That Promote Urination to Relieve Edema (cont.) Name of Medicinal

Similarity

Differences

Chinese Silkvine Root-Bark (xiang jia pi) (Cortex Periplocae)

Both act on liver and kidney channels, can dispel wind-damp and strengthen both sinew and bone, and treat painful bì syndrome due to wind-damp, spasms of the sinews, painful joints, flaccid sinews and bones, and infantile walk retardation. Both can promote urination and relieve edema, and are used for edema and difficulty in micturition

It is the root bark of Periploca sepium Bge. of the Asclepiadaceae family, and is poisonous. It also acts on the heart channel, and has stronger effects of strengthening heart and promoting urination, relieving edema, and pain than that of Cortex Acanthopanacis (wu jia pi), but no effects of supplementing and boosting

Eleutherococcus Root-Bark (wu jia pi) (Cortex Acanthopanacis)

It is the root bark of Acanthopanax gracilistylus W. W. Smith of the Araliaceae family, and is innocuous, and has stronger effects of dispelling wind-damp, supplementing the liver and kidney, and strengthening both sinews and bones than that of Cortex Periplocae (xiang jia pi)

SECTION 2  HERBS THAT PROMOTE URINATION AND RELIEVE STRANGURY Outline Most medicinals in this section are bitter in flavor and cold in nature, or sweet and bland in flavor and cold in nature. Medicinals with bitter property have the descending and purgative effects, and those with cold property can show the effect of clearing heat. They act on the lower jiao, especially can clear damp-heat in the lower jiao, and take the actions of promoting urination and relieving strangury as the main effects, and are indicated for the treatment of scanty and reddish urine, heat strangury, blood strangury, stony strangury, and chylous strangury. In clinic, it should select other herbs to appropriately combine according to the discretion in order to improve the efficacy.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 6.4) TABLE 6.4 Properties, Actions, and Application of Common Herbs That Promote Urination and Relieve Strangury Name of Medicinal Plantago Seed (che qian zi) (Semen Plantaginis)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured seed of Plantago asiatica L. or Plantago depressssa Willd. of the Plantaginaceae family. When seed is matured in summer and autumn, the fruit cluster is collected and dried under the sun and kneaded to separate seed; and impurities are removed

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sweet, cold; act on the liver, kidney, lung, and small intestine channels

Clear heat and promote urination, relieve strangury, drain dampness and arrest diarrhea, improve vision, and dispel phlegm

Indicated for the treatment of heat strangury with difficult and painful or (and) continuous and dribbling urination caused by damp-heat pouring downward to bladder, edema with distention and fullness due to water-dampness stagnation, diarrhea due to summer heat-damp, red eye with swelling and pain due to liver heat, blurred vision with nebula due to liverkidney yin deficiency, and cough with profuse phlegm due to lung heat. Normally, 9–15 g is wrapped by cloth and decocted with water as an oral dose

Its use is cautious in patients with spontaneous seminal emission due to kidney deficiency

(Continued)

TABLE 6.4 Properties, Actions, and Application of Common Herbs That Promote Urination and Relieve Strangury (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Talcum (hua shi) (Talcum)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the talc of the Talcum family of the silicates minerals. It mainly contains aqueous magnesium silicate [Mg3(Si4O10)(OH)2]. It is collected; after silt and mixed stone are removed, it is washed clean, smashed into pieces and ground into powder for use

Sweet, bland, cold; act on the bladder, lung, and stomach channels

Promote urination and relieve strangury, clear heat and resolve summer heat; external treatment: dispel dampness and close sore

Indicated for the treatment of heat strangury, suppression of urine, difficult and painful urination caused by damp-heat pouring downward to bladder, stony strangury, excessive thirst due to summer heat-damp, damp-warmth in the initial stage or summer heat-warmth complicated by dampness, watery diarrhea due to damp-heat, eczema, and miliaria. Normally, 10–20 g is wrapped and first decocted with water as an oral dose, or an appropriate amount is used externally

Its use is prohibited in pregnant women and patients with spleen deficiency or fluid damaged due to febrile disease

Akebia Stem (mu tong) (Caulis Akebiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rattan of Akebia quinata (Thunb.) Decne., Akebia trifoliata (Thunb.) Koidz. or Akebia trifoliate (Thunb.) Koidz. var. australis (Diels) Rehd. of the Laidizabalaceae family. The rattan is collected in autumn and intercepted; after twig is removed, it is dried in the shade

Bitter, cold; act on the heart, small intestine and bladder channels

Promote urination and relieve strangury, clear heart heat and relieve vexation, promote menstruation flow, and promote lactation

Indicated for the treatment of heat strangury with difficult and painful urination, scanty and reddish urine due to bladder damp-heat, edema, sore in mouth or tongue due to heartfire flaming upward, vexation, and dark urine due to heart fire moving down to small intestine, menstrual block due to blood stasis, inhibited lactation, and painful bì syndrome due to damp-heat. Normally, 3–6 g is decocted with water as an oral dose

It is not suitable for long-term use and taking too much. Its use is prohibited in pregnant women and patients with kidney insufficiency, and cautious in children, the old and the weak, or patients without dampheat

Rice Paper Plant Pith (tong cao) (Medulla Tetrapanacis)

Initially recorded in Supplement to ‘The Materia Medica’ (ben cao shi yi). It is the dried stem pith of Tetrapanax papyrifer (Hook.) K. Koch of the Araliaceae family. The stem is collected in autumn and intercepted into segments; the pith is taken out from stem while fresh, and then dried under the sun

Sweet, bland, slightly cold; act on the lung and stomach channels

Clear heat and promote urination, and promote qi flow to promote lactation

Indicated for the treatment of heat strangury with continuous and dribbling, difficult and painful urination due to damp-heat, stony strangury, blood strangury, edema, and scanty urine due to water-dampness stagnation, and inhibited lactation after childbirth. Normally, 3–5 g is decocted with water as an oral dose, or made into pills or powder

Its use is cautious in pregnant women and patients with deficiency of both qi and yin, and no internal dampheat

TABLE 6.4 Properties, Actions, and Application of Common Herbs That Promote Urination and Relieve Strangury (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Lilac Pink (qu mai) (Herba Dianthi)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried aerial part of Dianthus superbus L. or Dianthus chinensis L. of the Caryophyllaceae family. It is collected in the flowering fruit bearing stage in summer and autumn; after impurities are removed, it is dried under the sun

Bitter, cold; act on the heart and small intestine channels

Promote urination and relieve strangury, and invigorate blood to promote menstruation

Indicated for the treatment of heat strangury, stony strangury, blood strangury, continuous and dribbling or painful urination, difficulty in urination, menstrual block, or menstrual irregularities due to blood heat and stasis obstruction; also for red eye with nebula, eczema, and sores. Normally, 9–15 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is decocted with water for washing externally

Its use is prohibited in pregnant women and patients with spleen and kidney qi deficiency

Knotgrass (bian xu) (Herba Polygoni Avicularis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried aerial part of Polygonum aviculare L. of the Polygonaceae family. It is collected when leaf is flourishing in summer; after fibrous root and impurities are removed, it is dried under the sun

Bitter, slightly cold; act on the bladder channel

Promote urination and relieve strangury, kill worms, and relieve itching

Indicated for the treatment of heat strangury or stony strangury with difficult and painful urination, scanty and reddish urine, blood strangury, abdominal pain due to parasitic infestation, eczema of skin, vaginal itching, and abnormal vaginal discharge. Normally, 9–15 g is decocted with water as an oral dose; the fresh one should be doubled at the dose. Or an appropriate amount is decocted with water for washing the afflicted part externally

Its use is cautious in patients with spleen deficiency

Belvedere Fruit (di fu zi) (Fructus Kochiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured fruit of Kochia scoparia (L.) Schrad. of the Chenopodiaceae family. When fruit is matured in autumn, the plant is collected and dried under the sun, then stroked to separate the fruit, and impurities are removed

Acrid, bitter, cold; act on the kidney and bladder channels

Promote urination and relieve strangury, clear heat and drain dampness, dispel wind, and relieve itching

Indicated for the treatment of strangury with continuous, dribbling or painful urination and difficulty in micturition due to bladder damp-heat, vaginal itching and abnormal vaginal discharge, rubella, eczema, scabies and tinea, sores, and itch of skin. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount is decocted with water for fumigating and washing externally

Its use is prohibited in patients with profuse urine and no internal dampheat

(Continued)

148 PART | I Chinese Materia Medica TABLE 6.4 Properties, Actions, and Application of Common Herbs That Promote Urination and Relieve Strangury (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Japanese Climbing Fern Spore (hai jin sha) (Spora Lygodii)

Initially recorded in Materia Medica of the Jiayou Era (jia you ben cao). It is the dried matured spore of Lygodium japonicum (Thunb.) Sw. of the Schizaeaceae family. Before spore falls off in autumn, the vine leaf is collected and dried under the sun, kneaded or stroked to separate the spore, and the vine leaf is removed

Sweet, salty, cold; act on the bladder and small intestine channels

Promote urination and relieve strangury, relieve pain, clear heat and drain dampness, and invigorate blood

Indicated for the treatment of various kinds of strangury, such as heat strangury, stony strangury, blood strangury, and chylous strangury; an essential medicinal for the treatment of strangury with unsmoothness and pain of the urethra; or whitish and turbid urine, nephritis edema, swelling and pain of the throat; and also for the treatment of eczema. Normally, 6–15 g is wrapped by cloth and decocted with water as an oral dose

Its use is cautious in pregnant women and patients with kidney yin deficiency

Pyrrosia Leaf (shi wei) (Folium Pyrrosiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried leaf of Pyrrosia sheareri (Bak.) Ching, Pyrrosia lingua (Thunb.) Farwell or Pyrrosia petiolosa (Christ) Ching of the Polypodiaceae family. It is collected in whole year; after rhizome and root are removed, it is dried under the sun or in the shade

Sweet, bitter, slightly cold; act on the lung and bladder channels

Promote urination and relieve strangury, clear lung heat and relieve cough, cool the blood, and stanch bleeding

Indicated for the treatment of heat strangury, blood strangury and stony strangury, especially suitable for blood strangury, with urinary retention, continuous and dribbling, or difficult and painful urination, panting and cough due to lung heat, blood spitting, nosebleed, bloody urine, flooding and spotting (uterine bleeding) due to blood heat; also for the treatment of incised wound. Normally, 6–12 g is decocted with water as an oral dose

Its use is prohibited in patients with yin deficiency and no dampheat

Cluster Mallow Seed (dong kui zi) (Fructus Malvae Vertillatae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured seed of Malva verticillata L. of the Malvaceae family. It is collected when matured in summer; after impurities are removed, it is dried in the shade

Sweet, astringent, cool; act on the large intestine, small intestine, and bladder channels

Promote urination and relieve strangury, promote lactation, and moisten the intestines

Indicated for the treatment of various kinds of strangury such as heat strangury, stony strangury, blood strangury or strangury during pregnancy, edema or anuria and vomiting (gua¯n gé) with distention and fullness, difficulty in micturition, inhibited lactation, and distending pain in the breast after childbirth, constipation due to intestinal dryness. Normally, 3–9 g is decocted with water as an oral dose, or made into powder

Its use is cautious in pregnant women and patients with thin, unformed stool due to spleen deficiency

Herbs That Promote Urination and Percolate Dampness Chapter | 6

149

TABLE 6.4 Properties, Actions, and Application of Common Herbs That Promote Urination and Relieve Strangury (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Juncus (deng xin cao) (Medulla Junci)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the dried stem pith of Juncus effuses L. of the Juncaceae family. The stem is collected during the late summer to autumn, and then dried under the sun. The pith is taken out from stem and tied into wisp

Sweet, bland, slightly cold; act on the heart, lung, and small intestine channels

Promote urination and relieve strangury, clear heart heat, and subdue fire

Indicated for the treatment of strangury with difficulty in micturition, continuous and dribbling and painful urination, vexation, and insomnia due to heart-fire harassing the spirit, or infantile night crying due to heart heat, sore in mouth and tongue, swelling and pain of the throat. Normally, 1–3 g is decocted with water as an oral dose. And an appropriate amount is used externally

Its use is prohibited in patients with urinary incontinence due to deficiencycold in the lower jiao

Hypoglaucous Collett Yam Rhizome (bi xie) (Rhizoma Dioscoreae Hypoglaucae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome of Dioscorea septemloba Thunb., Dioscorea futschauensis Uline ex R. Kunth or D. hypoglauca Palibin of the Dioscoreaceae family. It is collected in autumn and winter; after fibrous root is removed, it is washed clean, cut into pieces and dried under the sun

Bitter, neutral; act on the kidney and stomach channels

Drain dampness and remove turbidity, dispel wind, and relieve bì syndrome

Indicated for the treatment of chylous strangury with whitish and turbid urine like washing water of ice, leukorrhagia due to exuberant dampness, painful bì syndrome due to wind-damp, especially for fixed bì (predominant dampness bì), bì syndrome of waist and knees with pain and inconvenient flexing and stretching of the joints, or sores due to damp-heat. Normally, 9–15 g is decocted with water as an oral dose, or made into pills or powder

Its use is cautious in patients with spontaneous seminal emission due to kidney yin deficiency

150 PART | I Chinese Materia Medica

2. Attached herbs (Table 6.5) TABLE 6.5 Introduction to Attached Herbs That Promote Urination and Relieve Strangury Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Talcum Powder (hua shi fen) (Pulvis Talci)

It is the dried purified white powder of talcum of the Talcum family of the silicates minerals. The clean broken talcum pieces are ground into fine powder; or the clean crude powder is ground with water for use

Sweet, bland, cold; act on the bladder, lung, and stomach channels

Promote urination, relieve strangury, clear heat and resolve summer heat, dispel dampness, and close sore

Indicated for the treatment of heat strangury, stony strangury, difficult and hot painful urination, excessive thirst due to summer heatdamp, diarrhea due to damp-heat, eczema, and miliaria. Normally, 10–20 g is wrapped and decocted with water as an oral dose, or an appropriate amount is used externally

It is not suitable for pregnant women and patients with spleenstomach weakness, and fluid consumption due to febrile disease

Plantain (che qian cao) (Herba Plantaginis)

It is the dried entire plant of Plantago asiatica L. or Plantago depressa willd. of the Plantaginaceae family. It is collected in summer; after sediment is removed, it is dried under the sun

Sweet, cold; act on the liver, kidney, lung, and small intestine channels

Clear heat and promote urination to relieve strangury, dispel phlegm, cool the blood, and resolve toxins

Indicated for the treatment of heat strangury with difficult, painful urination, edema with scanty urine, diarrhea due to summer heat-damp, cough due to phlegm-heat, spitting of blood, nosebleed, swollen sores, and carbuncles due to heat toxin. Normally, 9–30 g is decocted with water as an oral dose, or the fresh one is pounded for applying externally

Its use is prohibited in patients with spontaneous seminal emission due to essential qi insecurity

Clematidis Caulis (chuan mu tong) (Caulis Clematidis Armandii)

It is the dried rattan of Clematis armandii Franch. or Clematis montana Buch.-Ham. of the Ranunculaceae family. It is collected in spring and autumn; after thick bark is removed, it is dried under the sun, or cut into thin pieces while fresh and dried under the sun

Bland, bitter, cold; act on the heart, lung, small intestine and bladder channels

Promote urination and relieve strangury, clear heart heat and relieve vexation, promote menstruation flow, and promote lactation

Indicated for the treatment of strangury, edema, sore in mouth and tongue due to heart fire flaming upward, vexation and reddish urine, menstrual block, oligogalactia, and bì syndrome due to damp-heat, with pain and inconvenient flexing and stretching of the joints. Normally, 3–6 g is decocted with water as an oral dose

Its use is prohibited in patients with qi weakness, fluid consumption, spontaneous seminal emission, enuresis, and profuse urine

Manchurian Dutchmans Pipe Stem (guan mu tong) (Caulis Aristolochiae Manshuriensis)

It is the dried rattan of Aristolochia manshuriensis Kom. of the Aristolochiaceae family. It is collected in autumn, cut into pieces, and dried under the sun

Bitter, cold, poisonous; act on the heart, small intestine, and bladder channels

Clear heart fire, promote urination, promote menstruation flow, and promote lactation

Indicated for the treatment of sore in mouth and tongue due to heart fire flaming upward, vexation, reddish urine, edema, heat strangury with difficult and painful urination, abnormal vaginal discharge, menstrual block, oligogalactia, and painful bì syndrome due to damp-heat. Normally, 3–6 g is decocted with water as an oral dose

Its use is cautious in pregnant women and patients without internal damp-heat. Overdose may cause acute renal failure

Herbs That Promote Urination and Percolate Dampness Chapter | 6

151

TABLE 6.5 Introduction to Attached Herbs That Promote Urination and Relieve Strangury (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Stachyurus or Japanese Helwingia Pith (xiao tong cao) (Medulla Stachyuri; Medulla Helwingiae)

It is the dried stem pith of Stachyurus himalaicus Hook. f. et Thoms., Stachyurus chinensis Franch or Helwingia japonica (Thunb.) of the Stachyuraceae family. The stem is collected in autumn and intercepted into segments; the pith is taken out from stem while fresh and dried under the sun

Sweet, bland, cold; act on the lung, stomach and bladder channels

Clear heat, promote urination, and promote lactation

Indicated for the treatment of excessive thirst in febrile disease, difficulty in micturition, yellow or reddish urine, scanty urine or suppression of urine, strangury, or acute cystitis, nephritis edema, and inhibited lactation. Normally, 3–6 g is decocted with water as an oral dose

Its use is cautious in pregnant women and patients with qi deficiency, and no dampheat

Japanese Climing Fern Herbs (hai jin sha teng) (Herba Lygodii Japonici)

It is the entire plant of Lygodium japonicum (Thunb.) Sw. of the Schizaeaceae family. It is collected in summer and autumn; after impurities are removed, it is dried under the sun

Sweet, cold; act on the bladder, small intestine, and liver channels

Clear heat and resolve toxins, promote urination and relieve strangury, invigorate blood, and unblock the collaterals

Indicated for the treatment of various kinds of strangury due to bladder damp-heat, swollen carbuncles, and sores due to heat toxin, parotic swelling (mumps), and jaundice due to dampheat. Normally, 15–30 g is decocted with water for oral use, or an appropriate amount is decocted with water for washing externally or pounded for applying the afflicted part

Its use is cautious in pregnant women

3. Herb differentiation (Table 6.6) TABLE 6.6 Differentiation Between Similar Efficacy Herbs That Promote Urination and Relieve Strangury Name of Medicinal

Similarity

Differences

Raw Plantago Seed (sheng che qian zi)

All three are the different processing products of Semen Plantaginis (che qian zi), can promote urination and percolate dampness, and can treat strangury, edema, and diarrhea

It is good at promoting urination and relieving strangury, clearing lung and dissolving phlegm, and clearing liver heat and improving vision, and used for the treatment of edema, strangury, diarrhea due to summer heat-damp, cough due to phlegm-heat and red eyes due to liver heat

Dry-Fried Plantago Seed (chao che qian zi)

Its cold property decreases, but the efficacy of decocting is improved, its actions are similar to that of raw Semen Plantaginis (sheng che qian zi), but it is good at draining dampness and arrest diarrhea, and used for the treatment of diarrhea due to dampturbidity, and oliguresis

Salt-Fried Plantago Seed (yan che qian zi)

Its effect of discharging heat is stronger than that of the other two. It can promote urination but without damaging yin, boost the liver and improve vision, and is used for the treatment of blurred vision and visual deterioration

152 PART | I Chinese Materia Medica

SECTION 3  HERBS THAT CLEAR DAMP-HEAT AND RELIEVE JAUNDICE Outline Most of medicinals in this section are bitter in flavor and cold in nature, and act on the spleen, stomach, liver, and gallbladder channels. The bitter-cold property can show the effects on clearing and discharging damp-heat, so they take the actions of promoting urination and relieving jaundice as the main effects, and are mainly indicated for the treatment of jaundice due to damp-heat with symptoms of yellow eyes, yellow skin, and yellow urine. Some medicinals also can be used for the treatment of eczema and swollen carbuncles. In clinic, it should select other herbs to appropriately combine according to the different preponderance of damp-heat or cold-damp in yang jaundice or yin jaundice to strengthen the efficacy.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 6.7) TABLE 6.7 Properties, Actions, and Application of Common Herbs That Clear Damp-Heat and Relieve Jaundice Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Virgate Wormwood Herb (yin chen) (Herba Artemisiae Scopariae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried aerial part of Artemisia scoparia Waldst. et Kit. or Artemisia capillaris Thunb. of the Compositae family. It is collected when the height of seedling is 6–10 cm in spring or flower bud grows until first blooming in autumn; after impurities and old stem are removed, it is dried under the sun

Bitter, acrid, slightly cold; act on the spleen, stomach, liver, and gallbladder channels

Clear dampheat, promote gallbladder function and relieve jaundice, resolve toxins, and treat sores

Indicated for the treatment of jaundice due to liver-gallbladder damp-heat, difficulty in micturition, scanty urine, dampwarmth syndrome, summer heat-damp syndrome, urticaria and eczema with itching due to dampheat accumulated in interior; also for the treatment of sores and scabies. Normally, 6–15 g is decocted with water as an oral dose, or an appropriate amount is decocted with water for fumigating and washing externally

Its use is cautious in patients with jaundice due to blood stasis and withered yellow due to blood deficiency. Its use is prohibited in patients with jaundice not caused by dampheat

Christina Loosestrife (jin qian cao) (Herba Lysimachiae)

Initially recorded in Supplement to “The Grand Compendium of Materia Medica” (ben cao gang mu shi yi). It is the dried entire plant of Lysimachia christinae Hance of the Primulaceae family. It is collected in summer and autumn; after impurities are removed, it is dried under the sun

Sweet, salty, slightly cold; act on the liver, kidney, gallbladder, and bladder channels

Drain dampness and relieve jaundice, promote urination and relieve strangury, resolve toxins, and relieve swelling

Indicated for the treatment of jaundice with damp-heat pathogen, gallbladder distention and ribside pain; especially for the treatment of stony strangury, heat strangury, difficult and painful urination, liver and gallbladder calculosis with damp-heat pathogen, swollen carbuncles and boils, snake and insect bite. Normally, 15–60 g is decocted with water as an oral dose; the fresh one should be doubled at the dose. Or an appropriate amount is used externally

Patients with dorsal furuncle or diarrhea because spleen deficiency should avoid drinking the raw juice extracted from it by pounding

Herbs That Promote Urination and Percolate Dampness Chapter | 6 153 TABLE 6.7 Properties, Actions, and Application of Common Herbs That Clear Damp-Heat and Relieve Jaundice (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Giant Knotweed Rhizome (hu zhang) (Rhizoma Polygoni Cuspidati)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried rhizome and root of Polygonum cuspidatum Sieb. et Zucc. of the Polygonaceae family. It is collected in spring and autumn; after fibrous root is removed, it is washed clean, cut into short segments or thick pieces while fresh, and dried under the sun

Slightly bitter, slightly cold; act on the liver, gallbladder, and lung channels

Drain dampness and relieve jaundice, clear heat and resolve toxins, dissipate stasis, and relieve pain, relieve cough and dissolve phlegm

Indicated for the treatment of jaundice with damp-heat pathogen, stranguria with turbid discharge, abnormal vaginal discharge, burn due to hot liquid or fire, swollen carbuncles and sores, thanatophidia bite, menstrual block, concretions and conglomerations (zhe¯ng jia˘), injury from falling down, cough due to lung heat, and constipation due to heat bind. Normally, 9–15 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in pregnant women

Japanese St. John’s Wort (di er cao) (Herba Hyperici Japonici)

Initially recorded in Essentials of Raw Herbal Materia Medica Properties (sheng cao yao xing bei yao). It is the dried entire plant of Hypericum japonicum Thunb. ex Murray of the Clusiaceae family. It is collected in summer and autumn and dried under the sun

Bitter, sweet, cool; act on the liver and gallbladder channels

Drain dampness and relieve jaundice, clear heat and resolve toxins, invigorate blood, and relieve swelling

Indicated for the treatment of jaundice with damp-heat pathogen, lung abscess, mammary abscess or intestinal abscess, or carbuncles, furuncles, and sores due to damp-heat toxin, injury from falling down with swelling and pain due to blood stasis, and snake bite. Normally, 15–30 g is decocted with water as an oral dose, or an appropriate amount is used externally

No special contraindications

Stringy Stonecrop (chui pen cao) (Herba Sedi)

Supplement to ‘The Grand Compendium of Materia Medica’ (ben cao gang mu shi yi). It is the dried entire plant of Sedum sarmentosum Bunge of the Crassulaceae family. It is collected in summer and autumn; after impurities are removed, it is dried

Sweet, bland, slightly sour, slightly cold; act on the liver, gallbladder, and small intestine channels

Drain dampness and relieve jaundice, clear heat, and resolve toxins

Indicated for the treatment of jaundice with damp-heat pathogen, difficulty in micturition, swollen carbuncles, sores and ulcers, swelling and pain of the throat, thanatophidia bite, scald and burn, or acute and chronic hepatitis. Normally, 15–30 g of the dried one or 250 g of the fresh one is decocted with water or pounded to extract the juice as an oral dose. Or an appropriate amount is used externally

Its use is cautious in patients with deficiency-cold of the spleen and stomach

(Continued )

154 PART | I Chinese Materia Medica

TABLE 6.7 Properties, Actions, and Application of Common Herbs That Clear Damp-Heat and Relieve Jaundice (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Canton LovePea Vine (ji gu cao) (Herba Abri)

Initially recorded in Records of Medicinal Harvest in Lingnan (ling nan cai yao lu). It is the dried entire plant of Abrus cantoniensis Hance of the Leguminosae family. It is collected in whole year; after sediment is removed, it is dried

Sweet, slightly bitter, cool; act on the liver and stomach channels

Drain dampness and relieve jaundice, clear heat and resolve toxins, soothe the liver, and relieve pain

Indicated for the treatment of jaundice due to liver-gallbladder damp-heat constraint and steaming, mammary abscess with swelling and pain, discomfort in the hypochondrium, and distending pain in the stomach cavity. Normally, 15–30 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount of the fresh one is pounded for applying externally

Seed of this plant is poisonous, in order to avoid being poisoned, the bean pods should be removed before use

Common Leafflower (zhen zhu cao) (Herba Phyllanthi Urinariae)

Initially recorded in Essentials of Raw Herbal Materia Medica Properties (sheng cao yao xing bei yao). It is the dried entire plant (or with root) of Phyllanthus urinaria L. of the Euphorbiaceae family. It is collected in summer and washed clean; after impurities are removed, it is dried under the sun and then cut into segments

Sweet, bitter, cool; act on the liver and lung channels

Drain dampness and relieve jaundice, clear heat and resolve toxins, improve vision, disperse accumulation

Indicated for the treatment of jaundice due to damp-heat accumulated in the liver-gallbladder, strangury due to bladder dampheat, diarrhea, and dysentery due to damp-heat toxin pouring downward, swollen sores and ulcers due to heat toxin accumulated, bite by snake or dog, red eye with swelling and pain, and infantile malnutrition with accumulation. Normally, 15–30 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose. Or an appropriate amount is used externally

Due to its bitter and cool properties, its use should be cautious in the weak or patients with yang deficiency

Herbs That Promote Urination and Percolate Dampness Chapter | 6

155

2. Attached herbs (Table 6.8) TABLE 6.8 Introduction to Attached Herbs That Clear Damp-Heat and Relieve Jaundice Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sunset Abelmoschus (huang shu kui hua) (Flos Abelmoschi Manihot)

It is the dried corolla of Abelmoschus manihot (L.) Medic. of the Malvaceae family. When blooming in summer and autumn, it is collected and dried in time

Sweet, cold; act on the kidney and bladder channels

Clear dampheat, promote urination and relieve strangury, relieve swelling, and resolve toxins

Indicated for the treatment of damp-heat obstructing, strangury, edema, swollen carbuncle-abscess, burn and scald due to hot liquid or fire. Normally, 10–30 g is decocted with water as an oral dose, or ground into power for oral taking with 3–5 g each time, or an appropriate amount is used externally

Its use is cautious in pregnant women

Chicory (ju ju) (Herba Cichorii)

It is the dried aerial part or root of Cichorium glandulosum Boiss.et Huet or Cichorium intybus L. of the Compositae family. It is a habitually used medicinal in Uygur nationality, aerial part is collected in summer and autumn or root is collected in late autumn; after sediment and impurities are removed, it is dried under the sun

Slightly bitter, salty, cool

Clear liver heat and promote gallbladder function, fortify the stomach and promote digestion, promote urination and relieve edema

Indicated for the treatment of jaundice with dampheat pathogen, distending pain in the stomach cavity, less eating, or poor appetite, nephritis edema, and scanty urine. Normally, 9–18 g is decocted with water as an oral dose, or an appropriate amount is decocted with water for washing externally

No special contraindications

Long Tube Ground Ivy (lian qian cao) (Herba Glechomae)

It is the dried aerial part of Glechoma longituba (Nakai) Kupr. of the Labiatae family. It is collected during spring to autumn; after impurities are removed, it is dried under the sun

Acrid, slightly bitter, slightly cold; act on the liver, kidney, and bladder channels

Drain dampness and relieve strangury, clear heat and resolve toxins, dissipate stasis, and relieve swelling

Indicated for the treatment of heat strangury, stony strangury, and jaundice due to liver-gallbladder damp-heat, sores and carbuncles with swelling and pain, and injury from falling down. Normally, 15–30 g is decocted with water as an oral dose, or an appropriate amount is decocted with water for washing externally

Its use is cautious in pregnant women or patients with dorsal furuncle, or blood deficiency

Snowbell Leaf Tickclover (guang jin qian cao) (Herba Desmodii Styracifolii)

It is the dried aerial part of Desmodium styracifolium (Osb.) Merr. of the Leguminosae family. It is collected in summer and autumn; after impurities are removed, it is cut into segments and then dried under the sun

Sweet, bland, cool; act on the liver, kidney, and bladder channels

Drain dampness and relieve jaundice, promote urination, and relieve strangury

Indicated for the treatment of jaundice, reddish urine, heat strangury, stony strangury, sand strangury (i.e., urolithic strangury), difficult and painful urination, and edema with scanty urine. Normally, 15–30 g is decocted with water as an oral dose

Its use is cautious in pregnant women

(Continued )

156 PART | I Chinese Materia Medica

TABLE 6.8 Introduction to Attached Herbs That Clear Damp-Heat and Relieve Jaundice (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

BatrachiumLike Lawn Pennywort Herb (jiang xi jin qian cao) (Herba Hydrocotyles Sibthorpoidis)

It is the dried entire plant of Hydrocotyle sibthorpiodes Lam. var. batrachium (Hance) Hand.-Mazz. ex Shan or of the Umbelliferae family. It is collected in summer and autumn, then washed clean and dried under the sun

Sweet, bland, slightly acrid, cool; act on the liver, gallbladder, and kidney channels

Clear heat and drain dampness, resolve toxins, and relieve swelling

Indicated for the treatment of jaundice with dampheat pathogen, dysentery, edema, strangury, nebula, swelling of throat, swollen carbuncles and sores, herpes zoster, and injury from falling down. Normally, 9–15 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose, or an appropriate amount is pounded for applying the afflicted part externally

No special contraindications

Creeping Dichondra Herb (xiao jin qian cao) (Herba Dichondrae Repentis)

It is the dried entire plant of Dichondra repens Forst. of the Convolvulaceae family. It is collected in whole year; after impurities are removed, it is washed clean and then dried under the sun

Bitter, acrid, cool; act on the lung, liver, and gallbladder channels

Clear heat and drain dampness, promote urination and relieve edema (or swelling), invigorate blood and resolve toxins

Indicated for the treatment of jaundice with dampheat pathogen, damp-heat dysentery, heat strangury, sand strangury, difficulty in micturition, whitish and turbid urine, edema, swollen sores and boil, injury from falling down, and thanatophidia bite. Normally, 10–30 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose. Or an appropriate amount is used externally

When taking this medicinal, it should avoid salt and spicy food

Coriolous Dersicolor (yun zhi) (Coriolus)

It is the dried sporocarp of Coriolus versicolor (L. ex Fr.) Quel of the Polyporaceae family. It is collected in whole year; after impurities are removed, it is dried under the sun

Sweet, neutral; act on the heart, spleen, liver, and kidney channels

Fortify the spleen and drain dampness, clear heat, and resolve toxins

Indicated for the treatment of liver-gallbladder dampheat, ribside pain, poor appetite, fatigue, and lack of strength. Normally, 9–27 g is decocted with water as an oral dose

No special contraindications

Mile Swertia (qing ye dan) (Herba Swertiae Mileensis)

It is the dried entire plant of Swertia mileensis T. N. Ho et W. L. Shih of the Gentianaceae family. It is collected during flowering fruit bearing stage in autumn; after sediment is removed, it is dried under the sun

Bitter, sweet, cold; act on the liver, gallbladder, and bladder channels

Clear liver heat and promote gallbladder function, clear heat, and drain dampness

Indicated for the treatment of liver-gallbladder damp-heat, jaundice, reddish urine, gallbladder distention and ribside pain, heat strangury with difficult and painful urination. Normally, 10–15 g is decocted with water as an oral dose

Its use is cautious in patients with deficiency-cold of body constitution

Asiatic Pennywort (ji xue cao) (Herba Centellae)

It is the dried entire plant of Centella asiatica (L.) Urb. of the Umbelliferae family. It is collected in summer and autumn; after sediment is removed, it is dried under the sun

Bitter, acrid, cold; act on the liver, spleen and kidney channels

Clear heat and drain dampness, resolve toxins, and relieve swelling

Indicated for the treatment of jaundice with dampheat pathogen, summer heat-strike (heatstroke) and diarrhea, stony strangury, blood strangury, swollen carbuncles and sores, and injury from falling down. Normally, 15–30 g is decocted with water as an oral dose

Its use is cautious in patients with deficiency-cold of the spleen and stomach

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3. Herb differentiation (Table 6.9)

TABLE 6.9 Differentiation Between Similar Efficacy Herbs That Clear Damp-Heat and Relieve Jaundice Name of Medicinal

Similarity

Differences

Virgate Wormwood Herb (yin chen) (Herba Artemisiae Scopariae)

Both can clear liver-gallbladder dampheat and relieve jaundice, and are used for the treatment of jaundice caused by liver-gallbladder damp-heat. Both often combine with each other to reinforce their effects

It is bitter and slightly cold in nature, acts on the spleen, stomach, liver, and gallbladder channels, is good at clearing damp-heat in the liver and gallbladder channels, specializes in clearing heat, draining dampness, and relieving jaundice, so can treat jaundice with damp-heat pathogen. It also can dispel wind and relieve itching, scatter pathogenic heat from the skin, and treat eczema or rubella with itching

Cape Jasmine Fruit (zhi zi) (Fructus Gardeniae)

Christina Loosestrife (jin qian cao) (Herba Lysimachiae)

It is bitter and cold in nature, acts on the heart, lung, stomach and sanjiao channels, is good at clearing and draining sanjiao fire and can clear heart heat and relieve vexation, cool the blood, and resolve toxins, so it is used for the treatment of febrile disease with vexation and oppression, blood spitting and nosebleed due to blood heat, sores and ulcers with red swelling and pain due to heat toxin. It can treat blood strangury with difficult and painful urination Both act on the bladder channel, can promote urination and relieve strangury, treat sand stragury (i.e., urolithic strangury), stony strangury with unsmoothness and pain of the urethra. Both often combine with each other to reinforce their effects

Japanese Climbing Fern Spore (hai jin sha) (Spora Lygodii)

Virgate Wormwood Herb (yin chen) (Herba Artemisiae Scopariae)

Christina Loosestrife (jin qian cao) (Herba Lysimachiae)

It mainly acts on the liver and gallbladder channels, is salty in nature so as to soften hardness, and good at dissolving stone. It also has better effects of draining dampness and relieving jaundice, and clearing liver-gallbladder heat, so is often used for treating jaundice with damp-heat pathogen, biliary calculi, and cholangitis. It can clear heat and resolve toxins so as to treat swollen ulcers due to heat toxin, thanatophidia bite, and burn due to hot liquid or fire It also acts on the small intestine channel, is cold and sweet in nature so as to clear heat, percolate, and drain dampness as well as relieve strangury. It also acts on the blood aspect, is good at clearing the small intestine or bladder damp-heat at the blood aspect, has certain effects of cooling the blood and stanching bleeding so as to treat blood strangury. Its effect of relieving pain of the urethra is predominant, so it is suitable for the treatment of strangury with obvious pain. It has the effects of promoting urination and relieving edema so as to treat edema and difficulty in micturition due to damp-heat

Both are the herbs that drain dampness and relieve jaundice, cold in nature, and act on the liver and gallbladder channels, can clear liver-gallbladder damp-heat and abate jaundice, and are used for the treatment of jaundice with damp-heat pathogen, eczema of the skin with swelling.

It also acts on the spleen and stomach channels, can “weed through the old to new,” has stronger effects of clearing heat and draining dampness and abating jaundice than that of Herba Lysimachiae (jin qian cao), specializes in clearing spleen-stomach damp-heat, is an essential medicinal that can treat jaundice, and good at treating jaundice with damp-heat pathogen It also acts on the kidney and bladder channels, is sweet and bland in nature so as to percolate and drain dampness, is salty in nature so as to soften hardness. It is not only good at clearing liver-gallbladder fire, but also can eliminate damp-heat in the lower jiao. It has better effects of promoting urination and relieving strangury, is a specialized medicinal for the treatment of strangury, such as sand stragury (i.e., urolithic strangury), stony strangury, and liver and gallbladder calculus. It has stronger effects of clearing heat and resolving toxins than that of Herba Artemisiae Scopariae (yin chen) so as to treat ulcers, thanatophidia bite, scald, and burn (Continued )

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TABLE 6.9 Differentiation Between Similar Efficacy Herbs That Clear Damp-Heat and Relieve Jaundice (cont.) Name of Medicinal

Similarity

Differences

Giant Knotweed Rhizome (hu zhang) (Rhizoma Polygoni Cuspidati)

Both belong to the Polygonaceae family, are bitter in flavor and cold in nature, can clear heat, purge, invigorate blood, resolve toxins and drain dampness, and treat constipation due to heat bind, jaundice with damp-heat pathogen, menstrual block due to static blood obstruction, injury from falling down, swollen carbuncles, and sores.

It mainly acts on the liver, gallbladder, and lung channels, not only can invigorate blood and dispel stasis to promote menstruation flow, but also is good at clearing heat and draining dampness to relieve jaundice, and can be used for the treatment of painful bì syndrome due to wind-damp, injury with blood stasis and obstruction, jaundice with damp-heat pathogen, stranguria with turbid discharge, and abnormal vaginal discharge. Its effect of resolving toxins can be used for swollen sores and thanatophidia bite. It can clear lung heat and dissolve phlegm so as to treat cough due to lung heat

Rhubarb Root and Rhizome (da huang) (Radix et Rhizoma Rhei)

It mainly acts on the spleen, stomach, and large intestine channels, and is an essential medicinal for drastically purging and removing stagnation. Its efficacy of draining fire and cooling the blood is stronger than that of Giant Knotweed Rhizome (hu zhang), so it is more better for the treatment of constipation with a pattern of excess heat, abdominal fullness with dryness accumulation, blood spitting and nosebleed due to blood heat, and red eyes, gingiva swelling and oral ulcer due to fire toxin attacking upward

Chapter 7

Herbs That Warm the Interior Chapter Outline Specific Application Knowledge of Herbs

160

ABSTRACT Chinese herbal medicinals that warm the interior and dispel cold and mainly indicated for the treatment of interior cold syndrome are called “Herbs that Warm the Interior” or “Herbs That Dispel Cold.” Herbs that warm the interior are commonly used for the treatment of syndrome caused by external cold invading and directly attacking the spleen and stomach, or syndrome of spleen and stomach deficiencycold, such as cold pain in the stomach cavity and abdomen, vomiting and diarrhea, and pale tongue with white coating. Keywords: herbs that warm the interior; warm the center and dissipate cold; supplement fire and assist yang; dissipate cold and relieve pain; warm the stomach and arrest vomiting

Chinese herbal medicinals that warm the interior and dispel cold and mainly indicated for the treatment of interior cold syndrome are called “Herbs that Warm the Interior” or “Herbs that Dispel Cold”. Medicinals in this chapter are acrid in flavor, and warm and heat in nature. The acrid property has the effects of scattering and moving, and the warm property has the effect of unblocking, so this category of herbs are good at acting on the viscera and bowels to warm the interior and dispel cold, warm the channels and relieve pain, and can treat interior cold syndrome, especially the interior cold excess pattern. The meaning is exactly what is called “when there is cold, treat it with heat” in The Yellow Emperor’s Inner Classic (huang di nei jing) and “treat the cold pattern with the heat medicinal” in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). Several medicinals also can assist yang or restore yang so as to treat deficiency-cold syndrome or yang collapse syndrome. Medicinals in this chapter have multiple effects due to their different channel entries. These herbs that mainly act on the spleen and stomach channels can warm the center, dissipate cold and relieve pain; and can be commonly used for the treatment of syndrome caused by external cold invading and directly attacking the spleen and stomach, or syndrome of spleen and stomach deficiency-cold, such as cold pain in the stomach cavity and abdomen, vomiting and diarrhea, and pale tongue with white coating. Herbs that mainly act on the lung channel can warm the lung and dissolve rheum (fluid retention), and can be used for the treatment of syndrome of lung cold with phlegm rheum, such as cough and panting with wheezy phlegm, white-clear-thin phlegm, and pale tongue with white and glossy coating. Herbs that mainly act on the liver channel can warm the liver, dissipate cold and relieve pain; and can be used for the treatment of lesser abdominal pain caused by cold invading the liver channel, testicular hardness, pain due to cold (cold shàn), and abdominal pain or jueyin headache. Herbs that mainly act on the kidney channel can warm the kidney and assist yang; and can be used for the treatment of syndrome caused by kidney yang insufficiency, such as yang wĕi (impotence), cold in the uterus, cold pain in the waist and knees, profuse urine or frequent micturition at night, spontaneous seminal emission, and enuresis. Herbs that mainly act on both the heart and kidney channels can warm yang and unblock the vessels; and can be used for the treatment of syndrome of heart-kidney yang deficiency, such as palpitation, or severe palpitation, aversion to cold, cold of the four limbs, difficulty in urination, and edema of limbs, or can restore yang to rescue from counterflow [desertion], and can be used for the treatment of syndrome of yang collapse with reversal counterflow cold of the limbs, such as aversion to cold with body rolled up, sweating and mental fatigue, reversal counterflow cold of the four limbs (cold distal extremities with cold moving proximally, sì zhī jué nì), and faint pulse that nearly cannot be touched. Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00007-5 Copyright © 2017 Elsevier Inc. All rights reserved.

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160 PART | I Chinese Materia Medica

When using herbs that warm the interior, doctors should appropriately combine other herbs according to the different syndromes. For inward penetration of exterior cold pathogen with exterior cold pattern that hasn’t been released, they can combine with herbs that release the exterior with acrid-warm property to treat. For congealing cold in the channel with qi stagnation and blood stasis, they can combine with herbs that move qi and invigorate blood to treat. For internal obstruction of cold-damp, they should combine with aromatic medicinals that remove dampness or herbs that dispel dampness with warm-dry property to treat. For spleen-kidney yang deficiency, they should combine with herbs that warm and supplement the spleen and kidney to treat. For yang collapse and qi desertion, they should combine with herbs that powerfully supplement the original qi. Herbs in this category are partial to acrid, hot and fiercely dry in nature, easy to consume yin and cause bleeding, so their dosage should be reduced in the very hot summer or for patients with vigorous fire all along. Their application also should be prohibited in patients with heat lodging in interior, the deeper the heat the severer the reversal coldness, or true heat with false cold. They also should be contraindicated in patients with excess heat syndrome, vigorous fire due to yin deficiency or essence and blood depletion. Their application should be cautious in pregnant women. The modern pharmacological research indicates herbs that warm the interior commonly have the actions of sedation, analgesia, invigorating the stomach, dispelling wind, antithrombus, antiulcer, antagonizing diarrhea, anticoagulation, antagonizing platelet aggregation, antagonizing oxygen-poor, and expanding blood vessels. Some medicinals also can strengthen the heart function, antagonize shock and convulsion, regulate gastrointestinal motility, and promote bilification. Medicinals in this chapter are mainly indicated for chronic gastritis, chronic enteritis, chronic bronchitis, hernia, and shock.

SPECIFIC APPLICATION KNOWLEDGE OF HERBS 1. Primary herbs (Table 7.1)

TABLE 7.1 Properties, Actions, and Application of Common Herbs That Warm the Interior Name of Medicinal Aconite Root (fu zi) (Radix Aconiti Lateralis Praeparata)

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried daughter root product of Aconitum carmichaelii Debx. of the Ranunculaceae family. It is collected during the last third of June to the first 10 days of August; after mother root, fibrous root, and sediment are removed, it is processed into different products

Acrid, sweet, extremely hot, poisonous; act on the heart, kidney, and spleen channels

Restore yang to rescue from counterflow [desertion], supplement fire and assist yang, dissipate cold and relieve pain

Indicated for the treatment of yang collapse and desertion, cold of the four limbs with faint pulse, heart yang insufficiency, chest bì and precordial pain, vomiting and diarrhea due to deficiency-cold, cold pain in the stomach cavity and abdomen, yang we˘i (impotence) and cold in the uterus due to decline of kidney yang, edema due to yin cold, yang deficiency, and external contraction, and painful bì syndrome due to cold-damp. Normally, 3–15 g is first decocted with water for a long time as an oral dose

Caution for Use Its use is prohibited in pregnant women, patients with yin deficiency with yang hyperactivity. Antagonize Rhizoma Pinelliae (ban xia), Radix Ampelopsis (bai lian), Fructus Trichosanthis (gua lou), Bulbus Fritillaria (bei mu) and Rhizoma Bletillae (bai ji)

Herbs That Warm the Interior Chapter | 7

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TABLE 7.1 Properties, Actions, and Application of Common Herbs That Warm the Interior (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Dried Ginger Rhizome (gan jiang) (Rhizoma Zingiberis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome of Zingiber offcinale Rosc. of the Zingiberaceae family. It is collected in winter; after fibrous root and sediment are removed, it is cut into pieces and dried under the sun or at lower temperature

Acrid, hot; act on the spleen, stomach, kidney, heart, and lung channels

Warm the center and dissipate cold, restore yang to unblock the vessels, warm the lung and dissolve rheum (fluid retention)

Indicated for the treatment of cold pain in the stomach cavity and abdomen, vomiting and diarrhea due to center cold, yang collapse and reversal counterflow cold of the limbs with faint pulse due to heart-kidney yang deficiency, panting and cough due to cold rheum. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in patients with yin deficiency and internal heat, and bleeding due to blood heat

Cinnamon Bark (rou gui) (Cortex Cinnamomi)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried tree bark of Cinnamomum cassia Presl of the Lauraceae family. It is peeled off in autumn and then dried in the shade

Acrid, sweet, extremely hot; act on the kidney, spleen, heart, and liver channels

Supplement fire and assist yang, return fire to its source, dissipate cold and relieve pain, warm and unblock the channels

Indicated for the treatment of yang we˘i (impotence) and cold in the uterus, cold pain in the waist and knees, panting due to kidney deficiency, deficient yang with upper manifestations, such as dizziness and red complexion, cold pain in the abdomen, vomiting and diarrhea due to deficiency-cold, cold hernia, menstrual block or painful menstruation. Normally, 1–5 g is added later and decocted with water as an oral dose, or 1–2 g is ground into powder for taking infused.

Its use is cautious in patients with hemorrhagic tendency and pregnant women. It is not suited to use together with Halloysitum Rubrum (chi shi zhi)

(Continued )

162 PART | I Chinese Materia Medica

TABLE 7.1 Properties, Actions, and Application of Common Herbs That Warm the Interior (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Medicinal Evodia Fruit (wu zhu yu) (Fructus Evodiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried near matured fruit of Euodia rutaecarpa (Juss.) Benth., Euodia rutaecarpa (Juss.) Benth var. officinalis (Dode) Huang or Euodia rutaecarpa (Juss.) Benth. var. bodinieri (Dode) Huang of the Rutaceae family. The branch with fruits is cut before fruit is split during August to November; after branch, leaf, and carpopodium are removed, it is dried under the sun or at lower temperature

Acrid, bitter, hot, slightly poisonous; act on the liver, spleen, stomach, and kidney channels

Dissipate cold and relieve pain, direct counterflow downward and arrest vomiting, assist yang and arrest diarrhea

Indicated for the treatment of pain due to liver cold and qi stagnation, such as jueyin headache, cold hernia with abdominal pain, weak foot with puffiness and pain due to cold-damp, painful menstruation, vomiting and acid swallowing due to stomach cold, and fifth-watch diarrhea (diarrhea before dawn) due to deficiency-cold. Normally, 2–5 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is used externally

Due to its acrid and hot properties, it is not suitable for overdose and long-term using in order to avoid consuming qi and stirring fire. Its use is prohibited in patients with fever due to yin deficiency

Fennel (xiao hui xiang) (Fructus Foeniculi)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried matured fruit of Foeniculum vulgare Mill. of the Umbelliferae family. When fruit is initially matured in autumn, the plant is collected, dried under the sun, and stroked to separate the fruit, and then impurities are removed

Acrid, warm; act on the liver, kidney, spleen, and stomach channels

Dissipate cold and relieve pain, rectify qi and harmonize the stomach

Indicated for the treatment of cold hernia with abdominal pain, falling sensation and distending pain in the testis, dysmenorrhea, cold pain in the lower abdomen, distending pain in the stomach cavity and abdomen due to stomach cold and qi stagnation, less eating, vomiting, and diarrhea. Normally, 3–6 g is decocted with water as an oral dose. Or a suitable amount is used externally

Its use is cautious in patients with vigorous fire due to yin deficiency

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TABLE 7.1 Properties, Actions, and Application of Common Herbs That Warm the Interior (cont.)

Source and Collection

Property, Channel Entry

Chinese Star Anise (ba jiao hui xiang) (Fructus Anisi Stellati)

Initially recorded in Essentials of Materia Medica Distinctions (ben cao pin hui jing yao). It is the dried matured fruit of Illicium verum Hook. f. of the Magnoliaceae family. When fruit turns yellow from green in autumn and winter, it is collected and slightly scalded with boiling water, and then dried or directly dried

Clove Flower (ding xiang) (Flos Caryophylli)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the dried flower bud of Eugenia caryophyllata Thunb. of the Myrtaceae family. When bud turns red from green, it is collected and then dried under the sun

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Acrid, sweet, warm; act on the liver, kidney, spleen, and stomach channels

Warm yang and dissipate cold, rectify qi, and relieve pain

Indicated for the treatment of cold hernia with abdominal pain, low back pain due to kidney deficiency, cold pain in the knees, vomiting due to stomach cold, cold pain in the stomach cavity and abdomen, weak foot due to cold-damp. Normally, 3–6 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is ground into powder for applying externally

Its use is prohibited in patients with vigorous fire due to yin deficiency

Acrid, warm; act on the spleen, stomach, lung, and kidney channels

Warm the center and direct counterflow downward, supplement kidney and assist yang

Indicated for the treatment of hiccup and vomiting, regurgitation, less eating and diarrhea due to deficiency-cold of the spleen and stomach, or pernicious vomiting during pregnancy, cold pain in the stomach cavity and abdomen, yang we˘i (impotence) and cold in the uterus due to kidney deficiency, hernia or tinea. Normally, 1–3 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder for applying externally

Its use is prohibited in patients with heat pattern or yin deficiency and internal heat. Not combine with Turmeric Root Tuber (yu jin) to use.

Caution for Use

(Continued )

164 PART | I Chinese Materia Medica

TABLE 7.1 Properties, Actions, and Application of Common Herbs That Warm the Interior (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Galangal (gao liang jiang) (Rhizoma Alpiniae Officinarum)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried rhizome of Alpinia officinarum Hance of the Zingiberaceae family. It is collected in late summer and early autumn; after fibrous root and residual scale are removed, it is washed clean, then cut into segments, and dried under the sun

Acrid, hot; act on the spleen and stomach channels

Warm the stomach and arrest vomiting, dissipate cold, move qi, and relieve pain

Indicated for the treatment of cold pain in the stomach cavity and abdomen, sudden colicky pain in the epigastrium and abdomen with fullness and discomfort in the ribside, vomiting and diarrhea due to stomach cold or deficiencycold, belching and acid swallowing, dysphagia or regurgitation, and dyspeptic retention. Normally, 3–6 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in patients with fever due to yin deficiency

Pepper Fruit (hu jiao) (Fructus Piperis)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried near matured or matured fruit of Piper nigrum L. of the Piperaceae family. When fruit is dark green during the late autumn to the next spring, it is collected and dried under the sun, which is called black pepper. If collected when fruit turns red, and retted with water for several days; after sarcocarp is removed, it is dried under the sun, which is called white pepper

Acrid, hot; act on the stomach and large intestine channels

Warm the center and dissipate cold, lower qi, and disperse phlegm

Indicated for the treatment of vomiting and diarrhea, food accumulation syndrome, abdominal pain due to stomach cold, regurgitation and no desire to eat or drink, cold dysentery, epilepsy with profuse phlegm due to constraint and stagnation of phlegm and qi clouding the clear orifices, or as a condiment to increase appetite. Normally, 2–4 g is decocted with water or 0.6–1.5 g is ground into powder as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in patients with yin deficiency and internal fire

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TABLE 7.1 Properties, Actions, and Application of Common Herbs That Warm the Interior (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Pricklyash Peel (hua jiao) (Pericarpium Zanthoxyli)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured pericarp of Zanthoxylum schinifoliun Sieb. et Zucc. or Zanthoxylum bungeanum Maxim. of the Rutaceae family. The matured fruit is collected and dried under the sun, then the seed and impurities are removed

Acrid, warm; act on the spleen, stomach, and kidney channels

Warm the center and relieve pain, kill worms and relieve itching

Indicated for the treatment of cold pain in the stomach cavity and abdomen due to cold in the middle jiao, vomiting and diarrhea due to cold-damp, hiccup, bì syndrome due to windcold-damp, abdominal pain due to worm accumulation, hernia pain or toothache, eczema and pruritus vulvae. Normally, 3–6 g is decocted with water as an oral dose. Or an appropriate amount is decocted with water for fumigating and washing the afflicted part externally

Its use is prohibited in patients with vigorous fire due to yin deficiency. Its use is cautious in pregnant women

Bush Redpepper Fruit (la jiao) (Fructus Capsici Annui)

Initially recorded in Illustrated Reference of Botanical Nomenclature (zhi wu ming shi tu kao). It is the dried matured fruit of Capsicum annuum L. or its cultivated variety of the Solanaceae family. It is collected when fruit coats become red in summer and autumn; after branch and stalk are removed, it is dried under the sun

Acrid, hot; act on the heart, spleen, and stomach channels

Warm the center and dissipate cold, increase appetite and promote digestion

Indicated for the treatment of distending pain in the stomach cavity and abdomen, vomiting due to stomach cold and qi stagnation, diarrhea and dysentery, painful bì syndrome due to wind-damp, and chilblain. Normally, 0.9–2.4 g is decocted with water as an oral dose. Or an appropriate amount is decocted with water for fumigating and washing externally

Its use is prohibited in patients with bleeding or vigorous fire due to yin deficiency

(Continued )

166 PART | I Chinese Materia Medica

TABLE 7.1 Properties, Actions, and Application of Common Herbs That Warm the Interior (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Long Pepper Fruit (bi bo) (Fructus Piperis Longi)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried near matured or matured fruit cluster of Piper longum L. of the Piperaceae family. It is collected when it turns black from green; after impurities are removed, it is dried under the sun

Acrid, hot; act on the stomach and large intestine channels

Warm the center and dissipate cold, lower qi, and relieve pain

Indicated for the treatment of cold pain in the stomach cavity and abdomen, vomiting and acid swallowing, hiccup, and diarrhea with rugitus due to stomach cold, chest bì and precordial pain due to congealing cold and qi stagnation, headache, and pain of decayed tooth. Normally, 1–3 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder for stuffing hole of the decayed tooth

Its use is prohibited in patients with excess heat and fire from constraint, or vigorous fire due to yin deficiency

Cubeb Fruit (bi cheng qie) (Fructus Litseae)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the dried matured fruit of Litsea cubeba (Lour.) Pers. of the Lauraceae family. It is collected when matured in autumn; after impurities are removed, it is dried under the sun

Acrid, warm; act on the spleen, stomach, kidney, and bladder channels

Warm the center and dissipate cold, move qi, and relieve pain

Indicated for the treatment of vomiting and hiccup due to stomach cold, cold pain in the stomach cavity and abdomen, or cold hernia with abdominal pain, difficulty in micturition due to deficiency-cold in the lower jiao or turbid urine due to constraint and stagnation of colddamp. Normally, 1–3 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is used externally

Its use is prohibited in patients with yin deficiency, static heat in blood aspect, or cough with fever

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2. Attached herbs (Table 7.2) TABLE 7.2 Introduction to Attached Herbs That Warm the Interior

Name of Medicinal

Source and Collection

Property, Channel Entry

Mother Clove (mu ding xiang) (Fructus Caryophylli)

It is the dried near matured fruit of Eugenia caryophyllata Thunb. of the Myrtaceae family. When fruit will be matured, it is collected and then dried under the sun

Acrid, warm; act on the spleen, stomach, lung, and kidney channels

Spicy Ginger Seed (hong dou kou) (Fructus Galangae)

It is the dried matured fruit of Alpinia galanga Willd. of the Zingiberaceae family. It is collected when fruit turns red in autumn; after impurities are removed, it is dried in the shade

Bunge Pricklyash Seed (jiao mu) (Semen Zanthoxyli)

Tibetan Sweetflag Rhizome (zang chang pu) (Rhizoma Acori Calami)

Efficacy and Action

Clinical Application and Usage

Caution for Use

Warm the center and direct counterflow downward, supplement kidney, and assist yang

Indicated for the treatment of syndrome of deficiency-cold of the spleen and stomach, hiccup and vomiting, less eating and diarrhea, cold pain in the epigastrium and abdomen, and yang we˘i (impotence) due to kidney deficiency. Normally, 1–3 g is decocted with water or ground into powder as an oral dose. Or an appropriate amount is ground into powder for applying externally or as a suppository

It is not suitable for patients with heat pattern, or yin deficiency, and internal heat. Don’t combine with Turmeric Root Tuber (yu jin) to use

Acrid, warm; act on the spleen and lung channels

Scatter cold and dry dampness, awaken the spleen, and promote digestion

Indicated for the treatment of cold pain in the stomach cavity and abdomen, distention and fullness due to food accumulation, vomiting and diarrhea, regurgitation, dysentery, and profuse alcohol consumption. Normally, 3–6 g is decocted with water or ground into powder as an oral dose. Or an appropriate amount is ground into powder for snuffing or applying externally

Its use is prohibited in patients with fever due to yin deficiency

It is the dried seed of Zanthoxylum schinifoliun Sieb. et Zucc. or Zanthoxylum bungeanum Maxim. of the Rutaceae family. The fruit is collected when matured during September to October, and then dried in the open-air until pericarp and seed are divided, and seed is taken out for use

Bitter, cold; act on the lung, kidney, and bladder channels

Promote urination and relieve edema, direct qi downward, and relieve panting

Indicated for the treatment of edema with distention and fullness, and difficulty in micturition, or cough and panting due to phlegm-rheum. Normally, 3–10 g is decocted with water or 1.5 g is ground into powder as an oral dose, or made into pills or tablets or capsule. Or an appropriate amount is used externally

Its use is prohibited in patients with vigorous fire due to yin deficiency

It is the dried rhizome of Acorus calamus L. of the Araceae family. It is a habitually used medicinal in Tibetan nationality, collected in autumn and winter; after fibrous root and sediment are removed, it is dried under the sun

Bitter, acrid, warm, dry, and sharp

Warm the stomach, eliminate inflammation, and relieve pain

Indicated for the treatment of stomach yang insufficiency, indigestion, food accumulation and stagnation, diphtheria, and wool-sorter’s disease (anthrax). Normally, 3–6 g is decocted with water as an oral dose

It is not suitable for patients with yin fluid depletion and excess heat

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3. Herb differentiation (Table 7.3) TABLE 7.3 Differentiation Between Similar Efficacy Herbs That Warm the Interior Name of Medicinal

Similarity

Differences

Aconite Root (fu zi) (Radix Aconiti Lateralis Praeparata)

Both are acrid and sweet in flavor and hot in nature, act on the spleen, kidney, and heart channels, not only good at supplementing fire and assisting yang, and can treat kidney yang deficiency syndrome, and spleenkidney yang deficiency syndrome, but also good at dissipating cold and relieving pain, and can treat direct attack by pathogenic cold, cold pain in the stomach cavity and abdomen, and loose stool or diarrhea due to deficiency-cold of the spleen and stomach, painful bì syndrome due to cold-damp, chest bì (pectoral stuffiness pain) due to cold, and yin jaundice

It is poisonous and has a stronger efficacy, and is commonly used for the treatment of severe syndrome caused by yang deficiency and internal cold. It is good at restoring yang to rescue from counterflow [desertion], and can treat yang collapse or yang desertion, spontaneous sweating due to yang deficiency, or syndrome of yang deficiency, and external contraction

Both are acrid and hot in nature, act on the spleen, kidney, and heart channels, are good at restoring yang, dissipating cold, and relieving pain, can be used for the treatment of yang collapse, yang deficiency of the spleen and kidney, or syndrome caused by external cold directly attacking, and painful bì syndrome due to cold-damp

It is nonpoisonous and has a less strong efficacy than Radix Aconiti Lateralis Praeparata (fu zi), and can unblock the vessels. If it treats yang collapse, it should combine with Radix Aconiti Lateralis Praeparata (fu zi) to obtain the effect. It also acts on the lung and stomach channels, is good at warming the spleen yang, and can treat cold pain in the stomach cavity and abdomen, vomiting and diarrhea due to spleen yang insufficiency. It also can warm the lung and dissolve rheum (fluid retention) and treat cough and panting due to cold rheum

Both come from the same plant: Cinnamomum cassia Presl of the Lauraceae family. Both are acrid and sweet in flavor and hot in nature, can assist yang and dissipate cold, warm the channels and unblock the vessels so as to treat cold pain in the stomach cavity and abdomen, bì syndrome due to wind-cold-damp, edema due to yang deficiency, phlegm rheum, chest bì (pectoral stuffiness pain), dysmenorrhea and menstrual block due to cold congealing and blood stasis

It is the bark of trunk, has s stronger effect of warming the interior, and is good at supplementing fire and assisting yang, and returning fire to its source, and can treat yang we˘i (impotence), and uterus cold caused by kidney yang deficiency and decline of fire, or deficiency-type panting and palpitation due to upfloating of deficient yang and deficiency-cold of kidney qi, cold hernia with abdominal pain, dorsal furuncle, and multiple metastatic abscess

Both are acrid and hot in nature, act on the spleen and stomach channels, have the effects of warming the center and dissipating cold, and can be used for the treatment of cold pain in the stomach cavity and abdomen, vomiting, and diarrhea due to deficiency-cold in the middle jiao

It also acts on the liver and kidney channels, and is slightly poisonous, can dissipate cold in the liver channel, and resolve constraint and stagnation of liver qi. It is an essential medicinal to treat various pain caused by liver cold and qi stagnation. Moreover, it can assist yang and arrest diarrhea, can treat fifth-watch diarrhea (diarrhea before dawn) due to yang deficiency of the spleen and kidney

Cinnamon Bark (rou gui) (Cortex Cinnamomi)

Dried Ginger Rhizome (gan jiang) (Rhizoma Zingiberis)

Aconite Root (fu zi) (Radix Aconiti Lateralis Praeparata)

Cinnamon Bark (rou gui) (Cortex Cinnamomi)

Cassia Twig (gui zhi) (Ramulus Cinnamomi)

Medicinal Evodia Fruit (wu zhu yu) (Fructus Evodiae)

Dried Ginger Rhizome (gan jiang) (Rhizoma Zingiberis)

It is nonpoisonous and has a moderate efficacy, has no effect of restoring yang to rescue from counterflow [desertion], but is good at returning fire to its source, boosting yang for eliminating abundance of yin, can treat various syndromes caused by deficiency-cold of kidney qi, or upfloating of deficient yang. It also acts on the blood aspect, is good at warming the channels and unblocking the vessels, can treat dysmenorrhea and amenorrhea caused by deficiency-cold in in the chong and ren mai and blood stagnation, cold hernia with abdominal pain, low back pain, dorsal furuncle, and multiple metastatic abscess

It is poisonous, the first essential medicinal that restore yang to rescue from counterflow [desertion], and a preferred herb for the treatment of yang collapse. It is also good at supplementing fire and assisting yang and treat yang we˘i (impotence), uterus cold, enuresis and frequent micturition due to decline of vital gate fire, and edema, external contraction, spontaneous sweating, and chest bì pain due to yang deficiency

It is the twig, has a milder effect of warming the interior, but is good at dissipating exterior cold, and inducing sweating to release the exterior, can be used for the treatment of the exterior pattern due to windcold with sweating or absence of sweating. It also can assist yang to transform qi and move water (promote urination), and treat phlegmrheum syndrome, and water amassment syndrome

It also acts on the heart and lung channels, can restore yang and unblock the vessels, warm the lung and dissolve rheum (fluid retention), and can be used for the treatment of syndromes, such as yang collapse, cough, and panting due to cold rheum, cold body and back, profuse, and clear phlegm

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Herbs That Rectify Qi Chapter Outline Specific Application Knowledge of Herbs

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ABSTRACT Chinese herbal medicinals that rectify or regulate the qi movement (sometimes referred to as “qi mechanism” or “qi dynamic”) as the main role and treat qi stagnation or qi counterflow syndrome are called “Herbs That Rectify Qi” or “Herbs That Move Qi.” Herbs that rectify qi are mainly indicated for the treatment of distending pain in the stomach cavity and abdomen, belching and acid swallowing, nausea and vomiting, diarrhea or constipation caused by qi stagnation in the spleen and stomach; distending pain in the hypochondrium, depression and discomfort, hernia pain; distending pain in the breast, and menstrual irregularities caused by constraint and stagnation of the liver qi; chest oppression and pain, cough and panting caused by obstruction, and stagnation of the lung qi. Keywords: herbs that rectify qi; herbs that move qi; rectify qi and fortify the spleen; disperse accumulation and resolve [food] stagnation; rectify qi and loosen the center; rectify qi and relieve pain; soothe the liver and resolve constraint

Chinese herbal medicinals that rectify or regulate the qi movement (sometimes referred to as “qi mechanism” or “qi dynamic”) as the main role and treat qi stagnation or qi counterflow syndrome are called “Herbs That Rectify Qi” or “Herbs That Move Qi.” Medicinals in this chapter are more acrid and bitter in flavor and warm and fragrant in nature. The medicinal with acrid flavor has the effect of moving, with bitter flavor has the effect of discharging, with fragrant property has the effects of moving and scurrying, and with warm property has the effects of unblocking and moving, so medicinals in this chapter have the action of rectifying qi movement, such as moving qi, directing qi downward, resolving constraint, and dissipating masses. Through smoothing qi movement, they also can eliminate qi stagnation and obtain the efficacy of relieving pain. The meaning is exactly what is called “when there is inactivity, treat it by moving; treat inactivity by moving,” “when there is binding, treat it with dissipation; treat pathogenic accumulation with dissipation” and “when the wood (liver) is constrained, treat it with dispersion; treat hepatic stagnation with dispersion” in The Yellow Emperor’s Inner Classic (huang di nei jing). In view of this chapter’s medicinals that mainly act on the spleen, stomach, liver, and lung channels and according to their different properties and actions, they have the effects of rectifying qi and fortifying the spleen, soothing the liver and resolving constraint, rectifying qi and relieving chest stuffiness, moving qi and relieving pain, breaking stagnant qi, and dissipating masses, respectively. Herbs that rectify qi are mainly indicated for the treatment of distending pain in the stomach cavity and abdomen, belching and acid swallowing, nausea and vomiting, diarrhea or constipation caused by qi stagnation in the spleen and stomach; distending pain in the hypochondrium, depression and discomfort, and hernia pain; distending pain in the breast, and menstrual irregularities caused by constraint and stagnation of the liver qi; chest oppression and pain, cough and panting caused by obstruction and stagnation of the lung qi. When using this chapter’s medicinals, it should necessarily combine the corresponding efficacy herbs according to the specific diseases and syndromes. To treat patients with qi stagnation in the spleen and stomach, select the medicinals that can regulate the qi movement of the spleen and stomach to combine. To treat patients with drink and food accumula­ tion and retention, select the medicinals that can promote digestion and guide out [food] stagnation to combine. To treat patients with spleen-stomach qi deficiency, select the medicinals that can supplement the center and boost qi to combine.

Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00008-7 Copyright © 2017 Elsevier Inc. All rights reserved.

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To treat patients with damp-heat obstruction, select the medicinals that can clear heat and eliminate dampness to combine. To treat patients with cold-damp encumbering the spleen, select the bitter-warm medicinals that dry dampness to combine. To treat patients with liver constraint and qi stagnation, select the medicinals that can soothe the liver and rectify qi to combine. To treat patients with liver-blood insufficiency, select the medicinals that can nourish blood and soften the liver to combine. To treat patients with cold invading in the liver channel, select the medicinals that can warm the liver and dissipate cold to combine. To treat patients with stagnation of blood stasis, select the medicinals that can invigorate blood and dissolve stasis to combine. To treat patients with lung qi obstruction and stagnation, select the medicinals that can rectify qi and relieve chest stuffiness to combine. To treat patients with exogenous pathogen intruding the lung, select the medicinals that can diffuse the lung and release the exterior. To treat patients with phlegm-rheum obstructing the lung, select the medicinals that can dispel phlegm and dissolve rheum (fluid retention). This chapter’s medicinals are usually acrid, warm, fragrant and dry, and easy to consume qi and damage yin; so their applications are cautious in patients with deficiency of both qi and yin. The modern pharmacological research indicates most of the herbs that rectify qi can inhibit or stimulate the gastrointestinal smooth muscles, promote the secretion of digestive juices, or promote gallbladder function. Some have the effects of relaxing the bronchial smooth muscles, inhibiting the central nervous system, regulating the uterine smooth muscles, stimulating the cardiac muscles, increasing the coronary blood flow, boosting, or lowering blood pressure, and antagonizing bacteria. This chapter’s medicinals in modern medical treatment are more used for the treatment of gastritis, enteritis, alimentary canal ulcer, various liver diseases, cholecystitis, cholelithiasis, and chronic bronchitis.

SPECIFIC APPLICATION KNOWLEDGE OF HERBS 1. Primary herbs (Table 8.1)

TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi Name of Medicinal Aged Tangerine Peel (chen pi) (Pericarpium Citri Reticulatae)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured pericarp of Citrus reticulata Blanco and its cultivated variety of the Rutaceae family. The matured fruit is collected, and then the pericarp is peeled and dried under the sun, or at lower temperature

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Bitter, acrid, warm; act on the lung and spleen channels

Rectify qi and fortify the spleen, dry dampness, and dissolve phlegm

Indicated for the treatment of distention and fullness in the stomach cavity and abdomen, no desire to eat or drink, nausea and vomiting, and diarrhea due to qi stagnation in the spleen and stomach, hiccup and vomiting due to stomach cold, cough with profuse phlegm due to damp-phlegm or cold phlegm (as an essential medicinal for the treatment of phlegm syndrome), chest bì pain with shortness of breath due to qi stagnation in the chest. Normally, 3–10 g is decocted with water as an oral dose

Caution for Use It is not suitable for patients with qi deficiency and dry cough due to yin deficiency. Its use is cautious in patients with blood spitting

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TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Green Tangerine Peel (qing pi) (Pericarpium Citri Reticulatae Viride)

Initially recorded in Illustrated Classic of Materia Medica (ben cao tu jing). It is the dried pericarp of young fruit or immature fruit of Citrus reticulata Blanco and its cultivated variety of the Rutaceae family. Young fruit that falls spontaneously is collected during May to June and dried under the sun; or immature fruit is collected during July to August, and the pericarp is peeled and dried under the sun

Bitter, acrid, warm; act on the liver, gallbladder, and stomach channels

Soothe the liver and break stagnant qi, disperse accumulation and resolve [food] stagnation, dissipate masses, and relieve pain

Indicated for the treatment of distending pain in the chest and hypochondrium, and hernia pain due to liver constraint and qi stagnation, distending pain in the stomach cavity, and abdomen due to food accumulation and qi stagnation, breast lump and mammary abscess, concretions and conglomerations (zhēng jia˘ ) or accumulations and gatherings (jī jù) or ague-cake due to qi stagnation and blood stasis. Normally, 3–10 g is decocted with water as an oral dose, or made into pills

Its use is cautious in the weak, or patients with qi deficiency of the liver and spleen, or profuse sweating

Tangerine Seed (ju he) (Semen Citri Reticulatae)

Initially recorded in Ri Hua-zi’s Materia Medica (ri hua zi ben cao). It is the dried matured seed of Citrus reticulata Blanco and its cultivated variety of the Rutaceae family. When the fruit is matured, it is collected and washed clean and dried under the sun

Bitter, neutral; act on the liver and kidney channels

Rectify qi and dissipate masses, and relieve pain

Indicated for the treatment of hypochondriac pain due to binding constraint of liver qi, hernia pain, swelling and pain of the testis, low back pain, distending pain in the breast, or breast lump due to qi stagnation and blood stasis, and mammary abscess in the initial stage. Normally, 3–9 g is decocted with water as an oral dose, or made into pills or powder

Its use is cautious in patients with weak body constitution, and prohibited in patients with deficiency syndrome

(Continued )

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TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Pummelo Peel (hua ju hong) (Exocarpium Citri Grandis)

Initially recorded in Medicinals Recognition and Subtleties Differentiation (shi yao bian wei). It is the dried immature or near matured outer pericarp of Citrus grandis “Tomentosa” or Citrus grandis (L.) Osbeck of the Rutaceae family. Before the fruit is matured in summer, it is collected and slightly scalded in boiling water. Then the pericarp is cut into 5 or 7 sections; after pulp of fruit and parts of mesocarp are removed, it is pressed, formed, and dried

Acrid, bitter, warm; act on the lung and spleen channels

Rectify qi and loosen the center, dry dampness, and dissolve phlegm

Indicated for the treatment of cough and panting with a pattern of damp-phlegm or cold-phlegm in the chest, with profuse phlegm, distention and oppression in the chest and diaphragm, or distending pain in the stomach cavity and abdomen, vomiting and hiccup due to food accumulation, or alcoholic disease. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or doses

Its use is prohibited in patients with qi deficiency, yin deficiency, and dry cough with scanty phlegm

Immature Bitter Orange (zhi shi) (Fructus Aurantii Immaturus)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried young fruit of Citrus aurantium L. and its cultivated variety or Citrus sinensis Osbeck of the Rutaceae family. Young fruit that falls spontaneously is collected during May to June; after impurities are removed, it is horizontally cut in half from the middle, and dried under the sun or at lower temperature

Bitter, acrid, sour, slightly cold; act on the spleen and stomach channels

Break stagnant qi and disperse accumulation, dissolve phlegm, and disperse pĭ

Indicated for the treatment of distention and fullness and pain in the stomach cavity and abdomen due to food accumulation and stagnation in the stomach and intestines, diarrhea, and dysentery with tenesmus due to dampheat accumulation, or constipation, chest bì and thoracic accumulation due to phlegm stagnation and qi obstruction, thoracic and hypochondriac pain due to qi stagnation, postpartum abdominal pain and visceral prolapse. Normally, 3–10 g is decocted with water as an oral dose

Its use is cautious in the old, the weak, pregnant women or patients with qi weakness and spleen-stomach deficiency

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TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Bitter Orange (zhi qiao) (Fructus Aurantii)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the dried immature fruit of Citrus aurantium L. and its cultivated variety of the Rutaceae family. When pericarp is still green in July, it is collected and crosscut in half from the middle, and dried under the sun or at lower temperature

Bitter, acrid, sour, slightly cold; act on the spleen, stomach, and large intestine channels

Rectify qi and loosen the center, move stagnation, and relieve distention

Indicated for the treatment of pĭ and fullness in the chest and diaphragm, and distending pain in the hypochondrium due to qi stagnation, food accumulation without digestion, distention, and fullness in the stomach cavity and abdomen, dysentery with tenesmus, prolapse of the rectum or uterus, and syndrome of internal stagnation of phlegm rheum. Normally, 3–10 g is decocted with water as an oral dose

Its use is cautious in pregnant women or patients with weakness of the spleen and stomach, or qi and blood insufficiency

Common Aucklandia Root (mu xiang) (Radix Aucklandiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Aucklandia lappa Decne. of the Compositae family. It is collected in autumn and winter; after sediment and fibrous root are removed, it is cut into segments, then longitudinally cut into sections, dried, and stroked to separate the rough bark

Acrid, bitter, warm; act on the spleen, stomach, large intestine, sanjiao, and gallbladder channels

Move qi and relieve pain, fortify the spleen, and promote digestion

Indicated for the treatment of distention and fullness and pain in the stomach cavity and abdomen, food accumulation, and indigestion due to qi stagnation in the spleen and stomach, diarrhea and dysentery with tenesmus due to damp-heat and qi stagnation in the large intestine, thoracic and hypochondriac pain and jaundice due to damp constraint and qi obstruction, or hernia pain, heart pain due to congealing cold and qi stagnation, or chest bì due to qi stagnation and blood stasis. Normally, 3–6 g is decocted with water as an oral dose

Its use is cautious in patients with yin deficiency or body fluid insufficiency, and prohibited in patients with fever, heart pain with heat pattern, or dryness-heat of zang-fu

(Continued )

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TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Aquilaria Wood (chen xiang) (Lignum Aquilariae Resinatum)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the wood with resina of Aquilaria sinensis (Lour.) Gilg of the Thymelaceae family. It is collected in whole year and the wood with resina is collected; after the parts without resina are removed, it is dried in the shade

Acrid, bitter, slightly warm; act on the spleen, stomach and kidney channels

Move qi and relieve pain, warm the center and arrest vomiting, improve qi reception, and relieve panting

Indicated for the treatment of distention and oppression and pain in the chest and abdomen due to congealing cold and qi stagnation, hiccup, and vomiting due to stomach cold, and deficiency-type panting with qi counterflow due to deficiency-cold of kidney qi and failure of the kidney to grasp qi. Normally, 1–5 g is added later and decocted with water as an oral dose

Its use is cautious in patients with vigorous fire due to yin deficiency, or syndrome of sinking of qi deficiency

Sandalwood (tan xiang) (Lignum Santali Albi)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried heartwood of Santalum album L. of the Santalaceae family. It is collected in summer; after sapwood is removed, it is split

Acrid, warm; act on the spleen, stomach, heart, and lung channels

Move qi and warm the center, increase appetite, and relieve pain

Indicated for the treatment of discomfort in the chest and diaphragm, chest bì with colicky pain, or cold pain in the stomach cavity and abdomen with vomiting and less eating due to congealing cold and qi stagnation, or chest oppression due to turbid phlegm obstructed in interior. Normally, 2–5 g is added later and decocted with water as an oral dose

It is not suitable for patients with cough accompanied by bleeding due to yin deficiency and exuberance of fire

Jatamana Valeriana Rhizome (zhi zhu xiang) (Rhizoma et Radix Valerianae Jatamansi)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried rhizome and root of Valeriana jatamansi Jones of the Valerianaceae family. It is collected in autumn; after sediment is removed, it is dried under the sun

Slightly bitter, acrid, warm; act on the heart, spleen, and stomach channels

Rectify qi and relieve pain, promote digestion and arrest diarrhea, dispel wind, and eliminate dampness, suppress fright and calm the mind

Indicated for the treatment of distending pain in the stomach cavity and abdomen and vomiting due to food accumulation and qi stagnation, diarrhea and dysentery, infantile malnutrition with accumulation, painful bì syndrome due to wind-damp, soreness and weakness of waist and knees, sleeplessness, weak foot with edema, irregular menstruation, injury from falling down, sores, and furuncle. Normally, 3–6 g is decocted with water as an oral dose, or an appropriate amount is ground to extract the juice for applying externally

Its use is prohibited in pregnant women and patients with yang deficiency and qi weakness

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TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Toosendan Fruit (chuan lian zi) (Fructus Toosendan)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured fruit of Melia toosendan Sieb. et Zucc of the Meliaceae family. The fruit is collected when matured in winter; after impurities are removed, it is dried

Bitter, cold, slightly poisonous; act on the liver, small intestine, and bladder channels

Soothe the liver and discharge heat, move qi, and relieve pain, and kill worm

Indicated for the treatment of distending pain in the abdomen, stomach cavity, chest, and hypochondrium due to liver constraint and qi stagnation or liver constraint transforming into fire, or hernia pain, and abdominal pain due to worm accumulation. Normally, 5–10 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder for applying externally

Its use is cautious in patients with deficiency-cold of the spleen and stomach. It is not suitable for overdose and long-term application in order to avoid poisoning

Combined Spicebush Root (wu yao) (Radix Linderae)

Initially recorded in Supplement to “The Materia Medica” (ben cao shi yi). It is the dried root tuber of Lindera aggregata (Sims) Kosterm. of the Lauraceae family. It is collected in whole year; after radicles are removed, it is washed clean, cut into pieces while fresh, and dried under the sun

Acrid, warm; act on the lung, spleen, kidney, and bladder channels

Move qi and relieve pain, warm the kidney, and dissipate cold

Indicated for the treatment of distending pain or stuffy pain in the stomach cavity, abdomen, chest and hypochondrium, or abdominal pain during menstruation due to congealing cold and qi stagnation, dyspnea with rapid respiration and qi counterflow, frequent micturition, and enuresis due to kidney yang insufficiency and bladder deficiency-cold, and cold hernia pain. Normally, 6–10 g is decocted with water as an oral dose

Its use is prohibited in patients with qi deficiency and internal heat

Slender Dutchmanspipe Root (qing mu xiang) (Radix Aristolochiae)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried root of Aristolochia debilis Sieb. et Zucc. of the Aristolochiaceae family. It is collected in spring and autumn; after fibrous root and sediment are removed, it is dried under the sun and cut into pieces

Acrid, bitter, cold; act on the liver and stomach channels

Move qi and relieve pain, resolve toxins, and relieve swelling

Indicated for the treatment of distending pain in the chest and hypochondrium, or pain in the stomach cavity and abdomen due to qi stagnation in the liver and stomach, diarrhea, and dysentery with abdominal pain due to unhygienic diet and summer heat-damp obstructed in interior, swollen furuncles and sores, eczema, and thanatophidia bite. Normally, 3–9 g is decocted with water or 1.5–2 g of the powder each time for oral use. Or an appropriate amount is used externally

Its use is cautious in patients with deficiency-cold syndrome. It is not suitable for overdose, which may cause the gastrointestinal reaction, such as nausea and vomiting

(Continued )

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TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.)

Source and Collection

Property, Channel Entry

Lychee Seed (li zhi he) (Semen Litchi)

Initially recorded in Extension of the Materia Medica (ben cao yan yi). It is the dried matured seed of Litchi chinensis Sonn. of the Sapindaceae family. The matured fruit is collected in summer; after pericarp and pulps of aril are removed, it is washed clean and dried under the sun

Nutgrass Galingale Rhizome (xiang fu) (Rhizoma Cyperi)

Finger Citron Fruit (fo shou) (Fructus Citri Sarcodactylis)

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Sweet, slightly bitter, warm; act on the liver and kidney channels

Move qi and dissipate masses, dispel cold, and relieve pain

Indicated for the treatment of hernia pain, swelling and pain of the testis due to congealing cold and qi stagnation, chronic pain in the stomach cavity due to liverstomach disharmony, dysmenorrhea, and postpartum abdominal pain due to liver constraint and qi stagnation and blood stasis. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder

It is not suitable for patients without colddamp, or qi stagnation

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried rhizome of Cyperus rotundus L. of the Cyperaceae family. It is collected in autumn; after hair is singed, it is directly dried under the sun; or slightly decocted with boiling water or thoroughly steamed, and dried under the sun

Acrid, slightly bitter, slightly sweet, neutral; act on the liver, spleen and sanjiao channels

Soothe the liver and resolve constraint, rectify qi and loosen the center, regulate menstruation and relieve pain

Indicated for the treatment of distending pain in the chest, hypochondriac pain due to liver constraint and qi stagnation, hernia pain, pĭ and oppression, distention and fullness and pain in the stomach cavity and abdomen due to qi stagnation in the spleen and stomach, distending pain in the breast, menstrual irregularities, menstrual block, and dysmenorrhea due to binding constraint of liver qi. Normally, 6–10 g is decocted with water as an oral dose

Its use is prohibited in patients with qi deficiency, no stagnation, or blood heat due to yin deficiency

Initially recorded in Materia Medica of South Yunnan (dian nan ben cao). It is the dried fruit of Citrus medica L. var. sarcodactylis Swingle of the Rutaceae family. Before or when it turns yellow in autumn, it is collected and longitudinally cut into thin pieces, and then dried under the sun or at lower temperature

Acrid, bitter, sour, warm; act on the liver, spleen, stomach, and lung channels

Soothe the liver and resolve constraint and rectify qi, harmonize the stomach, and relieve pain, dry dampness and dissolve phlegm

Indicated for the treatment of distending pain in the chest and hypochondrium due to liver constraint and qi stagnation, pĭ and fullness in the stomach cavity with less eating and nausea and vomiting due to qi stagnation in the liver and stomach, and chronic cough with profuse phlegm and chest pain. Normally, 3–10 g is decocted with water as an oral dose

Its use is cautious in patients with yin deficiency, fire pattern, and no qi stagnation

Caution for Use

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TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Citron (xiang yuan) (Fructus Citri)

Initially recorded in Supplement to “The Materia Medica” (ben cao shi yi). It is the dried matured fruit of Citrus medica L. or Citrus wilsonii Tanaka of the Rutaceae family. When matured in autumn, it is collected and cut into pieces while fresh, then dried under the sun or at lower temperature

Acrid, bitter, sour, warm; act on the liver, spleen, and lung channels

Soothe the liver and rectify qi, loosen the center, and dissolve phlegm

Indicated for the treatment of distending pain in the chest and hypochondrium due to liver constraint, pĭ and fullness, or distending pain in the stomach cavity and abdomen with belching and acid swallowing, less eating, nausea, and vomiting due to qi stagnation in the spleen and stomach, cough with profuse phlegm and oppression in the chest and diaphragm due to phlegm-rheum. Normally, 3–9 g is decocted with water as an oral dose

Its use is cautious in pregnant women with qi deficiency or patients with yin deficiency and blood dryness

Rose Flower (mei gui hua) (Flos Rosae Rugosae)

Initially recorded in Food as Materia Medica (shi wu ben cao). It is the dried flower bud of Rosa rugosa Thunb. of the Rosaceae family. When the flower will blossom in late spring and early summer, it is collected in batch and then dried in lower temperature in time

Sweet, slightly bitter, warm; act on the liver and spleen channels

Move qi to resolve constraint, harmonize blood, and relieve pain

Indicated for the treatment of distending pain in the chest, hypochondrium, stomach cavity and abdomen with nausea, vomiting and less eating due to liver constraint and liver qi invading the stomach, menstrual irregularities, and distending pain in the breast before menstruation due to binding constraint of liver qi, and injury from falling down. Normally, 3–6 g is decocted with water as an oral dose

Its use is cautious in patients with vigorous fire due to yin deficiency

Plum Flower (lü e mei) (Flos Mume)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried flower bud of Prunus mume (Sieb.) Siezb. Et Zucc. of the Rosaceae family. Before blooming, it is collected and dried in lower temperature in time

Slight sour, astringent, neutral; act on the liver, stomach, and lung channels

Soothe the liver and resolve constraint, harmonize the center, dissolve phlegm and dissipate masses

Indicated for the treatNo special ment of distending pain in contraindications the hypochondrium, or pĭ and fullness in the stomach cavity and abdomen with belching, poor appetite and digestion, depression, and vexation due to qi stagnation in the liver and stomach, plum-stone qi (globus hystericus) due to binding constraint of phlegm and qi, or neurasthenia, scrofula, and sores. Normally, 3–5 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount of the fresh one is pounded for applying externally (Continued )

178 PART | I Chinese Materia Medica

TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Buckeye Seed (suo luo zi) (Semen Aesculi)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried matured seed of Aesculus chinensis Bge., Aesculus chinensis Bge. var. chekiangensis (Hu et Fang) Fang or Aesculus wilsonii Rehd. of the Hippocastanacease family. It is collected when matured in autumn; after pericarp is removed, it is dried under the sun or at lower temperature

Sweet, warm; act on the liver and stomach channels

Soothe the liver and rectify qi, harmonize the stomach, and relieve pain, and kill worms

Indicated for the treatment of chest oppression and hypochondriac pain, distending pain in the stomach cavity and abdomen due to qi stagnation in the liver and stomach, distending pain in the breast before menstruation due to binding constraint of liver qi, and worm accumulation and malnutrition with abdominal pain. Normally, 3–9 g is decocted with water as an oral dose

Its use is prohibited in patients with qi deficiency and yin deficiency

Akebia Fruit (ba yue zha) (Fructus Akebiae)

Initially recorded in Supplement to “The Grand Compendium of Materia Medica” (ben cao gang mu shi yi). It is the dried matured fruit of Akebia quinata (Thunb.) Decne., Akebia trifoliata (Thunb.) Koidz. or Akebia trifoliata (Thunb.) Koidz. var. australis (Diels) Rehd. of the Laidizabalaceae family. When matured during August to September, it is collected and dried in the shade, or thoroughly soaked in boiling water and dried under the sun

Sweet, slightly bitter, neutral; act on the liver, stomach, and bladder channels

Soothe the liver and rectify qi, invigorate blood and relieve pain, soften hardness, and dissipate masses, and promote urination

Indicated for the treatment of distending pain in the stomach cavity, abdomen and hypochondrium due to liver-stomach qi stagnation, poor appetite and digestion with vexation and thirst due to stomach heat, diarrhea or dysentery with red and white feces, low back pain, hernia pain, dysmenorrhea, and menstrual block, bearing down of uterus, goiter and scrofula, and tumor. Normally, 9–15 g is decocted with water as an oral dose, or steeped in wine for oral use

Its use is cautious in pregnant women

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TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Long Stamen Onion Bulb (xie bai) (Bulbus Allii Macrostemi)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried bulb of Allium macrostemon Bge. or Allium chinense G. Don of the Liliaceae family. It is collected in summer and autumn, and washed clean; after fibrous root is removed, it is thoroughly steamed or scalded in boiling water, and dried under the sun

Acrid, bitter, warm; act on the heart, lung, stomach, and large intestine channels

Unblock yang and dissipate masses, move qi, and guide out [food] stagnation

Indicated for the treatment of chest bì and heart pain due to cold-phlegm obstruction and hypofunction of yang qi in the chest, or intermingled phlegm and blood stasis, pĭ and fullness or distending pain in the stomach cavity and abdomen due to stomach cold and qi stagnation, diarrhea, and dysentery with tenesmus due to qi stagnation in the stomach and intestines. Normally, 5–10 g is decocted with water as an oral dose

Its use is cautious in patients with qi deficiency. It is not suitable for fever due to yin deficiency

Dutchmans Pipe Vine (tian xian teng) (Herba Aristolochiae)

Initially recorded in Illustrated Classic of Materia Medica (ben cao tu jing). It is the dried aerial part of Aristolochia debilis Sieb. et Zucc. or Aristolochia contota Bge. of the Aristolochiaceae family. It is collected in autumn; after impurities are removed, it is dried under the sun

Bitter, warm; act on the liver, spleen, and kidney channels

Move qi and invigorate blood, dispel dampness, unblock the collaterals, and relieve pain

Indicated for the treatment of stabbing pain in the stomach cavity and abdomen, hernia pain, postpartum abdominal pain, gestational edema, painful bì syndrome due to wind-damp, concretions and conglomerations (zhēng jia˘ ) or accumulations and gatherings (jī jù) due to qi stagnation and blood stasis. Normally, 3–6 g is decocted with water as an oral dose

Its use is cautious in the weak, the old and children, and prohibited in pregnant women, infants and patients with renal dysfunction

(Continued )

180 PART | I Chinese Materia Medica

TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Areca Peel (da fu pi) (Pericarpium Arecae)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the dried pericarp of Areca catechu L. of the Trachycarpaceae family. The immature fruit is collected during winter to next spring, or the matured fruit is collected during late spring to early autumn. Then it is decocted, dried, and longitudinally cut in half; the pericarp is peeled and dried under the sun

Acrid, slightly warm; act on the spleen, stomach, large intestine, and small intestine channels

Move qi and loosen the center, and move water (promote urination) to relieve edema

Indicated for the treatment of distention and oppression in the stomach cavity and abdomen with incomplete defecation due to dampness obstruction and qi stagnation in the stomach and intestines, edema with distention and fullness, weak foot with puffiness and difficulty in micturition. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is decocted with water for washing externally

Its use is cautious in patients with qi deficiency or the weak body constitution

Nardostachys Root (gan song) (Radix et Rhizoma Nardostachyos)

Initially recorded in Supplement to “The Materia Medica” (ben cao shi yi). It is the dried root and rhizome of Nardostachys jatamansi Dc. of the Valerianaceae family. It is collected in spring and autumn; after sediment and impurities are removed, it is dried under the sun or in the shade

Acrid, sweet, warm; act on the spleen and stomach channels

Rectify qi and relieve pain, expel stagnation, and awaken the spleen; external treatment: dispel dampness and relieve swelling

Indicated for the treatment of oppression and distending pain in the stomach cavity with no desire to eat due to congealing cold and qi stagnation, chest oppression, abdominal distention, poor appetite, and digestion due to excessive thinking damaging the spleen, toothache, and foot damp qi (tinea pedis). Normally, 3–6 g is decocted with water as an oral dose. Or an appropriate amount is decocted with water for washing or ground into powder for applying the afflicted part

Its use is prohibited in patients with qi deficiency and blood heat

Stink-Bug (jiu xiang chong) (Aspongopus)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried body of Aspongopus chinensis Dallas of the Pentatomidae family. During November to next March, it is caught and put into a container, suffocated to death with wine, then taken out and dried in the shade, or scalded to death by boiling water, then taken out and dried

Salty, warm; act on the liver, spleen, and kidney channels

Rectify qi and relieve pain, warm the center, and assist yang

Indicated for the treatment of distending pain in the chest and hypochondrium due to liver qi constraint and stagnation, pain in the stomach cavity and abdomen due to liverstomach disharmony, yang wĕi (impotence), cold pain of waist and knees and frequent micturition due to kidney yang insufficiency. Normally, 3–9 g is decocted with water as an oral dose

Its use is prohibited in patients with yin deficiency and internal heat or yang hyperactivity

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TABLE 8.1 Properties, Actions, and Application of Common Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sword Bean (dao dou) (Semen Canavaliae)

Initially recorded in Materia Medica for Famine Relief (jiu huang ben cao). It is the dried matured seed of Canavalia gladiate (Jacq.) DC. of the Leguminosae family. The matured fruit is collected in autumn; seed is taken out and dried under the sun

Sweet, warm; act on the stomach and kidney channels

Warm the center, lower qi and relieve hiccup, warm the kidney, and assist yang

Indicated for the treatment of vomiting, hiccup and abdominal distention due to deficiency-cold in the middle jiao, and low back pain due to kidney yang deficiency, or phlegm panting with qi counterflow. Normally, 6–9 g is decocted with water as an oral dose or charred with its property retained and ground into powder for taking orally

Its use is cautious in patients with intense stomach heat

Persimmon Calyx (shi di) (Calyx Kaki)

Initially recorded in Supplement to “The Materia Medica” (ben cao shi yi). It is the dried persistent calyx of Diospyros kaki Thunb. of the Ebenaceae family. The fruit is collected when matured in winter; then persistent calyx is taken down, washed clean, and dried under the sun

Bitter, astringent, neutral; act on the stomach channel

Direct counterflow downward and relieve hiccup

Indicated for the treatment of various kinds of hiccup caused by ascending counterflow of stomach qi, such as hiccup due to deficiency-cold, or stomach heat or turbid phlegm obstructed in interior. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder

Its use is cautious in patients with sinking of center qi and kidney qi insecurity

182 PART | I Chinese Materia Medica

2. Attached herbs (Table 8.2)

TABLE 8.2 Introduction to Attached Herbs That Rectify Qi Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Red Tangerine Peel (ju hong) (Exocarpium Citri Rubrum)

It is the dried outer pericarp of Citrus reticulata Blanco and its cultivated variety of the Rutaceae family. The fruit is collected when matured during late autumn to early winter, and then the outer pericarp is cut and dried under the sun or in the shade

Acrid, bitter, warm; act on the lung and spleen channels

Rectify qi and loosen the center, dry dampness, and dissolve phlegm

Indicated for the treatment of cough due to windcold, profuse phlegm with qi counterflow, food accumulation and alcoholic disease, nausea, and vomiting, pĭ and oppression or distention in the chest and stomach cavity. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in patients with dry cough due to yin deficiency and chronic cough due to qi deficiency

Tangerine Leaf (ju ye) (Folium Citri Reticulatae)

It is the dried leaf of Citrus reticulata Blanco and its cultivated variety of the Rutaceae family. It is collected in whole year, and dried under the sun or in the shade

Bitter, acrid, neutral; act on the liver and stomach channels

Soothe the liver and move qi, dissolve phlegm, and dissipate masses

Indicated for the treatment of mammary abscess (acute mastitis), breast lump, distending pain in the chest and hypochondrium, and hernia. Normally, 6–15 g of the dried one or 60–120 g of the fresh one is decocted with water as an oral dose. Or an appropriate amount is used externally

No special contraindications

Tangerine Pith (ju luo) (Vascular Aurantii)

It is the dried fiber bundle between mesocarp and endocarp of Citrus reticulata Blanco and its cultivated variety of the Rutaceae family. The fruit is collected during December to next January, then pericarp is peeled, and white fiber bundle is ripped from the internal surface of pericarp or the external surface of pulp, and dried under the sun

Sweet, bitter, neutral; act on the liver, lung, and spleen channels

Move qi and unblock the collaterals, rectify qi and dissolve phlegm, and relieve cough

Indicated for the treatment of chronic cough due to qi stagnation in the channels and collaterals, with chest pain and bloody sputum, or thirst due to drinking too much wine. Normally, 2.5–4.5 g is decocted with water as an oral dose

No special contraindications

Galanga Resurrection Lily Rhizome (shan nai) (Rhizoma Kaempferiae)

It is the dried rhizome of Kaempferia galanga L. of the Zingiberaceae family. It is collected in winter, and washed clean; after fibrous root is removed, it is cut into pieces and dried under the sun

Acrid, warm; act on the stomach channel

Move qi and warm the center, promote digestion, and relieve pain

Indicated for the treatment of distention and fullness in the chest and diaphragm, cold pain in the stomach cavity and abdomen, and indigestion. Normally, 6–9 g is decocted with water as an oral dose

Its use is prohibited in patients with yin deficiency and blood depletion, or internal fire or heat from constraint

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TABLE 8.2 Introduction to Attached Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Inula Root (tu mu xiang) (Radix Inulae)

It is the dried root of Inula helenium L. of the Compositae family. It is collected when the leaf is withered in autumn; after stem, leaf, fibrous root, and sediment are removed, it is cut into segments and dried under the sun. The bigger one is longitudinally cut in half

Acrid, bitter, warm; act on the liver and spleen channels

Fortify the spleen and harmonize the stomach, move qi and relieve pain, calm the fetus, and expel worms

Indicated for the treatment of distending pain in the chest, hypochondrium, stomach cavity and abdomen, vomiting, diarrhea and dysentery, thoracic and hypochondriac contusions with qi divergence and pain, restless fetus, and worm accumulation syndrome. Normally, 3-9g is made into pills or powder as an oral dose

Its use is cautious in patients with blood deficiency and internal heat

Common Vladimiria Root (chuan mu xiang) (Radix Vladimiriae)

It is the dried root of Vladimira souliei (Franch.) Ling or Vladimira souliei (Franch.) Ling var. cinerea Ling of the Compositae family. It is collected in autumn; after fibrous root, sediment and jelly on the root head are removed, it is dried under the sun

Acrid, bitter, warm; act on the spleen, stomach, large intestine and gallbladder channels

Move qi and relieve pain, warm the center, and harmonize the stomach

Indicated for the treatment of distending pain in the chest, hypochondrium, stomach cavity and abdomen, diarrhea with rugitus and tenesmus. Normally, 3–9 g is added later and decocted with water as an oral dose

Its use is cautious in patients with vigorous fire due to yin deficiency

St John’s Wort (guan ye jin si tao) (Herba Hyperici Perforati)

It is the dried aerial part of Hypericum perforatum L. of the Clusiaceae family. When blooming in summer and autumn, it is collected and dried in the shade or by baking at lower temperature

Acrid, cold; act on the liver channel

Soothe the liver and resolve constraint, clear heat and drain dampness, relieve swelling, and promote lactation

Indicated for the treatment of emotion-thought failing to become smooth, depression, oppression in the heart, and chest due to binding constraint of liver qi, swelling and pain of the joints, mammary abscess (acute mastitis), and inhibited lactation. Normally, 2–3 g is decocted with water as an oral dose

Its use is cautious in patients with deficiency- cold of the spleen and stomach

Axillary Choerospondias Fruit (guang zao) (Fructus Choerospondiatis)

It is the dried matured fruit of Choerospondias axillaris (Roxb.) Burtt et Hill of the Anacardiaceae family. It is a habitually used medicinal in Mongolia nationality, collected when matured in autumn; after impurities are removed, it is dried

Sweet, sour, neutral; acts on the heart and liver channels

Move qi and invigorate blood, nourish the heart, and calm the mind

Indicated for the treatment of chest bì (pectoral stuffiness pain) due to qi stagnation and blood stasis, palpitation, shortness of breath, uneasiness in the mind, and insomnia. Normally, 30–60 g is decocted with water as an oral dose

Its use is cautious in pregnant women

Murraya Jasminorage (jiu li xiang) (Folium et Cacumen Murrayae)

It is the dried leaf and twig with leaf of Murraya exotica L. or Murraya paniculata (L.) Jack of the Rutaceae family. It is collected in whole year; after old branch is removed, it is dried in the shade

Acrid, slightly bitter, warm, slightly poisonous; act on the liver and stomach channels

Move qi and relieve pain, invigorate blood, and dissipate stasis

Indicated for the treatment of stomachache, painful bì syndrome due to winddamp; external treatment: toothache, swelling and pain from falling down, and insect or snake bite. Normally, 6–12 g is decocted with water as an oral dose

Its use is prohibited in patients with vigorous fire due to yin deficiency

(Continued )

184 PART | I Chinese Materia Medica

TABLE 8.2 Introduction to Attached Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Yellow Yam Rhizome (huang shan yao) (Rhizoma Dioscoreae Panthaicae)

It is the dried rhizome of Dioscorea panthaica Prain et Burk. of the Dioscoreaceae family. It is collected in autumn; after fibrous root is removed, it is washed clean and cut into pieces and then dried under the sun

Bitter, slightly acrid, neutral; act on the stomach and heart channels

Rectify qi and relieve pain, resolve toxins, and relieve swelling

Indicated for the treatment of stomachache, vomiting or diarrhea with abdominal pain, injury from falling down; external treatment: swollen sores and carbuncles, scrofula and phlegm nodule. Normally, 15–30 g is decocted with water as an oral dose. Or an appropriate amount is pounded for applying the afflicted part

Its use is cautious in patients with kidney deficiency and yin depletion

Dill (shi luo zi) (Fructus Anethi)

It is the dried matured fruit of Anethum graveolens L. of the Umbelliferae family. It is collected when matured in summer and autumn; after impurities are removed, it is dried under the sun

Acrid, warm; act on the spleen, stomach, liver, and kidney channels

Move qi and relieve pain, warn the center, and dissipate cold, warm the liver, and increase appetite

Indicated for the treatment of distention and fullness in the chest and hypochondrium, cold pain in the abdomen, vomiting and hiccup, less eating, and cold hernia pain. Normally, 1–5 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in patients with insufficiency of qi and yin, and internal fire and heat

Shell of Sword Bean (dao dou ke) (Pericarpium Canavaliae)

It is the dried proper exciple of Canavalia gladiate (Jacq.) DC. of the Leguminosae family. The fruit is collected when matured in autumn, dried under the sun; after seeds are removed, the proper exciple was left and completely dried under the sun

Sweet, neutral; act on the spleen and stomach channels

Harmonize the center and lower qi, dissipate stasis, and invigorate blood

Indicated for the treatment of regurgitation, hiccup, chronic dysentery, throat bì (pharyngitis), membranous pharyngitis, menstrual block, distending pain in the abdomen and hypochondrium, and low back pain. Normally, 9–15 g is decocted with water as an oral dose

Its use is prohibited in pregnant women

Finger Citron Flower (fo shou hua) (Flos Citri Sarcodactylis)

It is the dried flower and bud of Citrus medica L. var. sarcodactylis Swingle of the Rutaceae family. It is collected before sunrise in the morning, or the falling blossom is picked up and dried under the sun or by baking

Slightly bitter, slightly warm; act on the liver and stomach channels

Soothe the liver and rectify qi, harmonize the stomach, and disinhibit diaphragm

Indicated for the treatment of qi-stagnant pain in the liver and stomach (hepatogenous gastralgia), poor appetite, and digestion. Normally, 3–6 g is decocted with water as an oral dose

Its use is cautious in patients with yin depletion

Seville Orange Flower (dai dai hua) (Flos Citri Aurantii Amarae)

It is the dried flower bud of Citrus aurantium L. var. amara Engl. of the Rutaceae family. It is collected during May to June, and then baked with strong flame until 70%–80% is dry and turns yellow, then baked with mild flame until it is full dry

Acrid, sweet, slightly bitter, neutral; act on the liver and stomach channels

Soothe the liver and rectify qi, harmonize the stomach, and relieve pain

Indicated for the treatment of hypochondriac pain due to liver constraint, pĭ and oppression in the chest, distending pain in the stomach cavity and abdomen, nausea and vomiting, no desire to eat, or less eating. Normally, 1.5–3 g is decocted with water as an oral dose, or an appropriate amount is made into tea for drinking

Its use is cautious in patients with constraint heat in the liver and gallbladder or spleen-stomach yin deficiency

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185

TABLE 8.2 Introduction to Attached Herbs That Rectify Qi (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Celandine (bai qu cai) (Herba Chelidonii)

It is the dried entire plant of Chelidonium majus L. of the Papaveraceae family. It is collected in summer and autumn; after sediment is removed, it is dried in the shade or sun

Acrid, bitter, cool, poisonous; act on the lung, stomach, heart, and kidney channels

Move qi and relieve pain, relieve cough and dissolve phlegm, promote urination, and resolve toxins

Indicated for the treatment of stomachache, and abdominal pain due to qi stagnation, enteritis, dysentery, chronic cough, whooping cough, edema, scabies, tinea, sores, snake, or insect bite. Normally, 3–6 g is decocted with water as an oral dose. Or an appropriate amount is pounded for applying the afflicted part externally

Due to its toxicity, overdose should be avoided

Pummelo Pericarp (you pi) (Pericarpium Citri Grandis)

It is the dried pericarp of Citrus grandis (L.) Osbeck of the Rutaceae family. Pericarp is collected in late autumn and early winter, and then cut into 5–7 sections and dried under the sun or in the shade

Acrid, sweet, bitter, and warm; act on the spleen, lung and kidney channels

Loosen the center and rectify qi, promote digestion, dissolve phlegm, relieve cough, and calm panting

Indicated for the treatment of chest oppression due to qi constraint, abdominal distention, and stomachache due to qi stagnation, or cold pain in the stomach cavity and abdomen, food accumulation, diarrhea and dysentery, cough and panting with qi counterflow and profuse phlegm, and hernia. Normally, 6–9 g is decocted with water as an oral dose, or made into powder

Its use is cautious in pregnant women and patients with qi deficiency

3. Herb differentiation (Table 8.3)

TABLE 8.3 Differentiation Between Similar Efficacy Herbs That Rectify Qi Name of Medicinal Similarity

Differences

Aged Tangerine Peel (chen pi) (Pericarpium Citri Reticulatae)

It is warm but not fierce in nature, its acrid flavor has dispersing, ascending and floating effects, its effect of moving qi is moderate, and action tendency is partial to regulating the spleen and lung. It is good at drying dampness and dissolving phlegm, and used for the treatment of cough and panting, vomiting and hiccup, abdominal pain, and diarrhea caused by phlegm-rheum stagnating in the lung and stomach. It is partial to moving the qi stagnation in the spleen and lung

Green Tangerine Peel (qing pi) (Pericarpium Citri Reticulatae Viride)

Both come from the fruit of Citrus reticulata Blanco, have the acrid, bitter, and warm properties, can rectify middle jiao qi and fortify the stomach, are indicated for the treatment of distending pain in the stomach cavity and abdomen, and food accumulation and indigestion due to qi stagnation in the spleen and stomach

Its property is fierce, and its effect of moving qi is stronger than that of Pericarpium Citri Reticulatae (chen pi), its bitter flavor has discharging and descending effects, action tendency is partial to regulating the liver and gallbladder. It can soothe the liver and break stagnant qi, dissipate masses, and relieve pain, disperse accumulation and resolve [food] stagnation, and is mainly used for the treatment of distending pain in the breast or breast lump, and distending pain in the hypochondrium due to liver constraint, hernia pain, and abdominal pain due to food accumulation, concretions, and conglomerations (zhēng jia˘) or accumulations and gatherings (jī jù). It is partial to moving qi stagnation in the liver and stomach (Continued )

186 PART | I Chinese Materia Medica

TABLE 8.3 Differentiation Between Similar Efficacy Herbs That Rectify Qi (cont.) Name of Medicinal Similarity

Differences

Common Aucklandia Root (mu xiang) (Radix Aucklandiae)

Its acrid flavor has dispersing effect, bitter flavor has descending effect, and fragrant property has warming and unblocking effects. It mainly acts on the spleen and stomach channels, and can regulate the sanjiao, is good at moving qi stagnation in the spleen, stomach, and large intestine. It is an essential medicinal that can move qi and relieve pain, also an essential medicinal that treat diarrhea and dysentery with tenesmus due to dampheat, and is often used for the treatment of syndrome of spleen-stomach qi stagnation with cold. It also can treat jaundice and hernia pain

Both are bitter and acrid in nature, can move qi and relieve pain, and are used for the treatment of distending pain in the stomach cavity, abdomen, chest, and hypochondrium due to qi stagnation, diarrhea or vomiting, dysentery with tenesmus

Slender Dutchmanspipe Root (qing mu xiang) (Radix Aristolochiae)

Nutgrass Galingale Rhizome (xiang fu) (Rhizoma Cyperi) Common Aucklandia Root (mu xiang) (Radix Aucklandiae)

Its cold property has clearing heat effect. It mainly acts on the liver and stomach channels, is good at moving qi stagnation in the liver and stomach, and is often used for the treatment of distending pain in the chest, hypochondrium, stomach cavity and abdomen due to qi stagnation in the liver and stomach, accompanied by heat pattern. It also can resolve toxins, relieve swelling and eliminate dampness, and used for the treatment of diarrhea and dysentery with abdominal pain in summer due to unhygienic diet, swollen sores and furunculosis, eczema, and thanatophidia bite. It also can treat high blood pressure with a pattern of ascendant hyperactivity of liver yang Both can rectify qi and relieve pain, loosen the center, and promote digestion, can be used for the treatment of distending pain in the stomach cavity and abdomen, and less eating due to qi stagnation in the spleen and stomach. Both can combine with each other to reinforce their effects

Its property is mild. It mainly acts on the liver channel, can soothe the liver, and resolve constraint, regulate menstruation and relieve pain, and is mainly used for the treatment of distending pain in the hypochondrium and breast, and menstrual irregularities, which is a miracle medicinal for gynecological disease Its property is partial to dryness. It mainly acts on the spleen and stomach channels, is good at treating food accumulation and indigestion, distending pain in the stomach cavity and abdomen, diarrhea, and dysentery with tenesmus due to qi stagnation in the spleen and stomach. It also can treat hypochondriac pain, jaundice, hernia pain, chest bì (pectoral stuffiness pain), or precordial pain. It is an essential medicinal that can rectify qi and relieve pain

Chapter 9

Herbs That Promote Digestion Chapter Outline Specific Application Knowledge of Herbs

188

ABSTRACT Chinese herbal medicinals that mainly promote digestion and remove food accumulation so as to treat drink and food accumulation syndrome (dyspeptic disease) are called “Herbs that Promote Digestion.” They are mainly used for the treatment of distention and fullness in the stomach cavity and abdomen, belching, fetid eructation and acid swallowing, nausea and vomiting, no desire to eat or drink, and disorderly defecation caused by retained or indigested food accumulating in the stomach, no pleasure in eating and indigestion due to weakness of the spleen and stomach. Keywords: herbs that promote digestion; promote digestion and fortify the stomach; promote digestion and harmonize the center

Chinese herbal medicinals that mainly promote digestion and remove food accumulation so as to treat drink and food accumulation syndrome (dyspeptic disease) are called “Herbs that Promote Digestion.” Most medicinals in this chapter are sweet in flavor and neutral in nature, mainly act on the spleen and stomach channels, have the actions of promoting digestion to remove accumulation, fortifying the spleen and stomach to increase appetite and harmonizing the center; mainly used for the treatment of distention and fullness in the stomach cavity and abdomen, belching, fetid eructation and acid swallowing, nausea and vomiting, no desire to eat or drink, and disorderly defecation caused by retained or indigested food accumulating in the stomach, no pleasure in eating and indigestion due to weakness of the spleen and stomach. Herbs that promote digestion have a certain therapeutic effect of duodenitis, duodenal ulcer (DU), uncertain gastritis, gastroduodenitis, dyspepsia, and other gastric function disorders, such as flatulence, eructation, and gas pains in modern medicine, respectively. Some herbs are used for the treatment of inguinal hernia, galactosidase disorders, and prostate inflammatory disorders, and also have obtained satisfactory treatment effectiveness. Most of this chapter’s medicinals gradually and slowly start the effects of promoting digestion and dispersing accumulation, so they are suitable for the treatment of patients with chronic condition, not serious dyspeptic disease. However, since patients with drink and food accumulation syndrome usually have the accompanied symptoms and signs, and the appropriate combination with other medicinals according to the different pathogenic condition should be given for them. To treat patients with syndrome of internal stagnation of retained food due to qi movement obstructing, should select the medicinals that rectify qi to combine in order to move qi to strengthen the action of removing accumulation. To treat patients with heat pattern transformed from food accumulation and stagnation, should select the bitter-cold medicinals that clear heat or mildly purge to combine. To treat patients with syndrome of cold-damp encumbering the spleen or dampturbidity in the stomach, should select the aromatic medicinals that remove dampness to combine. To treat patients with syndrome of deficiency-cold in the middle jiao, should select the medicinals that warm the center and fortify the spleen to combine. To treat patients with syndrome of internal stagnation of food accumulation due to consistent deficiency of the spleen and stomach and powerless transportation and transformation, should select the medicinals that fortify the spleen and boost qi to combine in order to treat the root and branch simultaneously and remove accumulation without damaging healthy qi. At this point, it is not suited to use a single herb that promotes digestion to treat the above-mentioned syndromes. Most medicinals in this category not only have the effects of promoting digestion and guiding out [food] stagnation, some of them also have the actions of moving qi, dissipating blood stasis, and astringing (something from leaking), which can be extensively used for the treatment of various diseases and syndromes. Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00009-9 Copyright © 2017 Elsevier Inc. All rights reserved.

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188 PART | I Chinese Materia Medica

Most medicinals in this category have slow effects, but some still can consume qi, the patients with qi deficiency and no accumulation and stagnation should be cautious to use. The modern pharmacological research indicates the herbs that promote digestion generally have the effect of assisting digestion in different degrees. Several medicinals have the actions of reducing blood fat, strengthening the heart, increasing the coronary flow, antagonizing myocardial ischemia, lowering blood pressure, or have antibacterial effects.

SPECIFIC APPLICATION KNOWLEDGE OF HERBS 1. Primary herbs (Table 9.1) TABLE 9.1 Properties, Actions, and Application of Common Herbs That Promote Digestion

Source and Collection

Property, Channel Entry

Chinese Hawthorn Fruit (shan zha) (Fructus Crataegi)

Initially recorded in Collected Commentaries on “Shen Nong’s Classic of the Materia Medica” (ben cao jing ji zhu). It is the dried matured fruit of Crataegus pinnatifida Bge. var. major N. E. Br. or Crataegus pinnatifida Bge. of the Rosaceae family. When matured in autumn, it is collected and cut into pieces and then dried

Medicated Leaven (shen qu) (Massa Medicata Fermentata)

Initially recorded in Treatise on Medicinal Properties (yao xing lun). It is the processed product of the fermented mixture of wheat flour and other medicinals [wheat bran, Herba Polygoni Hydropiperis (la liao), fresh Herba Artemisiae Annuae (qing hao), Semen Armeniacae Amarum (ku xing ren), Semen Phaseoli (chi xiao dou) powder, and fresh Fructus Xanthii (cang er zi)]. It can be produced in whole year

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Sour, sweet, slightly warm; act on the spleen, stomach, and liver channels

Promote digestion and fortify the stomach, move qi and dissipate stasis, remove turbidity, and reduce blood fat

Indicated for the treatment of animal food accumulation and stagnation, distention and fullness in the stomach cavity, diarrhea and dysentery with abdominal pain, menstrual block due to blood stasis, postpartum stabbing pain in the epigastrium and abdomen, chest bì and precordial pain due to static blood obstruction, hyperlipidemia or hernia pain. Normally, 9–12 g is decocted with water as an oral dose

Its use is cautious in patients with weakness of the spleen and stomach and no accumulation and stagnation, or profuse gastric acid secretion

Sweet, acrid, warm; act on the spleen and stomach channels

Promote digestion and harmonize the stomach, fortify the spleen, slightly release the exterior, and decrease fever

Indicated for the treatment of distention and fullness in the stomach cavity and abdomen, less eating, poor appetite and digestion or rugitus and diarrhea caused by food stagnation; also for externally-contracted exterior pattern with food stagnation. Normally, 6–15 g is decocted with water as an oral dose. The dryfried one is more suitable for promoting digestion

Its use is prohibited in women in lactation for infant, patients with spleen yin deficiency, intense stomach fire and no food accumulation, and cautious in pregnant women

Caution for Use

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TABLE 9.1 Properties, Actions, and Application of Common Herbs That Promote Digestion (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Germinated Barley (mai ya) (Fructus Hordei Germinatus)

Initially recorded in Treatise on Medicinal Properties (yao xing lun). It is the dried germinated matured fruit of Hordeum vulgare L. of the Poaceae family. The wheat is soaked in water, and kept under a suitable temperature and humidity until young bud grows to about 5 mm long, and then dried under the sun or at low temperature

Sweet, neutral; act on the spleen, stomach, and liver channels

Move qi and promote digestion, fortify the spleen and increase appetite, terminate lactation and relieve distention, soothe the liver, and resolve constraint

Indicated for the treatment of distending pain in the stomach cavity and abdomen due to food (rice, flour, yam, or taro) accumulation or indigestion, less eating due to spleen deficiency, distending pain in the breast due to lac feminium stasis, liver-constrained ribside pain or qi-stagnant pain in the liver and stomach; or for women to terminate lactation. Normally, 10–15 g is decocted with water as an oral dose. 60 g of the dry-fried one is more suitable for terminating lactation

It is not suitable for women in lactation for infant, and its use is cautious in pregnant women

Rice Grain Sprout (dao ya) (Fructus Oryzae Germinatus)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried germinated matured fruit of Oryza sativa L. of the Poaceae family. The rough rice is soaked in water, and kept under a suitable temperature and humidity until fibrous root grows to about 1 cm long, and then dried

Sweet, warm; act on the spleen and stomach channels

Promote digestion and harmonize the center, fortify the spleen, and increase appetite

Indicated for the treatment of distention or fullness in the stomach cavity and abdomen, and diarrhea due to food (rice, flour, yam, or taro) accumulation and stagnation, less eating and dyspepsia without hunger due to spleen deficiency, and weak foot with puffiness. Normally, 10–15 g is decocted with water as an oral dose, or ground into powder for taking orally. The large dose can be at 30 g

Its use is prohibited in patients with gastroptosis

(Continued)

190 PART | I Chinese Materia Medica TABLE 9.1 Properties, Actions, and Application of Common Herbs That Promote Digestion (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Grain Sprout (gu ya) (Fructus Setariae Germinatus)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried germinated matured fruit of Setaria italica (L.) Beauv. of the Poaceae family. The foxtail millet is soaked in water, and kept under a suitable temperature and humidity until fibrous root grows to about 6 mm long, and then dried under the sun or at low temperature

Sweet, warm; act on the spleen and stomach channels

Promote digestion and harmonize the center, fortify the spleen, and increase appetite

Indicated for the treatment of distending pain in the stomach cavity and abdomen, and bad breath due to food accumulation and indigestion, less eating without hunger due to weakness of the spleen and stomach, and poor appetite due to insufficiency of the stomach yin. Normally, 9–15 g is decocted with water as an oral dose

Its use is prohibited in patients with gastroptosis

Radish Seed (lai fu zi) (Semen Raphani)

Initially recorded in Ri Hua-zi’s Materia Medica (ri hua zi ben cao). It is the dried matured seed of Raphanus sativus L. of the Cruciferae family. When the fruit is matured in summer, the plant is cut and dried under the sun; then seed is collected; after impurities are removed, it is dried again

Acrid, sweet, neutral; act on the lung, spleen, and stomach channels

Promote digestion and eliminate distention, direct qi downward, and dissolve phlegm

Indicated for the treatment of distention and fullness or pain in the stomach cavity and abdomen, belching and acid swallowing, less eating but difficulty in digestion, constipation, or diarrhea and dysentery with tenesmus due to food accumulation and qi stagnation, or cough and panting with qi counterflow, profuse phlegm, and chest oppression complicated by food accumulation. Normally, 5–12 g is first pounded to pieces and decocted with water as an oral dose. The large dose can be at 20 g

Because its acrid flavor has the effects of dispersing and qi consumption, its use is cautious in patients with qi deficiency, no food accumulation, and phlegm stagnation. It is not suited to use together with Radix et Rhizoma Ginseng (ren shen)

Chicken Gizzard Lining (ji nei jin) (Endothelium Corneum Gigeriae Galli)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried gizzard inner wall of Gallus gallus domesticus Brisson of the Phasianidae family. After chicken is killed, gizzard is taken out, then inner wall is peeled and washed clean and dried

Sweet, neutral; act on the spleen, stomach, small intestine, and bladder channels

Fortify the stomach and promote digestion, astringe seminal emission and arrest enuresis, relieve strangury, and expel stones

Indicated for the treatment of food accumulation and stagnation, regurgitation, vomiting, diarrhea and dysentery, infantile malnutrition with accumulation with a pattern of spleen deficiency, enuresis, seminal emission, sand or stony strangury (i.e., urolithic strangury), difficult and painful urination, gallbladder distention, and hypochondriac pain. Normally, 3–10 g is decocted with water or 1.5–3 g is ground into powder as an oral dose

Its use is cautious in patients with spleen deficiency and no food accumulation and stagnation

Herbs That Promote Digestion Chapter | 9 TABLE 9.1 Properties, Actions, and Application of Common Herbs That Promote Digestion (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

191

Caution for Use

Chinese Fevervine (ji shi teng) (Herba Paederiae)

Initially recorded in Essentials of Raw Herbal Materia Medica Properties (sheng cao yao xing bei yao). It is the dried aerial part and root of Paederia scandens (Lour.) Merr. or P. scandens (Lour.) Merr. var. tomentosa (Bl.) H.-M. of the Rubiaceae family. The aerial part is collected in summer, and cut into segments; the root is collected in autumn and winter, washed clean and cut into pieces, and dried under the sun

Sweet, bitter, slightly cold; act on the spleen, stomach, liver, and lung channels

Promote digestion and fortify the stomach, dissolve phlegm and relieve cough, clear heat and resolve toxins, invigorate blood, and relieve pain

Indicated for the treatment of food accumulation and stagnation, less eating due to spleen deficiency, infantile malnutrition with accumulation, cough due to phlegmheat, diarrhea, and dysentery due to heat toxin, swelling and pain of the throat, swollen carbuncles and sores and furuncle, scald and burn, and various pain. Normally, 15–60 g is decocted with water as an oral dose. Or an appropriate amount is pounded for applying or decocted with water for washing

Its use is prohibited in pregnant women and patients with deficiency-cold of the spleen

Wilford Swallowwort Root (ge shan xiao) (Radix Cynanchi Wilfordii)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried root tuber of Cynanchum auriculatum Rayle ex Wight of the Asclepiadaceae family. It is collected in winter, washed clean, dried under the sun, and then cut into pieces

Sweet, bitter, neutral; act on the spleen, stomach, and liver channels

Promote digestion and fortify the stomach, rectify qi and relieve pain, and promote lactation

Indicated for the treatment of food accumulation and stagnation, distending pain in the stomach cavity and abdomen due to qi stagnation in the spleen and stomach, infantile abdominal mass or infantile malnutrition with accumulation, reduced lactation or inhibited lactation. Normally, 6–15 g is decocted with water or 1–3 g is ground into powder as an oral dose

If overdose, poisoning is easy to occur

Chinese Asafoetida (a wei) (Resina Ferulae)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the resin of Ferula sinkiangensis K. M. Shen or Ferula fukangensis K. M. Shen of the Umbelliferae family. During the full-blossom to first fruiting period in late spring and early summer, stem is bevelly cut from the upper to the lower, effused milky resin is collected and dried in the shade

Bitter, acrid, warm; act on the spleen and stomach channels

Disperse food accumulation and resolve concretions (masses), dissipate pĭ, and kill worms

Indicated for the treatment of animal food accumulation and stagnation, concretions (zhēng) and conglomerations (jia˘ ) due to blood stasis, or abdominal pĭ syndrome, abdominal pain due to worm accumulation; also for the treatment of malaria and dysentery. Normally, 1–1.5 g is often made into pills or powder as an oral dose. Or an appropriate amount is often made into plaster for applying externally

It cannot be decocted with water. Its use is prohibited in pregnant women and patients with weakness of the spleen and stomach

192 PART | I Chinese Materia Medica

2. Attached herbs (Table 9.2)

TABLE 9.2 Introduction to Attached Herbs That Promote Digestion Name of Medicinal

Source and Collection

Medicinal Fermented Mass (jian shen qu) (Massa Medicata Fermentata)

It is the fermented medicine produced by the mixture of wheat flour, wheat bran, and various kinds of medicinals. It can be produced in whole year

Red Monas Rice (hong qu) (Ultivarietas Oryzae Sativae et Monasci)

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Bitter, warm; act on the spleen and stomach channels

Fortify the spleen and promote digestion, rectify qi and remove dampness, and release the exterior

Indicated for the treatment of improper dietary disorders, food stagnation and indigestion, chest lumpy stiffness, abdominal pain, vomiting and diarrhea, dysentery, and common cold with headache. Normally, 6–15 g is decocted with water as an oral dose

Its use is cautious in patients with spleen yin insufficiency or intense stomach fire

It is the red kojic rice formed through the mycelium of monascus ruber of the Aspergillaceae family is parasitic on rice (Semen Oryzae Sativae)

Sweet, warm, nonpoisonous; act on the liver, spleen, stomach, and large intestine channels

Fortify the spleen and promote digestion, invigorate blood, and dissolve stasis

Indicated for the treatment of food accumulation with fullness and distention, persistent flow of lochia after childbirth, abdominal pain due to blood stasis and stagnation, dysentery with red and white feces, and injury from falling down. Normally, 6–15 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is pounded for applying externally

Its use is cautious in patients with spleen yin insufficiency and no food accumulation

Radish (lai fu) (Radix Raphani)

It is the fresh root of Raphanus sativus L. of the Cruciferae family. It is collected in autumn and winter; after stem leaf is removed, it is washed clean

Acrid, sweet, cool; the cooked one: sweet, neutral; act on the spleen, stomach, lung, and large intestine channels

Promote digestion and lower qi, dissolve phlegm, stanch bleeding, quench the thirst, and promote urination

Indicated for the treatment of indigestion, food accumulation with distention and fullness, acid swallowing, diarrhea, dysentery, cough due to phlegm-heat, throat discomfort, cough up blood, blood-spitting, nosebleed, bloody stool, wasting-thirst (xia¯o kĕ), turbid strangury, sores and ulcers, and injury with swelling. Normally, 30–100 g is for eating or pounded to extract the juice for drinking. Or an appropriate amount is used externally

It is not suitable for patients with indigestion due to deficiency-cold of the spleen and stomach to eat the raw

Garden Radish Leaf (lai fu ye) (Folium Raphani)

It is the root leaf of Raphanus sativus L. of the Cruciferae family. It is collected in winter or early spring, then dried in the open-air or under the sun

Acrid, bitter, neutral; act on the spleen, stomach, and lung channels

Promote digestion, and rectify qi

Indicated for the treatment of pĭ and fullness in the chest and diaphragm, hiccup, food stagnation and indigestion, diarrhea and dysentery, throat pain, female mammary swelling, and inhibited lactation. Normally, 10–15 g is decocted with water or ground into powder or pounded to extract the juice as an oral dose. Or an appropriate amount is used externally

Its use is cautious in patients with qi and blood deficiency

Turnip (wu jing) (Radix Brassicae Rapae)

It is the root and leaf of Brassica rapa L. of the Cruciferae family. It is collected during the winter to the next March, and dried under the sun

Bitter, acrid, sweet, warm; act on the stomach and liver channels

Promote digestion and lower qi, resolve toxins, and relieve swelling

Indicated for the treatment of food accumulation with indigestion, cold pain in the epigastrium and abdomen, cough, swollen boils, sores, and carbuncles. Normally, an appropriate amount is decocted with water, or the fresh one is pounded to extract the juice for drinking. Or an appropriate amount is used externally

Overdose or eating it too much may cause qi distention

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TABLE 9.2 Introduction to Attached Herbs That Promote Digestion (cont.) Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

It is the dried leaf of Microcos paniculata L. of the Tiliaceae family. It is collected in summer and autumn; after impurities are removed, it is dried in the shade or under the sun

Slightly sour, cool; act on the spleen, stomach, and liver channels

Promote digestion and resolve [food] stagnation, clear heat, and drain dampness

Indicated for the treatment of food accumulation and stagnation, common cold with fever, jaundice due to damp-heat, poor appetite, indigestion, distending pain in the stomach cavity and abdomen, diarrhea, sores and ulcers, and centipede bite. Normally, 15–30 g is decocted with water as an oral dose. Or an appropriate amount is used externally

No special contraindications

Roof Iris Rhizome (chuan she gan) (Rhizoma Iridis Tectori)

It is the dried rhizome of Iris tectorum Maxim. of the Iridaceae family. It is collected in whole year; after fibrous root and sediment are removed, it is dried under the sun

Acrid, bitter, cold, poisonous; act on the lung channel

Remove food retention, break up stasis, move water (promote urination), and resolve toxins

Indicated for the treatment of food accumulation with fullness and distention, concretions (zhēng) and conglomerations (jia˘), accumulations and gatherings (jī jù), abdominal tympanites, tumescence due to toxins, piles and fistula, and injury from falling down. Normally, 6–10 g is decocted with water as an oral dose, or ground into powder, or the fresh one is wringed to extract the juice for use

Its use is prohibited in pregnant women and patients with weak constitution and loose stool

Carrot (hu luo bo) (Radix Dauci Sativae)

It is the root of Daucus carota L. var. sativa Dc. of the Umbelliferae family. It is collected in winter; after stem leaf, and fibrous root are removed, it is washed clean

Sweet, acrid, neutral; act on the spleen, liver, lung, stomach, and kidney channels

Fortify the spleen and harmonize the center, enrich the liver and improve vision, dissolve phlegm and resolve toxins

Indicated for the treatment of less eating due to spleen deficiency, lack of strength, pain in the stomach cavity and abdomen, diarrhea and dysentery, blurred vision, sparrow vision (night blindness), cough and panting, whooping cough, swelling and pain of the throat, measles, chickenpox, furuncle, scald and burn, piles and fistula. Normally, 15–30 g is decocted with water as an oral dose, or pounded to extract the juice for use

Its use is cautious in patients with cough due to wind-heat invading the lung

Papaya (fan mu gua) (Fructus Caricae)

It is the matured fruit of Carica papaya L. of the Caricaceae family. It is collected when matured in summer and autumn

Sweet, neutral; act on the spleen and stomach channels

Promote digestion and lactation, eliminate dampness and resolve toxins

Indicated for the treatment of indigestion, stomachache, scanty lactation, wind-damp bì syndrome, limbs numbness, eczema, ulcers, and parasites in intestinal tract. Normally, 9–15 g is decocted with water as an oral dose, or an appropriate amount of the raw is for eating or used externally

Its use is cautious in patients with cold spontaneous seminal emission

Common Buckwheat Seed (qiao mai) (Semen Fagopyri Esculenti)

It is the dried seed of Fagopyrum esculentum Moench of the Polygonaceae family. It is collected when matured before or after first frost; after impurities are removed, it is dried under the sun

Sweet, slightly sour, cold; act on the spleen, stomach, and large intestine channels

Fortify the spleen and disperse accumulation, lower qi and loosen the intestine, resolve toxins and close sore

Indicated for the treatment of accumulation and stagnation in the stomach and intestines, diarrhea, dysentery, intestinal colicky disease, whitish and turbid urine, morbid leukorrhea, spontaneous or night sweat, herpes, erysipelas, carbuncleabscess, phlegmon of the dorsum, scrofula, scald, and burn. Normally, an appropriate amount is made into pills or powder for taking orally or used externally

It is not suitable for long-term use, and its use is prohibited in patients with deficiency-cold of the spleen and stomach

Name of Medicinal

Source and Collection

Paniculate Microcos Leaf (bu zha ye) (Folium Microci Paniculatae)

(Continued )

194 PART | I Chinese Materia Medica

TABLE 9.2 Introduction to Attached Herbs That Promote Digestion (cont.) Name of Medicinal

Source and Collection

Scorch-Fried Areca Seed (jiao bing lang) (Semen Arecae Praepareta)

It is the processed product of matured seed of Areca catechu L. of the Trachycarpaceae family. The fruit is collected when matured during the late spring to early autumn, and decocted with water and dried; after pericarp is removed, the seeds are taken out and dry-fried until scorched

Property, Channel Entry Bitter, acrid, warm; acts on the stomach and large intestine channels

Efficacy and Action Promote digestion and guide out [food] stagnation

Clinical Application and Usage

Caution for Use

Indicated for the treatment of food accumulation and indigestion, diarrhea and dysentery with tenesmus. Normally, 3–10 g is decocted with water as an oral dose

It is not suitable for overdose or long-term use

3. Herb differentiation (Table 9.3)

TABLE 9.3 Differentiation between Similar Efficacy Herbs That Promote Digestion Name of Medicinal

Similarity

Differences

Chinese Hawthorn Fruit (shan zha) (Fructus Crataegi)

Both act on the spleen and stomach channels, have good effects of promoting digestion and removing accumulation, and can treat food accumulation syndrome, indigestion, and distending pain in the stomach cavity and abdomen

It is good at dispersing accumulation and removing stagnation, and mainly used for the treatment of animal food accumulation and stagnation. It also acts on the liver channel, can dissipate blood stasis and move qi and relieve pain, and is used for the treatment of pain in the chest and abdomen and dysmenorrhea due to blood stasis, diarrhea, and dysentery with abdominal pain, and hernia pain

All three medicinals have the effects of fortifying the stomach and promoting digestion, are often used for the treatment of food accumulation and indigestion, distention and fullness in the stomach cavity, and reluctance to eat or drink. If they are dry-fried until scorched and used together, which calls “stir-baking Fructus Hordei Germinatus et Crataegi et Massa Fermentata Medicinalis,” can strengthen the respective effects of promoting digestion and guiding out [food] stagnation each other

It is good at dispersing the cereals food accumulation and stagnation, also has a certain effect of releasing the exterior, so it is especially suitable for the treatment of common cold patients complicated by indigestion due to cereals food accumulation and stagnation.

Radish Seed (lai fu zi) (Semen Raphani)

Medicated Leaven (shen qu) (Massa Medicata Fermentata) Chinese Hawthorn Fruit (shan zha) (Fructus Crataegi)

Germinated Barley (mai ya) (Fructus Hordei Germinatus)

It is good at promoting digestion, moving qi and dispersing distention, and mainly used for the treatment of food accumulation and qi stagnation. It also can lower qi and dissolve phlegm, and is used for the treatment of cough and panting with profuse phlegm and chest oppression

It is good at dispersing animal food accumulation, as well has the effects of moving qi and dissipating stasis to activate blood circulation, so it is more used for the treatment of animal food accumulation and stagnation, and pain in the epigastrium and abdomen and postpartum abdominal pain due to stagnation of blood stasis It is good at dispersing the cooked wheaten food accumulation. Its raw one can promote lactation, and dry-fried one can terminate lactation, so it is more used for the treatment of wheaten food accumulation and stagnation, breast milk stasis, and for ablactation

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TABLE 9.3 Differentiation between Similar Efficacy Herbs That Promote Digestion (cont.) Name of Medicinal

Similarity

Differences

Raw Chinese Hawthorn Fruit (sheng shan zha)

All four are the different processed products of matured fruit of Crataegus pinnatifida Bge. var. major N. E. Br. or Crataegus pinnatifida Bge. of the Rosaceae family. They all can promote digestion, but their respective effects are quite different due to the content of total flavonoids and organic compounds after processed is greatly different

It is good at invigorating blood and dissolving stasis, its effect of promoting digestion is also strong, so it is commonly used for the treatment of menstrual block due to blood stasis, postpartum abdominal pain due to static blood obstruction, hernia pain, and the modern medicine’s cardiovascular diseases, such as hyperlipidemia, hypertensive disease, and coronary heart disease, and also for the treatment of food accumulation

Dry-Fried Chinese Hawthorn Fruit (chao shan zha)

After Fructus Crataegi (shan zha) is dry-fried, its sour flavor is weakened, which can alleviate its stimulatory to stomach. So it is good at promoting digestion and removing accumulation, and often used for the treatment of food accumulation and stagnation, or food stagnation due to spleen deficiency

Scorch-Fried Chinese Hawthorn Fruit (jiao shan zha)

After Fructus Crataegi (shan zha) is dry-fried until scorched, not only its sour flavor is decreased, but the bitter flavor is increased. So it is good at promoting digestion and arresting diarrhea, has the effect of inhibiting bacillus dysenteriae and aeruginosus bacillus, and is often used for the treatment of food accumulation with diarrhea

Charred Chinese Hawthorn Fruit (shan zha tan)

After Fructus Crataegi (shan zha) is charred, its flavor becomes slightly bitter and astringent. It is good at acting on the blood aspect, has the effects of dissolving stasis, stanching bleeding and astringing, and is partial to arresting diarrhea and reducing bleeding, and is often used for the treatment of diarrhea due to spleen deficiency, dysentery, and gastrointestinal bleeding

Raw Medicated Leaven (sheng shen qu)

Dry-Fried Medicated Leaven (chao shen qu)

All four are the different processed products of the fermented mixture of a great quantity of flour and wheat bran, appropriate amount of Herba Polygoni Hydropiperis (la liao), fresh Herba Artemisiae Annuae (qing hao), Semen Armeniacae Amarum (ku xing ren), Semen Phaseoli (chi xiao dou) powder, and fresh Fructus Xanthii (cang er zi). They all can promote digestion, but their respective effects are different after processed

It is sweet and acrid in flavor and warm in nature, partial to promoting digestion and releasing the exterior, and often used for the treatment of food accumulation and stagnation complicated by externally contracted syndrome, such as distention and fullness in the stomach cavity and abdomen, no desire to eat or drink, aversion to cold and fever After Massa Medicata Fermentata (shen qu) is dry-fried, its flavor becomes sweet and slightly fragrant. It is partial to promoting digestion and removing [food] stagnation, good at supplementing the middle jiao-spleen, fortifying the spleen, and harmonizing the stomach, eliminating distention and arresting diarrhea, and often used for the treatment of food accumulation and indigestion, distention and fullness in the stomach cavity and abdomen, diarrhea due to improper dietary disorders, or diarrhea with rugitus due to spleen-stomach disharmony

Scorch-Fried Medicated Leaven (jiao shen qu)

After Massa Medicata Fermentata (shen qu) is dry-fried until scorched, its flavor becomes sweet, slightly astringent, and scorched fragrant. It can astringe the adverse rising qi, the effects of promoting digestion and guiding out [food] stagnation are strengthened, and its main indicated disease and syndrome are the same to that of dry-fried Massa Medicata Fermentata (chao shen qu)

Dry-Fried Medicated Leaven with Bran (fu chao shen qu)

After Massa Medicata Fermentata (shen qu) is stir-fried with bran, it is sweet, slightly astringent, and thick fragrant in flavor, and is more warm in nature. So its effects of fortifying the spleen and harmonizing the stomach and promoting digestion are strengthened. It can activate the spleen, increase appetite, and regulate the center, and is often used for the treatment of food accumulation and stagnation, chest lumpy stiffness and abdominal distention, vomiting and diarrhea and dysentery, and infantile abdominal distention with hardness and accumulation (Continued )

196 PART | I Chinese Materia Medica

TABLE 9.3 Differentiation between Similar Efficacy Herbs That Promote Digestion (cont.) Name of Medicinal

Similarity

Differences

Dry-Fried Grain Sprout (chao gu ya)

Both are the different processed products of germinated matured fruit of Setaria italica (L.) Beauv. of the Poaceae family. They can promote digestion and harmonize the center, fortify the spleen and increase appetite, and can treat food accumulation syndrome

Its effect of fortifying the spleen to promote digestion is stronger. It can promote the spleen’s transportation and transformation and increase appetite It is often used for the treatment of indigestion, less eating without hunger, stomach-abdomen fullness, and soft stool

All three are the different processed products of germinated matured fruit of Hordeum vulgare L. of the Poaceae family. All can move qi and promote digestion, fortify the spleen, and increase appetite. The diastase titer of Fructus Hordei Germinatus (mai ya) is almost disappeared after dry-fried and scorch-fried. The diastase content of scorch-fried Fructus Hordei Germinatus (jiao mai ya) is 43% of the raw one. So for fortifying the spleen and nourishing the stomach, the raw Fructus Hordei Germinatus (sheng mai ya) should be used, and for moving qi and dispersing accumulation, the dry-fried Fructus Hordei Germinatus (chao mai ya) should be used

It is sweet in flavor and neutral (partial to cool) in nature, acts on the spleen, stomach, and liver channels, specializes in soothing the liver and terminating lactation, can dissolve accumulation and increase appetite, and is often used for the treatment of indigestion, breast milk stasis, and breast lump (hyperplasia of the mammary gland)

Scorch-Fried Grain Sprout (jiao gu ya)

Raw Germinated Barley (sheng mai ya)

Dry-Fried Germinated Barley (chao mai ya)

Scorch-Fried Germinated Barley (jiao mai ya)

It is sweet, slightly astringent and fragrant in flavor and partial to warm property, has better effects on harmonizing the spleen and arresting diarrhea, is good at removing accumulation and stagnation, and used for the treatment of retention of food and drink, distention and oppression in the stomach cavity and abdomen, anorexia and no hunger

After Fructus Hordei Germinatus (mai ya) is dry-fried, its flavor becomes sweet and salty, its property is partial to warm. It has better effects of promoting digestion and harmonizing the center, can regulate and harmonize the spleen and stomach, and is used for the treatment of retention of food and drink, distention and fullness in the stomach cavity and abdomen, no hunger, anorexia, breast milk accumulation, weakness of the spleen and stomach, and also used for ablactation After Fructus Hordei Germinatus (mai ya) is scorch-fried, its effects of harmonizing the center and arresting diarrhea are strengthened. It can supplement qi and fortify the spleen, promote digestion, and disperse accumulation, and is often used for the treatment of retention of food and drink, thin and unformed stool, rugitus, and chest-abdomen fullness

Chapter 10

Herbs That Expel Parasites Chapter Outline Specific Application Knowledge of Herbs

198

ABSTRACT Chinese herbal medicinals that can eliminate or kill the parasites in human body, and mainly treat parasitosis are called “Herbs That Expel Parasites.” They can be used for the treatment of various kind of intestinal parasitic diseases, such as ascariasis, enterobiasis, taeniasis, ancylostomiasis, and fasciolopsiasis. Keywords: herbs that expel parasites; kill worms and disperse accumulation

Chinese herbal medicinals that can eliminate or kill the parasites in human body, and mainly treat parasitosis are called “Herbs That Expel Parasites.” Medicinals in this chapter act on the spleen, stomach, and large intestine channels. Some medicinals have a definite toxicity, and can kill or palsy the human parasites (especially the intestinal parasites), and drive them to discharge from the body, so they can be used for the treatment of various kinds of intestinal parasitic diseases, such as ascariasis, enterobiasis, taeniasis, ancylostomiasis, and fasciolopsiasis, which are often caused by damp-heat accumulated in interior or dirty diet, parasite ovum infection, or being ingested, and symptoms including no desire to eat or drink, or more eating with rapid hungering, food partiality with foreign bodies, intermittent abdominal pain around the navel, epigastric upset, vomiting with clear water, and anal itch. If parasitic diseases delay for a long time, symptoms, such as sallow complexion, muscle emaciation, abdominal enlargement with visible blue veins, and edema all over the body will occur. Some patients have mild symptoms and no obvious syndrome, and parasite just can be discovered through detecting the stools. All this above-mentioned diseases and syndromes should be treated with medicinals that expel parasites once and for all to bring under permanent control. To the parasites in other parts of the body like biharzia worm and trichomonas vaginalis, select some medicinals in this category to treat can also obtain worm-killing effect. Some medicinals also have the effects of moving qi, dispersing accumulation (food retention), moistening the intestines, and relieving itching; and can treat syndrome of food accumulation and qi stagnation, infantile malnutrition with accumulation, constipation, scabies, and tinea with itching. How to appropriately select the herbs that expel parasites in clinic should be according to the categories of parasites, the strong or weak body constitution, and chronic or acute symptom-complex. Meanwhile, it should appropriately select other herbs to combine to reinforce the effect according to the different accompanied symptoms and signs. To treat patients with constipation, select the medicinals that drain downward to combine. To treat patients with drink or food accumulation syndrome (dyspeptic disease), select the medicinals that remove food retention and guide out [food] stagnation to combine. To treat patients with syndrome of weakness of the spleen and stomach, select the medicinals that fortify the spleen and harmonize the stomach to combine. To treat patients with weak body constitution, select the medicinals that supplement deficiency to tonify first and follow by attack or treat with both attack and supplementation. When using these intestinal worm-expelling medicinals, they are often taken with the herbs that drain downward together in order to promote discharge of the polypide. Herbs that expel parasites are often easy to damage healthy qi, so the dosage should be under control so as to avoid excessive high dosage inducing poisoning or damaging the healthy qi. Their use should be more cautious in the weak, the old or pregnant women. Herbs that expel parasites generally should be taken on an empty stomach so as to ensure the curative effect through making full actions on the polypide. To the patients with fever or severe abdominal pain, it is not suited to expel parasites at once, and should apply the worm-expelling medicinals after the symptoms are relieved. Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00010-5 Copyright © 2017 Elsevier Inc. All rights reserved.

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The modern pharmacological research indicates the herbs that expel parasites have the effect of palsying the parasite polypides and can kill them by causing paralysis. Some herbs have the actions of antifungus, antivirus, and antitumor. Other herbs also have the effects of promoting gastrointestinal motility, stimulating uterus, slowing the heart rate, expanding blood vessel, and lowering blood pressure.

SPECIFIC APPLICATION KNOWLEDGE OF HERBS 1. Primary herbs (Table 10.1) TABLE 10.1 Properties, Actions, and Application of Common Herbs That Expel Parasites Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Rangoon Creeper Fruit (shi jun zi) (Fructus Quisqualis)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the dried matured fruit of Quisqualis indica L. of the Combretaceae family. It is collected when the color of pericarp turns purple black in autumn; after impurities are removed, it is dried

Sweet, warm; act on the spleen and stomach channels

Kill worms and disperse accumulation, and fortify the spleen

It is an essential medicinal for expelling ascarid, and indicated for the treatment of ascariasis, enterobiasis, abdominal pain due to parasitic infestation, and infantile malnutrition with accumulation, sallow complexion, and emaciation. Normally, 9–12 g is pounded to pieces and decocted with water as an oral dose, or 6–9 g of its kernel is dry-fried until fragrant for chewing. 1–1.5 pills for 1-yearold infant, total dose of one day should not be more than 20 pills

When taking orally, avoid drinking strong tea. Overdose can cause hiccup, dizziness, and vomiting

Sichuan Chinaberry Bark (ku lian pi) (Cortex Meliae)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried tree bark and root bark of Melia toosendan Sieb. et Zuec. or Melia azedarach L. of the Meliaceae family. It is collected in spring and autumn, and dried under the sun; or after the rough bark is removed, it is dried

Bitter, cold, poisonous; act on the liver, spleen, and stomach channels

Kill worms and cure tinea, clear heat, and dry dampness

Indicated for the treatment of ascariasis, enterobiasis and ancylostomiasis, and abdominal pain due to parasitic infestation. External treatment: rubella, scabies, tinea capitis, and eczema with itching. Normally, 3–6 g of the dried one or 15–30 g of the fresh one is decocted with water as an oral dose. Or an appropriate amount is ground into powder and mixed with swine fat for applying the afflicted part

Its use is cautious in the weak, pregnant women, and patients with hepatic or renal insufficiency or weakness of the spleen and stomach

Herbs That Expel Parasites Chapter | 10

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TABLE 10.1 Properties, Actions, and Application of Common Herbs That Expel Parasites (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Betel Nut (bing lang) (Semen Arecae)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried matured seed of Areca catechu L. of the Trachycarpaceae family. The matured fruit is collected during the late spring to early autumn, and decocted with water and dried; after the pericarp is removed, the seed is taken out and dried

Bitter, acrid, warm; act on the stomach and large intestine channels

Kill worms and disperse accumulation, move qi and promote urination, and prevent attack of malaria

Indicated for the treatment of parasitic diseases of intestinal tract, such as cestodiasis, ascariasis, enterobiasis, ancylostomiasis, and fasciolopsiasis, abdominal pain due to parasitic infestation, diarrhea and dysentery with tenesmus due to food accumulation, edema, weak foot with edema, and malaria. Normally, 3–10 g is decocted with water as an oral dose. 30–60 g is used for expelling cestodiasis and fasciolopsiasis

Its use is prohibited in patients with loose stool due to spleen deficiency or sinking of center qi due to qi deficiency, and cautious in pregnant women

Pumpkin Seed and Husk (nan gua zi) (Semen Cucurbitae)

Initially recorded in Modern Practical Chinese Materia Medica (xian dai shi yong zhong yao xue). It is the dried matured seed of Cucurbita moschata (Duch.) Poiet of the Cucurbitaceae family. The fruit is collected when matured in summer and autumn, and then the seed is taken out and dried under the sun

Sweet, neutral; act on the stomach and large intestine channels

Kill worms, promote urination, relieve cough, and cure piles

Indicated for the treatment of cestodiasis, ascariasis, schistosomiasis, hand and foot edema after childbirth, whooping cough, and hemorrhoids. Normally, 30–60 g is decocted with water, or 60–120 g is ground into powder and mixed with cool boiled water as an oral dose. Or an appropriate amount is decocted with water for fumigating and washing externally

Take it too much may cause qi obstruction and stagnation in the diaphragm

(Continued )

200 PART | I Chinese Materia Medica

TABLE 10.1 Properties, Actions, and Application of Common Herbs That Expel Parasites (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Hairyvein Agrimonia Herb and Bud (he cao ya) (Herba et Gemma Agrimoniae)

Initially recorded in National Medical Journal of China (zhong hua yi xue za zhi). It is the dried winter bud of Agrimonia pilosa Ledeb. of the Rosaceae family. The rhizome is collected before the new plant germinates in winter and spring; the old root and brownish floss are removed; the young bud is remained and dried under the sun

Bitter, astringent, cool; act on the liver, small intestine, and large intestine channels

Kill worms, resolve toxins, and relieve swelling

Indicated for the treatment of cestodiasis, vaginal trichomoniasis, sores and ulcers, scabies and tinea, swollen furuncle, and dysentery with red and white feces. Normally, 30–45 g is ground into powder for swallowing intact as daily dose. 0.7–0.8 g/kg of weight for infant, once a day, take it on empty stomach in the morning. Or an appropriate amount is decocted with water for washing, or the fresh one is pounded to a pulp for applying the afflicted part

Because its active components are almost not dissolved in water, it is not suitable for decoction. After taking, nausea, vomiting, diarrhea, dizziness, and sweating may occasionally occur

Thunder Ball (lei wan) (Omphalia)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried sclerotium of Omphalia lapidescens Schroet. of the Tricholomataceae family. It is collected in autumn, then washed clean and dried under the sun

Slightly bitter, cold, slightly poisonous; act on the stomach and large intestine channels

Kill worms and disperse accumulation

Indicated for the treatment of cestodiasis, ancylostomiasis, and ascariasis, abdominal pain due to parasitic infestation, and infantile malnutrition with accumulation. Normally, 15–21 g is ground into powder, 5–7 g each time is mixed with warm boiled water for taking orally after meals, 3 times a day for consecutive days; or made into pills for oral taking

It is not suitable for decoction because it contains protease, which is easy to lose efficacy if heated to 60°C. Its use is cautious in patients with worm’s accumulation and deficiencycold of the spleen and stomach

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TABLE 10.1 Properties, Actions, and Application of Common Herbs That Expel Parasites (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Carpesium Fruit (he shi) (Fructus Carpesii)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried matured fruit of Carpesium abrotanoides L. of the Compositae family. The fruit is collected when matured in autumn; after impurities are removed, it is dried under the sun

Bitter, acrid, neutral, slightly poisonous; act on the spleen, stomach, and large intestine channels

Kill worms and disperse accumulation

Indicated for the treatment of ascariasis, enterobiasis, cestodiasis, and ancylostomiasis, abdominal pain due to parasitic infestation, and infantile malnutrition with accumulation. Normally, 3–9 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is pounded for applying or decocted with water for washing externally

Due to its toxicity, it may cause dizziness, nausea, tinnitus, or abdominal pain. Its use is prohibited in pregnant women and patients with diarrhea

Torreya (fei zi) (Semen Torreyae)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried matured seed of Torreya grandis Fort. of the Taxaceae family. It is collected when matured in autumn; after pulp aril is removed, it is washed clean and dried under the sun

Sweet, neutral; act on the lung, stomach, and large intestine channels

Kill worms and disperse accumulation, moisten the lung to relieve cough, and moisten dryness to promote defecation

Indicated for the treatment of ancylostomiasis, ascariasis, cestodiasis, and filariasis, abdominal pain due to parasitic infestation, infantile malnutrition with accumulation, cough due to lung dryness, constipation due to intestinal dryness, and piles. Normally, 10–15 g is decocted with water as an oral dose, or made into pills or powder, or an appropriate amount is dry-fried for chewing with 15 g each time

If decocted with water, the raw one should be selected. It is not suitable for patients with thin and unformed stool, or cough due to lung heat, and also not suited to combine with Mung Bean (lü dou) to use

(Continued )

202 PART | I Chinese Materia Medica

TABLE 10.1 Properties, Actions, and Application of Common Herbs That Expel Parasites (cont.) Name of Medicinal Elm Cake (wu yi) (Fructus Ulmi Macrocarpae Praeparata)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried processed product of fruit of Ulmus macrocarpa Hance of the Ulmaceae family. The fruit is collected when matured in summer and dried under the sun. The seed is taken out and soaked in water until fermented; after elm cornu cutaneum, red soil, and chrysanthemum are added, all are mixed with warm boiled water and made into paste, spread on flat plate, diced, and dried under the sun

Property, Channel Entry Acrid, bitter, warm; act on the spleen and stomach channels

Efficacy and Action

Clinical Application and Usage

Kill worms and disperse accumulation, eliminate dampness, and arrest dysentery

Indicated for the treatment of yellowish complexion due to ascariasis, enterobiasis, and cestodiasis, abdominal pain due to parasitic infestation, infantile malnutrition with accumulation, chronic diarrhea and dysentery, scabies and tinea with itching, and ulcers of skin. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder for oral taking with 2–3 g each time. Or an appropriate amount is ground into powder and mixed with vinegar or honey for applying the afflicted part externally

Caution for Use Its use is prohibited in patients with weakness of the spleen and stomach, or lung and spleen dryness-heat. Overdose should be avoided

2. Attached herbs (Table 10.2) TABLE 10.2 Introduction to Attached Herbs That Expel Parasites Name of Medicinal

Source and Collection

Property, Channel Entry

Wild Carrot Fruit (nan he shi) (Fructus Carotae)

It is the dried matured fruit of Daucus carota L. of the Umbelliferae family. When fruit is matured, the branch with fruit is collected, dried under the sun, and stroked to separate the fruit. Then, impurities are removed

Bitter, acrid, neutral, slightly poisonous; act on the spleen and stomach channels

Efficacy and Action Kill worms and disperse accumulation

Clinical Application and Usage Indicated for the treatment of ascariasis, enterobiasis, and cestodiasis, abdominal pain due to parasitic infestation, and infantile malnutrition with accumulation. Normally, 6–9 g is decocted with water as an oral dose, or made into pills or powder

Caution for Use Its use is prohibited in pregnant women

Herbs That Expel Parasites Chapter | 10

203

TABLE 10.2 Introduction to Attached Herbs That Expel Parasites (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Wolf’s Bane (lang du) (Radix Euphorbiae Fischerianae)

It is the dried root of Euphorbia ebracteolata Hayata or Euphorbia fischeriana Steud. of the Euphorbiaceae family. It is collected in spring and autumn, then washed clean, cut into pieces, and dried under the sun

Acrid, neutral, poisonous; act on the liver and spleen channels

Dissipate masses and kill worms, draw out toxin, eliminate putridity, expel water, and dispel phlegm

Indicated for the treatment of edema, abdominal distention, phlegm or food or worm accumulation syndrome, pain in the epigastrium and abdomen, winter cough, panting, lymph node, cutaneous, bone or vice testicular tuberculosis, scabies, skin tinea, piles, and fistula. Normally, 1–2.4 g is processed and decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is used externally

It is not suited to combine with Lithargyrum (mi tuo seng) to use, and its use is prohibited in the weak, or pregnant women, and cautious for oral taking due to its toxicity

Leprieur Caloglossa (zhe gu cai) (Thallus Calogllossae Leprieurii)

It is the dried alga of Caloglossa leprieurii (Mont.) J. Ag. of the Delesseriaceae family. It is collected in summer and autumn; after impurities are removed, it is washed clean and dried under the sun

Salty, neutral; act on the kidney and large intestine channels

Expel ascarids and kill worms

Indicated for the treatment of ascariasis, ascaris intestinal obstruction, and infantile malnutrition with accumulation. Normally, 30–60 g is decocted with water as an oral dose, or ground into powder for oral taking. Or an appropriate amount is decocted for fumigating and washing externally

Its use is cautious in pregnant women and patients with low blood pressure

Efficacy and Action

Clinical Application and Usage

Caution for Use

3. Herb differentiation (Table 10.3)

TABLE 10.3 Differentiation Between Similar Efficacy Herbs That Expel Parasites Name of Medicinal

Similarity

Differences

Betel Nut (bing lang) (Semen Arecae)

All three are the different medicinal parts of Areca catechu L. of the Trachycarpaceae family. They all have a certain effect of regulating the stomach

It is the seed. Its effects are partial to killing worms and removing accumulation, promoting urination, and stopping malaria. It is often used for the treatment of malaria with a pattern of phlegm-damp, intestinal parasitic diseases, food accumulation and qi stagnation, distention and oppression in the chest and abdomen, gastric cavity and abdominal pain, incomplete defecation, dysentery or diarrhea with tenesmus, and edema with an excess pattern

Areca Peel (da fu pi) (Pericarpium Arecae)

It is the pericarp. Its effects are partial to dispersing and descending. It can move qi and dredge the stagnation, loosen the center and eliminate distention, promote urination, and relieve edema. It is often used for the treatment of damp-turbidity and qi stagnation including oppression, distention, and fullness in the stomach cavity and abdomen, general edema, difficulty in micturition, pedal edema, ascites of liver cirrhosis, and edema of nephrosis

Areca Flower (bing lang hua) (Flos Arecae)

It is the staminate flower bud. Its effects are partial to fortifying the stomach by its aromatic property, and cooling and quenching thirst. It is often used for the treatment of thirst due to stomach heat, and cough due to heat (Continued )

204 PART | I Chinese Materia Medica

TABLE 10.3 Differentiation Between Similar Efficacy Herbs That Expel Parasites (cont.) Name of Medicinal

Similarity

Differences

Raw Betel Nut (sheng bing lang)

All three are the different processed products of Areca catechu L. of the Trachycarpaceae family. They all have the effects of dispersing accumulation and harmonizing the center

The raw Semen Arecae (bing lang) is acrid, bitter, and slightly astringent in flavor and warm in nature. It has stronger effects of killing worms and breaking up accumulation, moving water, and relieving edema, so it is commonly used for the treatment of intestinal parasitic diseases, pedal edema with cold pain, chest oppression, nausea, weak foot with puffiness due to cold-damp, general edema, difficulty in micturition, and defecation with an excess pattern

Scorch-Fried Areca Seed (jiao bing lang)

Charred Areca Seed (bing lang tan)

Hairyvein Agrimonia Herb and Bud (he cao ya) (Herba et Gemma Agrimoniae) Hairyvein Agrimonia (xian he cao) (Herba Agrimoniae)

Its property and actions are moderate. It has stronger effects of lowering qi and dispersing fullness, promoting digestion, and removing distention, and is more used for the treatment of internal stagnation of food, with pĭ and fullness in the stomach cavity, nausea and belching, distending pain in the abdomen and inhibited defecation complicated by deficiency syndrome. Use the charred one, can avoid that the strong property of the raw one consumes the healthy qi After Semen Arecae (bing lang) is charred, its property becomes more moderate. It is good at dispersing accumulation and treating red dysentery, can be used for the treatment of dysentery with red and white feces and tenesmus due to internal obstruction of damp-heat and intestine and stomach disorders

Both are the different medicinal parts of Agrimonia pilosa Ledeb. of the Rosaceae family. Both have the effect of killing worms in different degree

It is the winter bud before germination, and can expel and kill tapeworms, and as a new medicinal specializing in promoting tapeworm polypide to discharge, it is commonly used for the treatment of various kinds of cestodiasis; also can treat sores and scabies. If it is made into suppository, also can treat trichomoniasis It is the entire plant collected when branch and leaf are flourishing and before blooming. It is bitter and astringent in flavor and neutral in nature, can stanch bleeding and arrest dysentery through astringent property, prevent attack of malaria, resolve toxins, and kill worms, and used for the treatment of various bleeding syndromes, dysentery with red and white feces, malaria, swollen carbuncles and sores, vaginal itching, and morbid leukorrhea

Chapter 11

Herbs That Stanch Bleeding Chapter Outline Section 1  Herbs That Cool the Blood and Stanch Bleeding Outline Specific Application Knowledge of Herbs Section 2  Herbs That Dissolve Stasis and Stanch Bleeding Outline Specific Application Knowledge of Herbs

206 206 207 212 212 213

Section 3  Herbs That Astringe and Stanch Bleeding Outline Specific Application Knowledge of Herbs Section 4  Herbs That Warm the Channels and Stanch Bleeding Outline Specific Application Knowledge of Herbs

218 218 218 224 224 224

ABSTRACT Chinese herbal medicinals that can stop or inhibit the body internal or external bleeding and mainly treat various bleeding diseases and syndromes are called “Herbs That Stanch Bleeding.” They are divided into four categories: herbs that cool the blood and stanch bleeding, herbs that dissolve stasis and stanch bleeding, herbs that warm the channels and stanch bleeding, and herbs that astringe and stanch bleeding. Herbs that stanch bleeding are indicated for the treatment of various internal or external bleeding diseases and syndromes, such as expectoration of blood (hemoptysis) or coughing of blood (the expectoration of blood or of blood-streaked sputum from the larynx, trachea, bronchi or lungs), nosebleed (epistaxis), spitting of blood (hematemesis), bloody stool (hemafecia), bloody urine (hematuria), flooding and spotting (uterine bleeding), purpura and bleeding due to trauma (external injury). Keywords: herbs that stanch bleeding; herbs that cool the blood and stanch bleeding; herbs that dissolve stasis and stanch bleeding; herbs that astringe and stanch bleeding; herbs that warm the channels and stanch bleeding; cool the blood and stanch bleeding; dissolve stasis and stanch bleeding; astringe and stanch bleeding; warm the channels and stanch bleeding

Chinese herbal medicinals that can stop or inhibit the body internal or external bleeding and mainly treat various bleeding diseases and syndromes are called “Herbs That Stanch Bleeding.” This chapter’s medicinals all act on the blood aspect. Because “the heart governs the blood and vessels,” “the liver stores the blood” and “the spleen controls the blood (keeps it within the vessels),” medicinals in this chapter mainly act on the heart, liver, and spleen channels, especially the most are the herbs that act on the heart and liver channels. They all have the effect of stanching bleeding. Due to their different properties, such as cold, warm, scattering, or astringing, they have the effects of cooling the blood and stanching bleeding, dissolving stasis and stanching bleeding, warming the channels and stanching bleeding, astringing and stanching bleeding, respectively. According to the different properties and efficacy, medicinals in this chapter are divided into four categories: (1) herbs that cool the blood and stanch bleeding, (2) herbs that dissolve stasis and stanch bleeding, (3) herbs that warm the channels and stanch bleeding, and (4) herbs that astringe and stanch bleeding. Herbs that stanch bleeding are indicated for the treatment of various internal or external bleeding diseases and syndromes, such as expectoration of blood (hemoptysis) or coughing of blood (the expectoration of blood or of blood-streaked sputum from the larynx, trachea, bronchi, or lungs), nosebleed (epistaxis), spitting of blood (hematemesis), bloody stool (hemafecia), bloody urine (hematuria), flooding and spotting (uterine bleeding), purpura and bleeding due to trauma (external injury). According to the different etiological factors, pathogenic conditions and positions of bleeding, the herbs that stanch bleeding should be through the corresponding selection and necessary combination in order to give consideration to treat both the root and branch simultaneously. To treat bleeding patients due to blood-heat, select the herbs that cool the blood and stanch bleeding to combine especially with herbs that clear heat and drain fire, or herbs that clear heat

Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00011-7 Copyright © 2017 Elsevier Inc. All rights reserved.

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and cool the blood. To treat bleeding patients with a pattern of vigorous fire due to yin deficiency or yin deficiency with yang hyperactivity, combine with herbs that enrich yin and subdue fire, or herbs that enrich yin and suppress yang. To treat bleeding patients due to internal obstruction of static blood and blood failing to circulate in the vessels, select the herbs that dissolve stasis and stanch bleeding to combine especially with herbs that move qi and invigorate blood. To treat bleeding patients with deficiency-cold pattern, select the herbs that warm the channels and stanch bleeding or herbs that astringe and stanch bleeding to combine especially with herbs that boost qi and fortify the spleen or herbs that warm yang. Based on previous doctor’s experience of medication—“when there is bleeding of inferior part, treat it with raising and lifting; when there is blood-spitting or nosebleed, treat it with lowering qi,” to treat the bleeding of inferior part, such as bloody stool and uterine bleeding should appropriately combine with herbs that can raise and lift center qi; to treat the bleeding of superior part, such as spitting of blood (hematemesis) and nosebleed should properly combine with herbs that lower qi. “Stanching bleeding without leaving stasis,” this is the point that should be paid attention to all the time when applying the herbs that stanch bleeding. The herbs that cool the blood and stanch bleeding as well as herbs that astringe and stanch bleeding are easy to linger the pathogens and have the disadvantage of leaving stasis after stanching bleeding, so treating patients with bleeding complicated by blood stasis and qi stagnation, the herbs that stanch bleeding should be not applied alone. If excessive bleeding leads to qi desertion following blood loss, select the medicinals that strongly supplement original qi to save the danger syndrome of qi desertion. According to previous doctor’s experience of medication, herbs that stanch bleeding are often used after carbonizing by stir-frying. Generally, if herb is dry-fried until charred, its property may become bitter and astringent, and the effect of stanching bleeding will be strengthened. But not all herbs that stanch bleeding are suited to be carbonized by stir-frying and the effect of some medicinals on stanching bleeding may be decreased after carbonizing by stir-frying, so the raw or fresh one should still be used. Therefore, whether the herbs that stanch bleeding are used after carbonizing by stir-frying should be depended on the specific medicinal and cannot process as the same in order to improve the therapeutic effect. The modern pharmacological research indicates the herbs that stanch bleeding have extensive mechanisms of action, such as promote the production of blood coagulation factors, increase the concentration and activity of blood coagulation factors, inhibit antithrombin activity, increase the platelet number, strengthen the thrombocytic function, contract the local blood vessels or ameliorate the blood vessel function, reinforce the blood capillary resistance, lower the vascular permeability, promote the production of fibrinogen or fibrin, and restrain fibrinolysis. Some medicinals can accelerate to stanch bleeding by extensive physical and chemical factors. Among the earlier mentioned, promote the blood coagulation and inhibit fibrinolysis are the major mechanisms. Some medicinals also have the actions of antiinflammation, antipathogenic microorganism, analgesia, and regulating cardiovascular function.

SECTION 1  HERBS THAT COOL THE BLOOD AND STANCH BLEEDING Outline Medicinals in this section are cold and cool in nature, are more sweet and bitter in flavor, act on the blood aspect, can clear and discharge heat in blood aspect to stanch bleeding, and used for the treatment of various bleeding syndromes due to blood-heat. Although they have the effect of cooling the blood, the effect of clearing heat is not strong. When treating bleeding due to blood-heat, they often need to combine with the herbs that clear heat and cool the blood. When treating bleeding due to blood-heat with blood stasis, they should combine with the herbs that dissolve stasis and stanch bleeding or a few medicinals that dissolve stasis and move qi. When treating serious acute bleeding, they should combine with the herbs that astringe and stanch bleeding to strengthen the hemostasis effect. Medicinals in this section are not suitable for the treatment of deficiency-cold bleeding and cannot be taken for long term or overdose due to the cold-cool property leaving stasis.

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Specific Application Knowledge of Herbs 1. Primary herbs (Table 11.1) TABLE 11.1 Properties, Actions, and Application of Common Herbs That Cool the Blood and Stanch Bleeding Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Field Thistle (xiao ji) (Herba Cirsii)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried aerial part of Cirsium setosum (Willd.) MB. of the Compositae family. It is collected when blooming in summer and autumn; after impurities are removed, it is dried under the sun

Sweet, bitter, cool; act on the heart and liver channels

Cool the blood and stanch bleeding, disperse stasis and resolve toxins, and relieve carbuncle

Indicated for the treatment of nosebleed, spitting of blood, bloody urine, blood strangury, bloody stool, flooding and spotting (uterine bleeding), bleeding due to external injury, swollen carbuncles, and sores due to heat toxin. Normally, 5–12 g is decocted with water as an oral dose. Dose of the fresh one should be doubled. And an appropriate amount is used externally

Its use is prohibited in patients with deficiencycold of the spleen and stomach and no blood stasis and stagnation

Japanese Thistle (da ji) (Herba Cirsii Japonici)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried aerial part of Cirsium japonicum Fisch. ex DC. of the Compositae family. It is collected when blooming in summer and autumn; after impurities are removed, it is dried under the sun

Sweet, bitter, cool; act on the heart and liver channels

Cool the blood and stanch bleeding, disperse stasis and resolve toxins and relieve carbuncle

Indicated for the treatment of nosebleed, spitting of blood, bloody urine, bloody stool, flooding and spotting (uterine bleeding), bleeding due to trauma (external injury), lung abscess and swollen carbuncles due to heat toxin. Normally, 9–15 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose. Or an appropriate amount is pounded for applying the afflicted part

Its use is prohibited in patients with diarrhea due to deficiencycold of the spleen and stomach, and no blood stasis and stagnation

(Continued )

208 PART | I Chinese Materia Medica

TABLE 11.1 Properties, Actions, and Application of Common Herbs That Cool the Blood and Stanch Bleeding (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Garden Burnet Root (di yu) (Radix Sanguisorbae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Sanguisorba officinalis L. or Sanguisorba officinalis L. var. longifolia (Bert.) Yü et Li of the Rosaceae family. It is collected when sprouting in spring or after withering in autumn; after fibrous root is removed, it is washed clean and dried, or cut into pieces while fresh and dried

Bitter, sour, astringent, slightly cold; act on the liver and large intestine channels

Cool the blood and stanch bleeding, resolve toxins, and close sore

Indicated for the treatment of bloody stool, bleeding from piles, red dysentery, flooding and spotting (uterine bleeding), burn due to hot liquid or fire, eczema and skin ulceration, swollen carbuncles and sores due to heat toxin. Normally, 9–15 g is decocted with water as an oral dose. The large dose can be at 30 g. Or it is made into pills or powder for oral taking. Or an appropriate amount is ground into powder for applying the afflicted part

Its use is cautious in patients with deficiencycold bloody stool, dysentery and uterine bleeding, or bleeding with stasis. Use the sanguisorba preparation to apply externally is not suitable for large area burn patients

Pagoda Tree Flower (huai hua) (Flos Sophorae)

Initially recorded in Ri Hua-zi’s Materia Medica (ri hua zi ben cao). It is the dried flower or bud of Sophora japonica L. of the Leguminosae family. When blooming or bud forming in summer, it is collected and dried in time; then branch, stalk, and impurities are removed

Bitter, slightly cold; act on the liver and large intestine channels

Cool the blood and stanch bleeding, clear liver heat, and drain fire

Indicated for the treatment of intestinal wind (bloody stool), new or chronic bleeding from piles due to blood heat, red dysentery, flooding and spotting (uterine bleeding), bloody urine, blood strangury, nosebleed, or red eyes, distention of head or headache and dizziness due to liver heat, carbuncle-abscess and sores due to heat toxin. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder for oral taking

Its use is cautious in patients with deficiencycold of the spleen and stomach, fever due to yin deficiency, and no excess fire

Oriental Arborvitae Leafy Twig (ce bai ye) (Cacumen Platycladi)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried thin end of twig and leaf of Platycladus orientalis (L.) Franco of the Cupressaceae family. It is usually collected in summer and autumn, and then dried in the shade

Bitter, astringent, cold; act on the lung, liver, and spleen channels

Cool the blood and stanch bleeding, dissolve phlegm and relieve cough, promote hair growth and darkening

Indicated for the treatment of spitting of blood, nosebleed and coughing of blood due to blood heat, bloody stool, flooding and spotting (uterine bleeding), or cough and panting with thick phlegm due to lung heat, hair loss due to blood heat, and early graying hair. Normally, 6–12 g is decocted with water as an oral dose. An appropriate amount is used externally

It is not suited to take too much orally, otherwise, desire to vomit will occur

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TABLE 11.1 Properties, Actions, and Application of Common Herbs That Cool the Blood and Stanch Bleeding (cont.)

Source and Collection

Property, Channel Entry

Imperata Rhizome (bai mao gen) (Rhizoma Imperatae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome of Imperata cylindrica Beauv. var. major (Nees) C. E. Hubb. of the Poaceae family. It is collected in spring and autumn, washed clean, and dried under the sun; after fibrous root and membranous leaf sheath are removed, it is binded to small bunches

Ramie Root (zhu ma gen) (Radix Boehmeriae)

Japanese Dock Root (yang ti) (Radix Rumicis Japonici)

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sweet, cold; act on the lung, stomach, and bladder channels

Cool the blood and stanch bleeding, clear heat and promote urination, and clear lung and stomach heat

Indicated for the treatment of spitting of blood, nosebleed and bloody urine due to blood heat, excessive thirst in febrile disease, jaundice due to damp-heat, edema and scanty urine, heat strangury, and difficult and painful urination, vomiting due to stomach heat, cough and panting due to lung heat. Normally, 9–30 g is decocted with water as an oral dose. The fresh one is better and should be doubled at the dose. It also can be pounded to extract the juice for drinking

Its use is prohibited in patients with deficiencycold of the spleen and stomach and profuse urine and no thirst

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried root and rhizome of Boehmeria nivea (L.) Gaud. of the Urticaceae family. It is collected in winter and spring, washed clean, dried under the sun and cut into segments

Sweet, cold; act on the heart and liver channels

Cool the blood and stanch bleeding, calm the fetus, clear heat and resolve toxins, and promote urination

Indicated for the treatment of bleeding due to blood heat, restless fetus, vaginal bleeding (painless spotting) during pregnancy, continuous and dribbling urination, swollen carbuncles due to heat toxin, insect or snake bite. Normally, 10–30 g is decocted with water as an oral dose; or 30–60 g of the fresh one is pounded to extract the juice for oral taking. Or an appropriate amount is decocted with water for washing or pounded for applying externally

Its use is cautious in patients without excess heat

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Rumex japonicus Houtt. or R. nepalensis Spreng of the Polygonaceae family. It is collected during August to September in autumn, washed clean, dried under the sun, and cut into pieces

Bitter, astringent, cold; act on the heart, liver, and large intestine channels

Cool the blood and stanch bleeding, resolve toxins and kill worms, and relieve constipation by purgation

Indicated for the treatment of expectoration of blood, spitting of blood, nosebleed and purpura due to blood heat, intestinal wind (bloody stool), scabies and tinea, sores and ulcers, scald, and constipation. Normally, 10–15 g is decocted with water as an oral dose; or 30–50 g of the fresh one is wringed to extract the juice for taking. Or an appropriate amount is used externally

Its use is prohibited in patients with diarrhea and no eating due to deficiencycold of the spleen and stomach

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2. Attached herbs (Table 11.2) TABLE 11.2 Introduction to Attached Herbs That Cool the Blood and Stanch Bleeding Name of Medicinal

Source and Collection

Charred Japanese Cirsii (da ji tan) (Herba Cirsii Japonici Carbonisatus)

It is the processed product of of Cirsium japonicum Fisch. ex DC. of the Compositae family. The Japanese Thistle (da ji) is dry-fried until its surface is burned black

Japanese Pagoda Tree Pod (huai jiao) (Fructus Sophorae)

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Bitter, astringent, cool; act on the heart and liver channels

Cool the blood and stanch bleeding

Indicated for the treatment of nosebleed, spitting of blood, bloody urine, bloody stool, flooding and spotting (uterine bleeding) and bleeding due to trauma (external injury). Normally, 5–10 g is often made into pills or powder as an oral dose

Its use is prohibited in patients with deficiency-cold of the spleen and stomach and no stasis and stagnation

It is the dried matured fruit of Sophora japonica L. of the Leguminosae family. It is collected in winter; after impurities are removed, it is dried

Bitter, cold; act on the liver and large intestine channels

Clear heat and drain fire, cool the blood and stanch bleeding, and cool the liver

Indicated for the treatment of bloody stool due to intestine heat, swollen piles with bleeding, flooding and spotting (uterine bleeding), blood strangury, bloody flux, headache and dizziness, chest oppression and vexation and red eyes due to liver heat, and pudendal sore with itching. Normally, 6–9 g is decocted with water as an oral dose

Its use is prohibited in pregnant women and patients with deficiency-cold of the spleen and stomach

Obtuseleaf Dock Root (tu da huang) (Radix Rumicis Obtusifolii)

It is the root of Rumex obtusifolius L. of the Polygonaceae family. It is collected during September to October; after earth and impurities are removed, it is washed clean, cut into pieces, and dried in the shade

Bitter, acrid, cool; act on the lung, spleen, and large intestine channels

Clear heat and resolve toxins, cool the blood and stanch bleeding, dispel stasis and promote defecation

Indicated for the treatment of coughing of blood from tuberculosis, lung abscess, spitting of blood, abdominal pain due to blood stasis, injury from falling down, constipation, mumps, swollen carbuncles, scald, tinea, and eczema. Normally, 10–15 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in pregnant women and patients with diarrhea due to spleen deficiency

Lalang Grass Inflorescence (bai mao hua) (Inflorescentia Imperatae)

It is the spica of Imperata cylindrica Beauv. var. major (Nees) C. E. Hubb. of the Poaceae family. Before blooming during April to May, it is collected and dried under the sun

Sweet, warm; act on the lung and liver channels

Invigorate blood and stanch bleeding, eliminate stasis, and relieve pain

Indicated for the treatment of Its use is spitting of blood, nosebleed, prohibited in knife injury, and abdominal pain pregnant women which refuses pressure due to blood stasis. Normally, 9–15 g is decocted with water as an oral dose. Or an appropriate amount is pounded to apply the afflicted part or stuff nose

Fimbriate Orostachys Herb (wa song) (Herba Orostachyis Fimbriati)

It is the dried aerial part of Orostachys fimbriata (Turcz.) Berg. of the Crassulaceae family. It is collected when blooming in summer and autumn; after root and impurities are removed, it is dried under the sun

Sour, bitter, cold; act on the liver, lung, and spleen channels

Cool the blood and stanch bleeding, resolve toxins, and close sore

Indicated for the treatment of red dysentery, bloody stool, bleeding from piles, nosebleed, coughing of blood, opening of sore disclosed for a long time, swelling and pain of the throat, oral ulcer, eczema, and scald. Normally, 3–9 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder for applying the afflicted part

Caution for Use

Its use is cautious in patients with deficiency-cold of the spleen and stomach

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TABLE 11.2 Introduction to Attached Herbs That Cool the Blood and Stanch Bleeding (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Scorch-Fried Cape Jasmine Fruit (jiao zhi zi) (Fructus Gardeniae Praeparatus)

It is the processed product of matured fruit of Gardenia jasminoides Ellis of the Rubiaceae family. The collection methods is the same to Fructus Gardeniae (zhi zi). It is dryfried until scorched

Bitter, cold; act on the heart, lung, and sanjiao channels

Cool the blood and stanch bleeding

Indicated for the treatment of spitting of blood, nosebleed, bloody urine, flooding and spotting (uterine bleeding) due to blood heat. Normally, 6–9 g is decocted with water as an oral dose

It is not suitable for patients with loose stool due to spleen deficiency

Japanese Camellia Flower (shan cha hua) (Flos Camelliae Japonicae)

It is the dried flower of Camellia japonica L. of the Theaceae family. It is collected in batch in the blooming period during April to May, then dried under the sun or baked until dry

Sweet, bitter, acrid, cool; act on the liver, lung, and large intestine channels

Cool the blood and stanch bleeding, invigorate blood and dissolve stasis, resolve toxins, and treat sore

Indicated for the treatment of spitting of blood, nosebleed, coughing of blood, bloody stool, bleeding from piles, dysentery with red and white feces, blood strangury, profuse uterine bleeding, scald, and injury from falling down. Normally, 5–10 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder and mixed with sesame oil for applying the afflicted part

Its use is cautious in patients with middle jiao deficiency-cold and no blood stasis

3. Herb differentiation (Table 11.3) TABLE 11.3 Differentiation Between Similar Efficacy Herbs That Cool the Blood and Stanch Bleeding Name of Medicinal

Similarity

Differences

Japanese Thistle (da ji) (Herba Cirsii Japonici)

Both are sweet, bitter, and cool in nature, act on the blood aspect, act on the heart and liver channels, and can cool the blood and stanch bleeding, disperse stasis and resolve toxins and relieve carbuncle, and are extensively used for the treatment of various bleeding syndromes due to blood heat, swollen sores, ulcers and carbuncles due to heat toxin. They often combine with each other to reinforce their effects

It has stronger effects of dispersing stasis and relieving carbuncle than Herba Cirsii (xiao ji). Its effect of stanching bleeding is extensive, so it is especially suitable for the treatment of expectoration of blood, spitting of blood, and flooding and spotting (uterine bleeding)

Both are bitter in flavor and slightly cold in nature, act on the liver and large intestine channels, can cool the blood and stanch bleeding, and are used for the treatment of various bleeding syndromes due to blood heat. Because their properties are partial to descending, they are suitable for the treatment of bleeding in the inferior part

It can cool the blood and combines the effect of astringing, so is more suitable for the treatment of the inferior part bleeding, such as bloody stool, bleeding from piles, flooding, and spotting (uterine bleeding), and red dysentery with a pattern of blood heat

Field Thistle (xiao ji) (Herba Cirsii)

Garden Burnet Root (di yu) (Radix Sanguisorbae)

Pagoda Tree Flower (huai hua) (Flos Sophorae)

It also can promote urination and relieve strangury, so it is good at treating bloody urine and blood strangury. Due to its cool property, it also can be used for the treatment of heat strangury

It has no property of astringency and its effect of stanching bleeding mainly aims at the large intestine, so is good at treating bloody stool and bleeding from piles (Continued )

212 PART | I Chinese Materia Medica

TABLE 11.3 Differentiation Between Similar Efficacy Herbs That Cool the Blood and Stanch Bleeding (cont.) Name of Medicinal

Similarity

Differences

Imperata Rhizome (bai mao gen) (Rhizoma Imperatae)

Both are sweet in flavor and cold in nature, act on the lung and stomach channels, can clear the lung and stomach heat and promote urination, and are used for the treatment of cough due to lung heat, vomiting due to stomach heat, continuous and dribbling urination with pain. Both often combine with each other in order to reinforce their effects

It is partial to acting on the blood aspect, and good at cooling the blood and stanching bleeding, and used for treating various bleeding syndromes due to blood heat. It also acts on the bladder channel, and is especially suitable for the treatment of bloody urine and blood strangury due to damp-heat accumulated in the bladder

All three medicinals are the different processed products of the flower or bud of Sophora japonica L. of the Leguminosae family. All are partial to cool property, can play the effect of clearing heat in different degree. Both raw Flos Sophorae (sheng huai hua) and dry-fried Flos Sophorae (chao huai hua) can treat swelling and pain due to fire heat. Both the raw one and charred Flos Sophorae (huai hua tan) can cool the blood and stanch bleeding and treat various bleeding syndromes

It mainly has the effects of calming the liver and improving vision, clearing heat and cooling the blood, resolving toxins and curing sores, and is used for the treatment of dizziness due to ascendant hyperactivity of liver yang, bleeding syndromes due to exuberant fire heat congestion causing blood move in disorder, boils and sores, swollen carbuncles and phlegmon of the dorsum of the hand or foot, red swelling and hot pain

Reed Rhizome (lu gen) (Rhizoma Phragmitis) Raw Pagoda Tree Flower (sheng huai hua)

Dry-Fried Pagoda Tree Flower (chao huai hua)

Charred Pagoda Tree Flower (huai hua tan)

It is partial to enter the qi aspect, and its effects more lie in clearing heat and promoting fluid production, and is often used for the treatment of fluid consumption and (or) excessive thirst in the febrile diseases

After dry-fried, its bitter and cold properties become moderate, and has the effects of clearing throat and relieving sore-throat, killing worms and relieving infantile malnutrition, and can be used for the treatment of aphasia from wind-strike (apoplexy), swelling and pain of the throat, throat bì (pharyngitis), and dry mouth due to exuberant fire It has very mild effects of clearing heat and cooling the blood, but has astringent property, is good at stanching bleeding, and used for the treatment of bloody stool and bleeding from piles due to damp-heat in the large intestine, expectoration of blood, nosebleed, blood-stained phlegm, or flooding and spotting (uterine bleeding)

SECTION 2  HERBS THAT DISSOLVE STASIS AND STANCH BLEEDING Outline Medicinals in this section are more sweet, bitter, and acrid in flavor, and neutral in nature. The bitter medicinals have the effects of discharging and descending, and the acrid medicinals have the effects of moving and dispersing. So they not only can stanch bleeding, but also dissolve stasis, have the characteristic of “stanching bleeding without leaving stasis,” and are indicated for the treatment of bleeding diseases and syndromes due to internal obstruction of static blood and blood failing to circulate in the vessels. This section’s medicinals also can disperse swelling and relieve pain, and are used for the treatment of injury from falling down, menstrual block, pain in the epigastrium and abdomen due to blood stasis and stagnation. In clinic, the main points of pattern differentiation are repeated and unceasing bleeding with purple dark blood, containing clots, blackish complexion, and purple dark tongue or with stasis macules or spots, thready and choppy pulse. Although they are suited to treat bleeding syndromes complicated by blood stasis and stagnation, they also can be used for the treatment of other bleeding syndromes through combining with other herbs followed the patterns. This chapter’s medicinals have the properties of moving and dispersing, so which use should be cautious in pregnant women and patients with bleeding but no blood stasis.

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Specific Application Knowledge of Herbs 1. Primary herbs (Table 11.4)

TABLE 11.4 Properties, Actions, and Application of Common Herbs That Dissolve Stasis and Stanch Bleeding Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Pseudoginseng Root (san qi) (Radix et Rhizoma Notoginseng)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried root and rhizome of Panax notoginseng (Burk.) F. H. Chen of the Araliaceae family. It is collected before blooming in autumn, then washed clean; after main root, rootlet, and rhizome are separated, it is dried

Sweet, slightly bitter, warm; act on the liver and stomach channels

Dissipate blood stasis and stanch bleeding, relieve swelling and pain

Indicated for the treatment of expectoration of blood, spitting of blood, nosebleed, bloody stool, flooding and spotting (uterine bleeding), bleeding from external injury, stabbing pain in the chest and abdomen, or swelling and pain from falling down. Normally, 3–9 g is decocted with water as an oral dose, or an appropriate amount is ground into powder for oral taking with 1–3 g each time or is used externally

Its use is prohibited in pregnant women

Indian Madder Root (qian cao) (Radix et Rhizoma Rubiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root and rhizome of Rubia cordifolia L. of the Rubiaceae family. It is collected in spring and autumn; after impurities are removed, it is dried

Bitter, cold; act on the liver channel

Cool the blood, dispel stasis, stanch bleeding, and promote menstruation

Indicated for the treatment of spitting of blood, nosebleed, flooding and spotting (uterine bleeding), bleeding from external injury, menstrual block due to static blood obstruction, painful bì syndrome of joints, swelling and pain from falling down. Normally, 6–10 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in patients with deficiencycold of the spleen and stomach and no blood stasis and stagnation

(Continued )

214 PART | I Chinese Materia Medica

TABLE 11.4 Properties, Actions, and Application of Common Herbs That Dissolve Stasis and Stanch Bleeding (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Cattail Pollen (pu huang) (Pollen Typhae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried pollen of Typha angustifolia L. or Typha orientalis Presl of the Typhaceae family. Yellow male inflorescence on the longbract cattail fruit upside is collected in summer; dried under the sun and ground, then the pollen is sieved for use

Sweet, neutral; act on the liver and pericardium channels

Stanch bleeding, dissolve stasis, and relieve strangury

Indicated for the treatment of spitting of blood, expectoration of blood, nosebleed, flooding and spotting (uterine bleeding), bleeding from external injury, menstrual block, dysmenorrhea, stabbing pain in the chest and abdomen, swelling and pain from falling down, blood strangury or bloody urine. Normally, 5–10 g is wrapped first and decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in pregnant women

Ophicalcite (hua rui shi) (Ophicalcitum)

Initially recorded in Materia Medica of the Jiayou Era (jia you ben cao). It is the stone of Ophicalcite. of the metamorphite group. It is collected in whole year, and then other mixed stones and sediment are removed

Sour, astringent, neutral; act on the liver channel

Dissolve stasis and stanch bleeding

Indicated for the treatment of expectoration of blood, spitting of blood, bleeding from external injury, and wound with pain from falling down complicated by a pattern of stasis and stagnation. Normally, 4.5–9 g is often ground into powder as an oral dose with 1–1.5 g each time, or 10–15 g is wrapped and decocted with water as an oral dose. Or an appropriate amount is used for applying externally

Its use is prohibited in pregnant women, and cautious in patients without internal stasis

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TABLE 11.4 Properties, Actions, and Application of Common Herbs That Dissolve Stasis and Stanch Bleeding (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Rosewood (jiang xiang) (Lignum Dalbergiae Odoriferae)

Initially recorded in Materia Medica Arranged According to Pattern (zheng lei ben cao). It is the dried heart wood of trunk and root of Dalbergia odorifera T. Chen of the Leguminosae family. It is collected in whole year; after sapwood is removed, it is dried in the shade

Acrid, warm; act on the liver and spleen channels

Dissolve stasis and stanch bleeding, rectify qi, and relieve pain

Indicated for the treatment of spitting of blood, nosebleed, bleeding from external injury, hypochondriac pain due to liver constraint, chest bì with stabbing pain, wound with pain from falling down, vomiting and abdominal pain. Normally, 9–15 g is added later and decocted with water as an oral dose, or ground into powder for swallowing intact with 1–2 g each time. Or an appropriate amount is ground into fine powder for applying externally

It is not suitable for patients with yin deficiency and exuberant fire, bleeding due to blood heat, and constipation with excess pulse

Japanese Ginseng (zhu jie shen) (Rhizoma Panacis Japonici)

Initially recorded in Scientific Folk Medicinals (ke xue de min jian yao cao). It is the dried rhizome of Panax japonicus C. A. Mey. of the Araliaceae family. It is collected in autumn; after axial root and outer bark are removed, it is dried

Sweet, slightly bitter, warm; act on the liver, spleen, and lung channels

Dissipate blood stasis and stanch bleeding, relieve swelling and pain, dispel phlegm and relieve cough, supplement deficiency and tonify

Indicated for the treatment of expectoration of blood from tuberculosis, injury from falling down, cough with profuse phlegm, and weakness after illness. Normally, 6–9 g is decocted with water as an oral dose, or steeped in wine, or made into pills or powder. Or an appropriate amount is ground into powder for applying the afflicted part externally

Its use is prohibited in pregnant women, and it is also not suitable for patients without deficiency and blood stasis

216 PART | I Chinese Materia Medica

2. Attached herbs (Table 11.5) TABLE 11.5 Introduction to Attached Herbs That Dissolve Stasis and Stanch Bleeding Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Gynura Root It is the dried root and leaf of (ju ye san qi) Gynura segetum (Lour.) Merr. (Radix Gynura) of the Compositae family. It is collected when aerial part is withered; after residual stem and earth are removed, it is dried under the sun

Sweet, slightly bitter, warm; act on the spleen and liver channels

Stanch bleeding, dissipate blood stasis, relieve swelling and pain, and resolve toxins

Indicated for the treatment of spitting of blood, nosebleed, bloody stool, flooding and spotting (uterine bleeding), bleeding from external injury, postpartum abdominal pain due to blood stasis and stagnation, injury from falling down, sores and carbuncles. Normally, 6–9 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is cautious in pregnant women

Aizoon Stonecrop (jing tian san qi) (Herba Sedi Aizoon)

It is the dried root or entire plant of Sedum aizoon L. or Sedum kamtschaticum Fisch. of the Crassulaceae family. The root is collected in spring and autumn, then washed and dried under the sun. The entire plant is collected anytime or in autumn, and dried

Sweet, slightly sour, neutral; act on the heart and liver channels

Dissipate blood stasis and stanch bleeding, calm the heart and mind, resolve toxins

Indicated for the treatment of spitting of blood, nosebleed, expectoration of blood, bloody stool, bloody urine, flooding and spotting (uterine bleeding), purpura, bleeding from external injury, injury from falling down, palpitation, insomnia, swollen sores and furuncles and carbuncles, scald and burn, and insect bite. Normally, 15–30 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in patients with deficiencycold of the spleen and stomach

Big Leaf Beautyberry Root or Leaf (da ye zi zhu) (Radix seu Folium Callicarpae Macrophyllae)

It is the dried leaf or twig with leaf of Callicarpa macrophylla Vahl of the Verbenaceae family. It is collected in summer and autumn, and dried under the sun

Acrid, bitter, neutral; act on the liver, lung, and stomach channels

Dissipate blood stasis and stanch bleeding, relieve swelling and pain

Indicated for the treatment of nosebleed, expectoration of blood, spitting of blood, bloody stool, bleeding from external injury, swelling and pain from falling down. Normally, 15–30 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder or pounded for externally applying the afflicted part

Its use is cautious in pregnant women

Largeleaf Japanese Ginseng Rhizome (zhu zi shen) (Rhizoma Panacis Majoris)

It is the dried root of Codonopsis convolvulacea Kurz var. forrestii (Diels) Ballard of the Campanulaceae family. It is collected in autumn, and then washed clean, cut into pieces and dried under the sun

Sweet, neutral; act on the liver, spleen, and lung channels

Stanch bleeding and engender flesh, supplement the lung and relieve cough

Indicated for the treatment of bleeding from external injury, or knife injury, cough due to lung deficiency, dry cough without phlegm, shortness of breath and panting. Normally, 15–30 g is decocted with water as an oral dose. Or an appropriate amount is used externally

No special contraindications.

Lotus Receptacle (lian fang) (Receptaculum Nelumbinis)

It is the dried floral receptacle of Nelumbo nucifera Gaertn. of the Nymphaeaceae family. It is collected when fruit is matured in autumn; after fruit is removed, it is dried under the sun

Bitter, astringent, warm; act on the liver and spleen channels

Remove stasis, stanch bleeding, dispel dampness

Indicated for the treatment of profuse uterine bleeding, profuse menstruation, vaginal bleeding during pregnancy, abdominal pain due to blood stasis, retention of the placenta, red dysentery, blood strangury, piles and prolapse of the rectum, and skin eczema. Normally, 5–10 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder for applying or decocted with water for fumigating and washing the afflicted part

Its use is cautious in pregnant women

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TABLE 11.5 Introduction to Attached Herbs That Dissolve Stasis and Stanch Bleeding (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Lamiophlomis (du yi wei) (Herba Lamiophlomis)

It is the dried aerial part of Lamiophlomis rotata (Benth.) Kudo of the Lamiaceae family. It is a habitually used medicinal in Tibetan nationality, collected during the flowering fruit bearing stage, then washed clean, and dried under the sun

Sweet, bitter, neutral; act on the liver channel

Invigorate blood and stanch bleeding, dispel wind and relieve pain

Indicated for the treatment of injury from falling down, bleeding from external injury, painful bì syndrome due to wind-damp, dysmenorrhea, flooding and spotting (uterine bleeding). Normally, 2–3 g is decocted with water as an oral dose

It is not suitable for pregnant women and patients without stasis and stagnation

Fruticose Dracaena Leaf (tie shu ye) (Folium Cordylines Fruticosae)

It is the dried leaf of Cordyline frunicosa (L.) A. Cheval. of the Agavaceae family. It is collected in whole year, and dried under the sun

Sweet, bland, cool; act on the spleen and stomach channels

Clear heat, dissipate blood stasis and stanch bleeding

Indicated for the treatment of stomachache, dysentery, spitting of blood, bloody stool, bloody urine, profuse menstruation, and injury from falling down. Normally, 15–30 g is decocted with water as an oral dose

Its use is cautious in pregnant women

Insect Wax (chong bai la) (Cera Chinensis)

It is the refined product of the white ceraceous substance secreted by male white wax insect Ericerus pela (Chavannes) Guerin of the Coccidae family.

Sweet, bland, warm; act on the liver channel

Stanch bleeding, engender flesh, and relieve pain

Indicated for the treatment of bleeding from incised wound, bloody urine, bloody stool, sores and ulcers disclosed for a long time. Normally, 3–6 g is made into pills or powder for oral use. Or an appropriate amount is melted and made into ointment for applying externally

No special contraindications

Common Gendarussa Herb (xiao bo gu) (Herba Genderussae Vulgaris)

It is the dried aerial part of Gendarussa vulgaris Nees of the Acanthaceae family. It is collected in whole year; after impurities are removed, it is dried under the sun

Acrid, bitter, neutral; act on the liver and kidney channels

Dispel stasis and relieve pain, promote reunion of fractured tendon and bone, and dispel winddamp

Indicated for the treatment of injury from falling down, injury of tendons, bone fractures, bone pain due to winddamp, menstrual block and abdominal pain due to blood stasis. Normally, 9–15 g is decocted with water as an oral dose, or ground into powder or steeped in wine for use. Or an appropriate amount is used externally

Its use is cautious in pregnant women

Fistular Onion Juice (cong zhi) (Succus Allii Fistulosi)

It is the fresh juice extracted from pounding the Allium fistulosum L. of the Liliaceae family. The plant stem or entire plant is collected in whole year, and then pounded to extract the juice for fresh use

Acrid, warm; act on the liver channel

Dissipate blood stasis, unblock the orifices, expel worms, and resolve toxins

Indicated for the treatment of nosebleed, bloody urine, headache, deafness, worm accumulation syndrome, bleeding from external injury, injury from falling down, swollen sores and carbuncles with pain. Normally, 5–10 mL is for drinking each time, or mixed with wine for oral use. Or an appropriate amount is used externally

Its use is cautious in patients with exterior deficiency accompanied by profuse sweating

Fish SwimBladder (yu biao) (Colla Piscis)

It is the dried swim bladder of Pseudosciaena crocea (Richardson), Pseudosciaena polyactis (Bleeker) or Nibea albifiora (Richardson) of the Roncadores family, or Acipenser sinensis Gray or Huso dauricus (Georgi) of the Acipenseridae family. The swim bladder is taken out from the fish abdomen; after vessel and mucosa are removed, it is dried

Sweet, neutral; act on the kidney and liver channels

Supplement the liver and kidney, nourish the blood and stanch bleeding, dissipate blood stasis, and relieve swelling

Indicated for the treatment of seminal emission due to kidney deficiency, spasm due to blood deficiency, postpartum convulsion, tetanus, spitting of blood, expectoration of blood, bloody urine, flooding and spotting (uterine bleeding), bleeding from external injury and piles. Normally, 10–30 g is decocted with water or 3–6 g is ground into powder as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in patients with anorexia and profuse phlegm

218 PART | I Chinese Materia Medica

3. Herb differentiation (Table 11.6) TABLE 11.6 Differentiation Between Similar Efficacy Herbs That Dissolve Stasis and Stanch Bleeding Name of Medicinal

Similarity

Differences

Indian Madder Root (qian cao) (Radix et Rhizoma Rubiae)

Both act on the liver channel, can dissolve stasis and stanch bleeding, and are extensively used for the treatment of various internal or external bleeding syndromes complicated by blood stasis and stagnation

It is bitter and cold in nature and has the effects of discharging and descending, not only can cool the blood and stanch bleeding, but also can invigorate blood and dissipate blood stasis, so it is more used for the treatment of bleeding with a pattern of blood heat complicated by stasis. It can remove stasis and stagnation, unblock the blood vessels and smooth joint movement, and can be used for the treatment of menstrual block due to blood stagnation, injury from falling down and painful bì syndrome due to wind-damp

Ophicalcite (hua rui shi) (Ophicalcitum)

It is neutral in nature, and can be selected for the treatment of internal or external bleeding with a pattern of whether cold or heat. It is more used for the treatment of spitting of blood, nosebleed, and bleeding from trauma

SECTION 3  HERBS THAT ASTRINGE AND STANCH BLEEDING Outline Most of medicinals in this section are astringent in flavor, or the charred products, or sticking in nature, have the effects of astringing and stanching bleeding, and can be extensively used for the treatment of various internal or external bleeding syndromes. However, the astringency may be easy to cause stasis left and pathogens lingering while stanching bleeding. When using this section’s medicinals in clinic, they usually combine with herbs that dissolve stasis and stanch bleeding, or herbs that invigorate blood and dispel stasis. Their application should be cautious in patients with bleeding complicated by blood stasis or bleeding in the initial stage complicated by excess pathogen.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 11.7) TABLE 11.7 Properties, Actions and Application of Common Herbs That Astringe and Stanch Bleeding Name of Medicinal Bletilla Rhizome (bai ji) (Rhizoma Bletillae)

Source and Collection

Property, Channel Entry

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried tuber of Bletilla sfriata (Thunb.) Reiehb. f. of the Orchidaceae family. It is collected in summer and autumn; after fibrous root is removed, it is washed clean, then placed in boiling water, and decocted or steamed until no white heart, and then dried until 50% is dry; after outer bark is removed, it is dried under the sun

Bitter, sweet, astringent, slightly cold; act on the lung, liver, and stomach channels

Efficacy Clinical Application and Action and Usage Astringe and stanch bleeding, relieve swelling, and engender flesh

Indicated for the treatment of expectoration of blood and spitting of blood (lung and stomach bleeding), nosebleed, bleeding from external injury or incised wound, swollen carbuncles and sores and ulcers due to heat toxin, and chapped skin of hand and foot. Normally, 6–15 g is decocted with water as an oral dose, or made into pills with 2–5 g each time, or ground into powder for swallowing intact with 1–1.5 g each time. Or an appropriate amount is used externally

Caution It is not suited to combine with Radix Aconiti (chuan wu), Radix Aconiti Kusnezoffii (cao wu) and Radix Aconiti Lateralis Praeparata (fu zi) to use

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TABLE 11.7 Properties, Actions and Application of Common Herbs That Astringe and Stanch Bleeding (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy Clinical Application and Action and Usage

Caution

Hairyvein Agrimonia (xian he cao) (Herba Agrimoniae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried aerial part of Agrimonia pilosa Ledeb. of the Rosaceae family. It is collected when stem and leaf are flourishing in summer and autumn; after impurities are removed, it is dried

Bitter, astringent, neutral; act on the heart and liver channels

Astringe and stanch bleeding, prevent attack of malaria, arrest dysentery, resolve toxins, and supplement deficiency

Indicated for the treatment of expectoration of blood, spitting of blood, bloody urine, bloody stool, flooding and spotting (uterine bleeding), chronic diarrhea, red dysentery, malaria with chills and fever, swollen carbuncles and sores due to heat toxin, vaginal itching, morbid leukorrhea, and impairment caused by overstrain. Normally, 6–12 g is decocted with water as an oral dose; the large dose can be at 30–60 g. Or an appropriate amount is used externally

It is not suitable for patients without unceasing bleeding. After oral taking, palpitation, hyperemia of face or flush may occur

Beauty-Berry Leaf (zi zhu ye) (Folium Callicarpae Pedunculatae)

Initially recorded in Supplement to ‘The Materia Medica’ (ben cao shi yi). It is the dried leaf of Callicarpa formosana Rolfe of the Verbenaceae family. It is collected when branch and leaf are flourishing in summer and autumn, and then dried

Bitter, astringent, cool; act on the liver, lung, and stomach channels

Cool the blood, astringe and stanch bleeding, dissolve stasis, resolve toxins, and relieve swelling

Indicated for the treatment of nosebleed, expectoration of blood, spitting of blood, bloody stool, flooding and spotting (uterine bleeding), bleeding from external injury, sores and ulcers due to heat toxin, burn due to hot liquid or fire. Normally, 10–15 g is decocted with water or 1.5–3 g is ground into powder as an oral dose. Or an appropriate amount is pounded for applying the affected area

Due to its astringency, its use is cautious in patients with exterior pattern in initial phase

Charred Fortune Windmillpalm Petiole (zong lü tan) (Petiolus Trachycarpi Carbonisatus)

Initially recorded in Supplement to “The Materia Medica” (ben cao shi yi). It is the processed product of leaf sheath fiber of Trachycarpus fortunei (Hook. f.) H. Wendl. of the Trachycarpaceae family. Leaf sheath fiber is usually collected during September to October, and then dried under the sun, and charred for use

Bitter, astringent, neutral; act on the liver, lung, and large intestine channels

Astringe and stanch bleeding, arrest diarrhea, and vaginal discharge

It is an essential medicinal that can astringe and stanch bleeding, and indicated for the treatment of expectoration of blood and spitting of blood due to blood heat, bloody stool, flooding and spotting (uterine bleeding), chronic diarrhea or lingering dysentery, and morbid leukorrhea. Normally, 3–10 g is decocted with water or 1–1.5 g is ground into powder as an oral dose. Or an appropriate amount is used externally

Its use is cautious in bleeding complicated by blood stasis and stagnation, or dampheat dysentery in initial phase

(Continued )

220 PART | I Chinese Materia Medica

TABLE 11.7 Properties, Actions and Application of Common Herbs That Astringe and Stanch Bleeding (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy Clinical Application and Action and Usage

Caution

Charred Hair (xue yu tan) (Crinis Carbonisatus)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the charred material of human hair. Human hair is collected; after impurities are removed, it is washed with lye to remove oily dirt, rinsed with clear water, dried under the sun, calcined into coal, and then cooled for use

Bitter, neutral; act on the liver and stomach channels

Astringe and stanch bleeding, dissolve stasis, and promote urination

Indicated for the treatment of spitting of blood, expectoration of blood or coughing of blood, nosebleed, gingival bleeding, blood strangury, bloody urine, bloody stool, flooding and spotting (uterine bleeding), bleeding from external injury, and difficulty in micturition. Normally, 5–10 g is decocted with water or 1.5–3 g is ground into powder as an oral dose. Or an appropriate amount is used externally

Its use is cautious in patients with weakness of the spleen and stomach

Lotus Rhizome Node (ou jie) (Nodus Nelumbinis Rhizomatis)

Initially recorded in Treatise on Medicinal Properties (yao xing lun). It is the dried rhizome node of Nelumbo nuifera Gaertn. of the Nymphaeaceae family. The rhizome is collected in autumn and winter; the node is cut down and washed clean; after fibrous root is removed, it is dried under the sun

Sweet, astringent, neutral; act on the liver, lung, and stomach channels

Astringe and stanch bleeding, and dissolve stasis

Indicated for the treatment of spitting of blood, expectoration of blood, nosebleed, bloody urine, bloody stool, red dysentery, flooding and spotting (uterine bleeding). Normally, 9–15 g is decocted with water as an oral dose; the large dose can be at 30 g. Or 30–60 g of the fresh one is pounded to extract the juice for drinking. Or an appropriate amount is made into pills or powder for oral taking. The raw one is to stanch bleeding and dissolve stasis; the charred one is to astringe and stanch bleeding

When decocting, it should avoid using the iron

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TABLE 11.7 Properties, Actions and Application of Common Herbs That Astringe and Stanch Bleeding (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy Clinical Application and Action and Usage

Caution

Chinese Loropetalum Flower (ji mu) (Flos Loropetali Chinensis)

Initially recorded in Illustrated Reference of Botanical Nomenclature (zhi wu ming shi tu kao). It is the root, stem, leaf, or flower of Loropetalum chinense (R. BR.) Oliv. of the Hamamelidaceae family. The flower is collected in summer, leaf is collected in growing season, root or stem is collected in four seasons; and then washed clean and dried under the sun

Bitter, astringent, neutral; act on the liver, stomach, and large intestine channels

Astringe and stanch bleeding, clear heat and resolve toxins, and arrest diarrhea

Indicated for the treatment of bleeding syndromes, such as nosebleed, expectoration of blood, and bleeding from external injury, burn due to hot liquid or fire, diarrhea and dysentery. Normally, 6–10 g of the flower or 15–30 g of the stem and leaf or 30–60 g of the root is decocted with water as an oral dose; the fresh one should be doubled at the dose. Or an appropriate amount is used externally

No special contraindications

Cockscomb (ji guan hua) (Flos Celosiae Cristatae)

Initially recorded in Materia Medica of South Yunnan (dian nan ben cao). It is the dried inflorescence of Celosia cristata L. of the Amaranthaceae family. It is collected when flower is flourishing in autumn, and then dried under the sun

Sweet, astringent, cool; act on the liver and large intestine channels

Astringe and stanch bleeding, arrest vaginal discharge, and arrest dysentery

Indicated for the treatment of spitting of blood, flooding and spotting (uterine bleeding), bloody stool, bleeding from piles, leukorrhea with red and white discharge, and lingering dysentery or diarrhea. Normally, 6–12 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is decocted with water for fumigating and washing or ground into powder for applying

It is not suitable for patients with flooding and spotting (uterine bleeding) due to static blood obstruction or dampheat dysentery in initial phase complicated by exterior cold or heat pattern

222 PART | I Chinese Materia Medica

2. Attached herbs (Table 11.8) TABLE 11.8 Introduction to Attached Herbs That Astringe and Stanch Bleeding Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Trachycarpus Stiple Fiber (zong lü) (Petiolus Trachycarpi)

It is the dried leafstalk of Trachycarpus fortunei (Hook. f.) H. Wendl. of the Trachycarpaceae family. The old part of leafstalk extended to down and leaf sheath is collected; after fibriform palm fiber is removed, it is dried under the sun

Bitter, astringent, neutral; act on the lung, liver, and large intestine channels

Astringe and stanch bleeding

Indicated for the treatment of spitting of blood, nosebleed, bloody urine, bloody stool, flooding and spotting (uterine bleeding). Normally, 3–9 g of the processed one is decocted with water as an oral dose

It is not suitable for patients with bleeding syndromes complicated by blood stasis

Charred Fineleaf Schizonepeta Spike (jing jie sui tan) (Spica Schizonepetae Carbonisata)

It is the processed product of spica of Schizonepeta tenuifolia Briq. of the Labiatae family. The spica is collected when the flower is blooming and the spica is green during the summer and autumn; after impurities are removed, it is dried under the sun and charred for use

Acrid, astringent, slightly warm; act on the lung and liver channels

Astringe and stanch bleeding

Indicated for the treatment of bloody stool, flooding and spotting (uterine bleeding), and postpartum fainting due to hemorrhage. Normally, 5–10 g is decocted with water as an oral dose

It is not suitable for patients with flooding and spotting due to static blood obstruction

Plant Soot (bai cao shuang) (Palvis Fumi Carbonisatus)

It is the soot of various weeds after being on fire, which attached in kitchen stove or chimney. It is collected from the cooker bottom or the inside of chimney; after the impurities are removed, it is placed in bottle for use

Acrid, bitter, warm; act on the liver, lung, spleen, and stomach channels

Stanch bleeding, disperse accumulation, and resolve toxins

Indicated for the treatment of spitting of blood, expectoration of blood, nosebleed, bloody stool, profuse uterine bleeding, abnormal vaginal discharge, food accumulation, dysentery, jaundice, sore throat, oral ulcer, and bleeding from external injury. Normally, 0.9–4.5 g is made into pills or powder as an oral dose. Or an appropriate amount is used externally

Its use is cautious in patients with yin deficiency and internal heat

Pine Pollen (song hua fen) (Pollen Pini)

It is the dried pollen of Pinus massoniana Lamb., Pinus tabuliformis Carr. or sibling many kinds of plants of the Pinaceae family. The spica is collected just when blooming in spring, and then dried under the sun; the pollen is collected; then the impurities are removed

Sweet, warm; act on the liver and spleen channels

Astringe and stanch bleeding, dry dampness, and close sore

Indicated for the treatment of bleeding from external injury, eczema, yellow-water sore (huáng shuĭ chua¯ng, roughly equivalent to impetigo), skin erosion with pus like dripping wet. Normally, 3–6 g is decocted with water as an oral dose, or steeped in wine. Or an appropriate amount is applied on the affected area

Its use is cautious in patients with blood deficiency and internal heat

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TABLE 11.8 Introduction to Attached Herbs That Astringe and Stanch Bleeding (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Clinopodii (duan xue liu) (Herba Clinopodii)

It is the dried aerial part of Clinopodium polycephalum (Vaniot) C. Y. Wu et Hsuan or Clinopodium chinense (Benth.) O. Kuntze of the Labiatae family. It is collected before blooming in summer; after sediment is removed, it is dried under the sun

Slightly bitter, astringent, cool; act on the liver channel

Astringe and stanch bleeding, cool the blood, clear heat, and resolve toxins

Indicated for the treatment of flooding and spotting (uterine bleeding), bloody urine, nosebleed, gingival bleeding, bleeding from trauma, swelling and pain of the throat, swollen sores and ulcers. Normally, 9–15 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder for applying the affected area

It is not suitable for patients with deficiency-cold of the spleen and stomach to use for longterm

Immature Peach Fruit (bi tao gan) (Fructus Persicae Immaturus)

It is the young fruit of Amygdalus persica L. or A. davidiana (Carr.) C. de Vos ex Henry of the Rosaceae family. The immature young fruit is collected during April to June, and then dried under the sun for 4–6 days until its green color turns green yellow

Sour, bitter, neutral; act on the lung and liver channels

Arrest sweating and emission, invigorate blood and stanch bleeding, and relieve pain

Indicated for the treatment of night sweating, seminal emission, pain in the epigastrium and abdomen, spitting of blood, and vaginal bleeding (painless spotting) during pregnancy. Normally, 6–9 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is ground into powder for applying or burn for fumigating

No special contraindications

Perforate St. John’s Wort Herb (guan ye lian qiao) (Herba Hyperici Perforati)

It is the entire plant of Hypericum perforatum L. of the Clusiaceae family. It is collected during July to October, and then washed clean and dried under the sun

Bitter, astringent, neutral; act on the liver channel

Astringe and stanch bleeding, regulate menstruation and promote lactation, clear heat and resolve toxins, and drain dampness

Indicated for the treatment of expectoration of blood, spitting of blood, intestinal wind (bloody stool), flooding and spotting (uterine bleeding), bleeding from external injury, menstrual irregularities, inhibited lactation, jaundice, sore throat, red eye with swelling and pain, urinary tract infection, oral ulcer, carbuncles and furuncles, scald, and burn. Normally, 9–15 g is decocted with water for oral use. Or an appropriate amount is used externally

No special contraindications

Egg-Shell (ji zi ke) (Chorion Ovi Galli)

It is the hard outer shell of Gallus gallus domesticus Brisson of the Phasianidae family. When eating the egg, it is collected, washed clean, and then dried by baking

Bland, neutral; act on the stomach and kidney channels

Astringe, relieve hyperacidity, strengthen the bone, stanch bleeding, and improve vision

Indicated for the treatment of gastric cavity pain, nausea, acid regurgitation, infantile rickets, various kinds of bleeding, nebula, malnutrition sore, and pock. Normally, 1–9 g is baked and ground into powder as an oral dose. Or an appropriate amount is used externally

No special contraindications

224 PART | I Chinese Materia Medica

3. Herb differentiation (Table 11.9) TABLE 11.9 Differentiation Between Similar Efficacy Herbs That Astringe and Stanch Bleeding Name of Medicinal

Similarity

Differences

Bletilla Rhizome (bai ji) (Rhizoma Bletillae)

Both act on the liver and stomach channels, can stanch bleeding, relieve swelling and supplement deficiency, and treat various bleeding syndromes

It has the effects of cooling the blood and discharging heat, relieving swelling, and engendering flesh, and can be used for the treatment of various internal or external bleeding syndromes, swollen carbuncles and sores (due to heat toxin) in initial phase whether not ulcerated or ulcerated with disclosing for a long time, burn due to hot liquid or fire, and rhagades of hand and foot

Pseudoginseng Root (san qi) (Radix et Rhizoma Notoginseng) Hairyvein Agrimonia (xian he cao) (Herba Agrimoniae) Cape Jasmine Fruit (zhi zi) (Fructus Gardeniae) Charred Fortune Windmillpalm Petiole (zong lü tan) (Petiolus Trachycarpi Carbonisatus)

It can stanch bleeding but not leave stasis, is especially suitable for patients with bleeding complicated by blood stasis, and used for the treatment of injury from falling down, swelling and pain due to blood stasis, swollen carbuncles, and sores. It also can supplement qi and blood and strengthen the body Both have the effect of cooling the blood, and can be used for the treatment of various bleeding syndromes, such as spitting of blood and nosebleed due to blood heat. Both have the effects of resolving toxins and relieving swelling

It has the effect of astringing and stanching bleeding, and can treat bleeding syndromes with whether cold or heat pattern. It also can arrest diarrhea and dysentery, prevent attack of malaria, and supplement deficiency

Both are bitter and neutral in nature, act on the liver channel, have the effects of astringing and stanching bleeding, and can be used for the treatment of various bleeding syndromes

It is more used for the treatment of patients with excessive bleeding but without pathogenic heat or (and) blood stasis and stagnation, can astringe and arrest dysentery, arrest diarrhea, and arrest vaginal discharge, and can be used for the treatment of chronic diarrhea and lingering dysentery, or female abnormal vaginal discharge

Charred Hair (xue yu tan) (Crinis Carbonisatus)

Its effects of cooling the blood and resolving toxins, relieving swelling, and pain are stronger than that of Hairyvein Agrimonia (xian he cao). It also can drain fire and relieve vexation, drain dampness and relieve strangury

It can dissolve stasis, so has not the disadvantage of leaving stasis, and can be used for the treatment of various bleeding syndromes. It also can promote urination, and is more used for the treatment of difficulty in micturition, and strangury with bloody urine. It can engender flesh and close sore, and is used for the treatment of sores and ulcers without disclosing, and scald

SECTION 4  HERBS THAT WARM THE CHANNELS AND STANCH BLEEDING Outline This section’s medicinals are warm and hot in nature, can warm the internal organs, boost spleen yang, consolidate the chong mai to contain blood (i.e., keep it within the vessels), have the effects of warming the channels and stanching bleeding, and are indicated for the treatment of deficiency-cold bleeding syndromes due to spleen failing to control blood or insecurity of the chong mai, such as bloody stool, purpura, or flooding, and spotting (uterine bleeding) with bleeding for a long time and dimmed blood, accompanied by shortness of breath, lack of strength, lack of warm in the limbs, lusterless complexion, pale tongue, thready and weak pulse. When using medicinals in this section, for patients with spleen failing to control blood, it should combine with herbs that boost qi and fortify the spleen to treat; for patients with kidney deficiency and insecurity of the chong mai, it should combine with herbs that boost the kidney and warm the uterus to treat. However, patients with bleeding due to exuberant heat and vigorous fire should be prohibited to use these medicinals due to its warm and hot property.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 11.10)

TABLE 11.10 Properties, Actions and Application of Common Herbs That Warm the Channels and Stanch Bleeding Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Mugwort Leaf (ai ye) (Folium Artemisiae Argyi)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried leaf of Artemisia argyi Lévl. et Vant. of the Compositae family. It is collected before blooming in summer; after impurities are removed, it is dried under the sun

Acrid, bitter, warm, slightly poisonous; act on the liver, spleen, and kidney channels

Warm the channels and stanch bleeding, dissipate cold and relieve pain, regulate menstruation, calm the fetus; external use: dispel dampness and relieve itching

Indicated for the treatment of spitting of blood, nosebleed, flooding and spotting (uterine bleeding), profuse menstruation, vaginal bleeding (painless spotting) during pregnancy, cold pain in the lower abdomen, dysmenorrhea or menstrual irregularities due to cold, infertility due to uterus cold, and itch of skin. Normally, 3–9 g is decocted with water as an oral dose. Or an appropriate amount is used for moxibustion or fumigating and washing externally

Its use is cautious in patients with yin deficiency and blood heat, or loss of blood all along

Prepared Dried Ginger (pao jiang) (Rhizoma Zingiberis Praeparatum)

Initially recorded in Pouch of Pearls (zhen zhu nang). It is the processed product of dried rhizome of Zingiber offcinale Rosc. of the Zingiberaceae family. The dried Ginger is scalded with sand until it is protruded and its surface turns brown, or dry-fried until charred with black outer surface and brown inside for use

Acrid, hot; act on the spleen, stomach, and kidney channels

Warm the channels and stanch bleeding, warm the center, and relieve pain

Indicated for the treatment of bleeding syndromes, such as spitting of blood, nosebleed and flooding and spotting (uterine bleeding) with a pattern of yang deficiency, abdominal pain, vomiting and diarrhea due to deficiency-cold of the spleen and stomach. Normally, 3–9 g is decocted with water as an oral dose, or made into pills or powder

Its use is prohibited in pregnant women and patients with yin deficiency and fever

Ignited Yellow Earth (zao xin tu) (Terra Flava Usta)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the brown clod in the bottom center of kitchen mud stove that burns firewood or weeds. When repairing the stove or kiln that burns firewood, the caking clod is taken down, and then the burned black part and impurities are removed

Acrid, warm; act on the spleen stomach channels

Warm the center and arrest vomiting, stanch bleeding, and arrest diarrhea

Indicated for the treatment of bleeding syndromes, such as spitting of blood and bloody stool due to deficient spleen failing to control the blood, vomiting due to stomach cold, and chronic diarrhea due to spleen deficiency. Normally, 15–30 g is wrapped with cloth and decocted first with water as an oral dose; or 60–120 g is decocted for drinking as water; or made into pills or powder. Or an appropriate amount is used externally

Its use is prohibited in patients with bleeding accompanied by yin deficiency or heat pattern accompanied by vomiting and regurgitation

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2. Herb differentiation (Table 11.11) TABLE 11.11 Differentiation Between Similar Efficacy Herbs That Warm the Channels and Stanch Bleeding Name of Medicinal

Similarity

Differences

Fresh Ginger (sheng jiang) (Rhizoma Zingiberis Recens)

All four medicinals are the different processed products of rhizome of Zingiber officinale Rosc. of the Zingiberaceae family. They are warm in nature, can warm the center or the channels, and can be used for the treatment of deficiencycold in the middle jiao

It is acrid and warm in nature, has the effects of releasing the exterior and dissipating cold, warming the center and arresting vomiting, warming the lung, and dissolving rheum (fluid retention), and can be used for the treatment of common cold due to wind-cold and vomiting due to stomach cold

Dried Ginger Rhizome (gan jiang) (Rhizoma Zingiberis)

Its property is heat and partial to dryness. It mainly can warm the center and dissipate cold, restore yang and unblock the vessel, dry dampness and dissolve phlegm, and is especially suited to treat pathogenic cold exuberance in the middle jiao complicated by dampness, and panting and cough due to cold fluid-retention lodging in the lung. It is good at restoring yang and unblocking the vessel, and often used for the treatment of cold pain in the stomach cavity and abdomen, vomiting and diarrhea, cold limbs and faint pulse

Prepared Dried Ginger (pao jiang) (Rhizoma Zingiberis Praeparatum)

It is bitter, acrid, and warm in nature, its acrid and dry property is less than that of Rhizoma Zingiberis (gan jiang), its effect of warming the interior is not as good as that of Rhizoma Zingiberis (gan jiang), but its effects are moderate and lasting. It is good at warming the center and relieving pain, arresting diarrhea, warming the channels, and stanching bleeding, so often used for the treatment of abdominal pain and diarrhea due to deficiency-cold in the middle jiao, and deficiency-cold spitting of blood, bloody stool, or flooding and spotting (uterine bleeding)

Charred Dried Ginger (jiang tan) (Rhizoma Zingiberis Carbonisatum)

After dry-fried until charred, its acrid flavor is lost, and it specializes in stanching bleeding and warming the channels; its flavor is bitter and astringent, and effects of astringing and stanching bleeding are stronger than that of Rhizoma Zingiberis Praeparatum (pao jiang), and effect of warming the channels is inferior to that of Rhizoma Zingiberis Praeparatum (pao jiang), so it is often used for the treatment of various deficiency-cold bleeding syndromes in clinic

Mugwort Leaf (ai ye) (Folium Artemisiae Argyi)

Prepared Dried Ginger (pao jiang) (Rhizoma Zingiberis Praeparatum)

Both are bitter and warm in nature, act on the liver and spleen channels, can warm the channels and stanch bleeding, and are used for the treatment of deficiency-cold bleeding syndromes

It can warm the channels, stanch bleeding, and warm the uterus, and is more used for the treatment of flooding and spotting (uterine bleeding) with a pattern of deficiency-cold. It also can calm the fetus, and is used for the treatment of infertility due to uterus cold, vaginal bleeding (painless spotting) during pregnancy, and restless fetus due to deficiencycold in the lower jiao or cold invading the uterus It is the medicinal of first choice for patients with spleen yang deficiency and spleen failing to control the blood. It also can warm the center and relieve pain, and is used for the treatment of abdominal pain and diarrhea due to deficiency-cold

Chapter 12

Herbs That Invigorate Blood and Dissolve Stasis Chapter Outline Section 1 Herbs That Invigorate Blood and Relieve Pain Outline Specific Application Knowledge of Herbs Section 2 Herbs That Invigorate Blood and Regulate Menstruation Outline Specific Application Knowledge of Herbs

228 228 229 236 236 236

Section 3 Herbs That Invigorate Blood and Cure Injury 246 Outline 246 Specific Application Knowledge of Herbs 246 Section 4 Herbs That Break up Blood Stasis and Resolve Masses 251 Outline 251 Specific Application Knowledge of Herbs 252

ABSTRACT Chinese herbal medicinals that can mainly unblock the blood vessels, promote blood circulation, and dissipate static blood, and are used for the treatment of blood stasis syndromes or diseases are called “Herbs that Invigorate Blood and Dissolve Stasis” or “herbs that invigorate blood and dispel stasis,” briefly called “herbs that invigorate blood” or “herbs that dissolve stasis.” Herbs that invigorate blood and dissolve stasis are applicable to treat all syndromes of stagnation of blood stasis. Herbs that invigorate blood and dissolve stasis can be divided into four categories: herbs that invigorate blood and relieve pain, herbs that invigorate blood and regulate menstruation, herbs that invigorate blood and cure injury, and herbs that break up blood stasis and resolve masses. Keywords: herbs that invigorate blood and dissolve stasis; herbs that invigorate blood and relieve pain; herbs that invigorate blood and regulate menstruation; herbs that invigorate blood and cure injury; herbs that break up blood stasis and resolve masses; Invigorate blood and move qi; invigorate blood and relieve pain; invigorate blood and promote menstruation; invigorate blood and dispel stasis; break up blood and expel stasis; unblock the collaterals and relieve pain; invigorate blood and disperse concretions (zhēng)

Chinese herbal medicinals that can mainly unblock the blood vessels, promote blood circulation, and dissipate static blood, and are used for the treatment of blood stasis syndromes or diseases are called “Herbs That Invigorate Blood and Dissolve Stasis” or “Herbs That Invigorate Blood and Dispel Stasis,” briefly called “Herbs That Invigorate Blood” or “Herbs That Dissolve Stasis.” Medicinals that have a strong effect of invigorating blood are also called “Herbs That Break Up Blood” or “Herbs That Expel Stasis.” Seeking Accuracy in the Materia Medica (ben cao qiu zhen) points out that “if blood and qi are circumfluent all over the body and not static and stagnant, all diseases will not be resulted in.” Blood is an important substance in human body and can nourish the whole body; but the circulation must be smooth. If blood stream is unsmooth or obstructed in local area, syndrome will be generated that is blood stasis syndrome (or pattern). Herbs that invigorate blood and dissolve stasis are more acrid and bitter in flavor and warm in nature (some animal medicinals are salty in flavor), and mainly act on the heart and liver channels. The medicinals with acrid flavor have the effects of dispersing and moving, medicinals with bitter flavor have the effects of unblocking and purging. They all act on the blood aspect, so can move blood and invigorate blood to unblock the vessels and disperse stasis and stagnation. The meaning is exactly what is called “blood excess syndrome should be treated by removal” in The Yellow Emperor’s Inner Classic (huang di nei jing). In clinic, herbs that invigorate blood and dissolve stasis can show various efficacy, such as invigorate blood to relieve pain, invigorate blood to regulate menstruation, invigorate blood to relieve swelling, invigorate blood to cure injury, invigorate blood to relieve carbuncle, and break up blood to disperse concretions (zhēng). Essentials of Chinese Materia Medica and Medical Formulas. http://dx.doi.org/10.1016/B978-0-12-812722-3.00012-9 Copyright © 2017 Elsevier Inc. All rights reserved.

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228 PART | I Chinese Materia Medica

Herbs that invigorate blood and dissolve stasis are applicable to treat all syndromes of stagnation of blood stasis. Stagnant blood is not only the pathological product, but also the etiological factor of many diseases or syndromes. Therefore, the indications of herbs that invigorate blood and dissolve stasis are quite extensive, including internal medicine diseases and syndromes, such as chest pain, abdominal pain, headache, stabbing and fixed pain, internal concretions and conglomerations (lower abdominal masses; zhēng jia˘ ), or accumulations and gatherings (abdominal masses; jī jù), wind-strike (apoplexy) with hemiplegia (half-body paralysis) and numbness of limbs, and a long time painful bì syndrome of joints; external diseases, such as sores and ulcers with swelling and pain; traumatological diseases, such as injuries from falling down with blood stasis and pain; gynecological diseases, such as menstrual irregularities, menstrual block, painful menstruation, postpartum abdominal pain, retention of lochia, and inhibited lactation; and some pediatric diseases. Herbs that invigorate blood and dissolve stasis have a definite therapeutic effect on coronary heart disease with angina pectoris, myocardial infarction (MI), cerebral thrombosis, ischemic cerebrovascular disease, sequelae of brain vascular accident, thromboangiitis obliterans, retinal angiemphraxis, menstrual disorder, uterine fibroids, ectopic pregnancy, abortion, dysmenorrhea, endometriosis, pelvic infection, dystocia, and placental retention in modern medicine, respectively. Some herbs also achieved good therapeutic effects of treating carcinoma, chronic hepatitis, hepatic cirrhosis, gastric ulcer, polyarthritis destruens, insomnia, and scleroderma. Herbs that invigorate blood and dissolve stasis can be divided into four categories: (1) herbs that invigorate blood and relieve pain, (2) herbs that invigorate blood and regulate menstruation, (3) herbs that invigorate blood and cure injury, and (4) herbs that break up blood stasis and resolve masses according to the strength of the different effects, characteristics of their actions, and clinical application. When using herbs that invigorate blood and dissolve stasis, doctors should select them according to their different characteristics of efficacy and the syndromes, and also should aim at the cause of blood stasis to combine in order to treat the root and branch simultaneously. For patients with cold congealing and blood stasis, doctors should select herbs that warm the interior and dissipate cold, and herbs that warm and unblock the channels to combine. For patients with heat scorching nutrient-blood and binding of blood stasis and heat, should select herbs that clear heat and cool the blood, and herbs that drain fire and resolve toxins to combine. For patients with unsmooth movement of blood due to obstruction of phlegm-damp, should select herbs that dissolve phlegm and eliminate dampness to combine. For patients with blocked channels due to winddamp obstruction, should select herbs that dispel wind and eliminate dampness and unblock the collaterals to combine. For weak patients with blood stasis or stasis due to body deficiency, should select herbs that supplement deficiency to combine. For patients with concretions and conglomerations (lower abdominal masses; zhēng jiă ) or accumulations and gatherings (abdominal masses; jī jù), should select herbs that soften hardness and dissipate masses to combine. Due to the close relationship between qi and blood, “qi flow promotes blood transportation, qi stagnation leads to blood congealing,” doctors often select herbs that move qi to combine in order to strengthen the efficacy of invigorating blood and dissipating blood stasis. Medicinals in this category have strong effects of moving and dispersing, and are easy to consume blood and induce bleeding. Some of them even can induce abortion and hasten parturition, so they are not suitable for women with profuse menstruation and other bleeding syndromes without blood stasis, and they should be cautious or prohibited in pregnant women. Herbs that break up blood stasis and expel stasis are easy to damage healthy qi, so using them should obey the principle of discontinue medication as soon as getting effect. The modern pharmacological research indicates the herbs that invigorate blood and dissolve stasis can improve blood circulation, especially microcirculation to promote recovery of the pathological change; have the function of anticoagulated blood in order to prevent the formation of thrombus and arteriosclerosis plaque; can improve the metabolic function to promote tissue repair, wound and fracture healing; may ameliorate the permeability of blood capillary to relieve inflammatory reaction and promote the regression and absorption of inflammation lesion; can ameliorate the metabolism of connective tissue to promote the transformation and absorption of hyperplasia and recover the atrophic connective tissue; also can regulate the body immunity function and have the antibiotic action.

SECTION 1  HERBS THAT INVIGORATE BLOOD AND RELIEVE PAIN Outline Medicinals in this section are more acrid in flavor, act on both the blood and qi aspects, can invigorate blood and move qi, have a good effect of relieving pain, and are mainly used for the treatment of various pain syndromes caused by stasis and stagnation of qi and blood, such as headache, chest and ribside pain, epigastric and abdominal pain, dysmenorrhea, postpartum abdominal pain, painful bì syndrome of limbs, and pain of injury from falling down. They also can be used for the treatment of other blood stasis syndromes.

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When using herbs that invigorate blood and relieve pain in clinic, doctors should select corresponding medicinals appropriately according to the different positions of pain, etiological factors, and pathogenic conditions to combine. For patients with liver constraint and blood stasis, doctors should select herbs that rectify qi and soothe the liver to combine. For patients with injury from falling down accompanied by pain with blood stasis, should select herbs in this section that have the effects of relieving swelling and engendering flesh to combine with herbs that invigorate blood and cure injury. For patients with pain from menstruation or childbirth, should select herbs that invigorate blood and regulate menstruation to combine with herbs that nourish blood. For patients with swollen sores and ulcers and carbuncles, should select herbs that invigorate blood and relieve swelling to combine with herbs that clear heat, relieve carbuncle, and resolve toxins.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 12.1) TABLE 12.1 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Relieve Pain Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sichuan Lovage Root (chuan xiong) (Rhizoma Chuanxiong)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried rhizome of Ligusticum chuanxiong Hort. of the Umbelliferae family. It is collected when node disc on rhizome protrudes significantly and is purplish in summer; after sediment and fibrous root are removed, it is dried under the sun and then baked until dry

Acrid, warm; act on the liver, gallbladder, and pericardium channels

Invigorate blood and move qi, dispel wind and relieve pain, and regulate menstruation

Indicated for the treatment of chest bì and precordial pain, stabbing pain in the chest and ribside, swelling and pain from falling down, dysmenorrhea and menstrual block or irregularities, concretions, and conglomerations (zhēng jia˘ ) with abdominal pain, and headache due to qi stagnation and blood stasis, and painful bì syndrome due to winddamp. Normally, 3–10 g is decocted with water as an oral dose

Its use is cautious in pregnant women and patients with vigorous fire due to yin deficiency, profuse sweating, exuberant heat, and bleeding without blood stasis

Corydalis Rhizome (yan hu suo) (Rhizoma Corydalis)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the dried tuber of Corydalis yanhusuo W. T. Wang of the Papaveraceae family. It is collected when stem and leaf are withered in the early summer; after fibrous root is removed, it is decocted with boiling water until just no white heart, taken out and dried under the sun

Acrid, bitter, warm; act on the liver and spleen channels

Invigorate blood and move qi, and relieve pain

Indicated for the treatment of pain caused by qi stagnation and blood stasis, pain in the chest and ribside, stomach cavity and abdomen, chest bì and precordial pain, menstrual block and dysmenorrhea, postpartum abdominal pain, swelling and pain from falling down. Normally, 3–10 g is decocted with water as an oral dose, or ground into powder for oral taking with 1.5–3 g each time

Its use is prohibited in pregnant women and patients with blood heat and qi deficiency

(Continued )

230 PART | I Chinese Materia Medica

TABLE 12.1 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Relieve Pain (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Turmeric Root Tuber (yu jin) (Radix Curcumae)

Initially recorded in Treatise on Medicinal Properties (yao xing lun). It is the dried tuber of Curcuma wenyujin Y. H. Chen et C. Ling, Curcuma longa L., Curcuma kwangsiensis S. G. Lee et C. F. Liang or Curcuma phaeocaulis Val. of the Zingiberaceae family. It is collected when stem and leaf are withered in winter; after sediment and radicula are removed, it is steamed or decocted until no white heart, then dried

Acrid, bitter, cold; act on the liver, heart, and lung channels

Invigorate blood and relieve pain, move qi, and resolve constraint, clear heart heat and cool the blood, promote gallbladder function, and relieve jaundice

Indicated for the treatment of stabbing pain in the chest and ribside, chest bì and precordial pain, menstrual block, dysmenorrhea, and distending pain in the breast due to qi stagnation and blood stasis, loss of consciousness (in febrile disease), epilepsy and mania, spitting of blood and nosebleed due to blood heat, bloody urine and blood strangury, jaundice due to dampheat. Normally, 3–10 g is decocted with water or 2–5 g is ground into powder as an oral dose

Its use is prohibited in patients with yin deficiency and blood loss, and no qi stagnation and blood stasis, cautious in pregnant women, and not suited to combine with Clove Flower (ding xiang)

Common Turmeric Rhizome (jiang huang) (Rhizoma Curcumae Longae)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried rhizome of Curcuma longa L. of the Zingiberaceae family. When stem and leaf are withered in winter, it is collected and washed clean, then decocted or steamed to heart, dried under the sun, and then fibrous root is removed

Acrid, bitter, warm; act on the spleen and liver channels

Invigorate blood and move qi, unblock the channels, and relieve pain

Indicated for the treatment of stabbing pain in the chest and ribside, chest bì and precordial pain, menstrual block and dysmenorrhea due to qi stagnation and blood stasis, concretions and conglomerations (zhēng jia˘ ), painful bì syndrome of shoulder and arm due to winddamp, and swelling and pain from falling down. Normally, 3–10 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is cautious in patients with blood deficiency and no qi stagnation and blood stasis, and prohibited in pregnant women

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TABLE 12.1 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Relieve Pain (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Wenyujin Rhizome (pian jiang huang) (Rhizoma Wenyujin Concisum)

Initially recorded in Chinese Pharmacopoeia (zhong hua ren min gong he guo yao dian). It is the dried rhizome of Curcuma wenyujin Y. H. Chenet C. Ling of the Zingiberaceae family. When stem and leaf are withered in winter, it is collected and washed clean; after fibrous root is removed, it is slivered into thick pieces while fresh, and then dried under the sun

Acrid, bitter, warm; act on the spleen and liver channels

Break up blood stasis and move qi, unblock the channels, and relieve pain

Indicated for the treatment of pain caused by qi stagnation and blood stasis, stabbing pain in the chest and ribside, chest bì, and precordial pain, dysmenorrhea and menstrual block, concretions and conglomerations (zhēng jia˘), shoulder and arm pain due to wind-damp, and swelling and pain from falling down. Normally, 3–9 g is decocted with water as an oral dose

Its use is cautious in pregnant women and patients with blood deficiency and no qi stagnation and blood stasis

Frankincense (ru xiang) (Olibanum)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried resina effused from tree bark of Boswellia carterii Birdw. and its sibling Boswellia bhaw-dajiana Birdw. of the Burseraceae family. It is collected in spring and autumn, and then broken into pieces or dry-fried for use

Acrid, bitter, warm; act on the heart, liver, and spleen channels

Invigorate blood and move qi and relieve pain, relieve swelling, and engender flesh

Indicated for the treatment of chest bì and precordial pain, gastric cavity pain, dysmenorrhea and menstrual block, postpartum static blood obstruction, concretions and conglomerations (zhēng jia˘) with abdominal pain, painful bì syndrome due to wind-damp, injury from falling down, swollen carbuncles and sores. Normally, 3–5 g is decocted with water or made into pills or powder as an oral dose. Or an appropriate amount is ground into powder for applying

Its use is cautious in patients with weak stomach, and prohibited in pregnant women and patients without blood stasis

(Continued )

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TABLE 12.1 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Relieve Pain (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Myrrh (mo yao) (Myrrha)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the dried resina of Commiphora myrrha Engl. or Commiphora molmol Engl. of the Burseraceae family. It is divided into natural myrrh and colloid myrrh. It is collected during November to the next February, then broken into pieces or processed for use

Acrid, bitter, neutral; act on the heart, liver, and spleen channels

Dissipate blood stasis and relieve pain, relieve swelling, and engender flesh

Indicated for the treatment of chest bì and precordial pain, dysmenorrhea and menstrual block, and stomachache due to blood stasis and qi stagnation, postpartum static blood obstruction, pain with blood stasis, painful bì syndrome due to wind-damp, injury from falling down, swollen carbuncle-abscess with pain, sores and ulcers without closing for a long time. Normally, 3–5 g is processed to deoil and often made into pills or powder for oral taking. Or an appropriate amount is used externally

Its use is cautious in patients with weak stomach, and prohibited in pregnant women and patients without blood stasis

Flying Squirrel Faeces (wu ling zhi) (Faeces Trogopterori)

Initially recorded in Materia Medica of the Kaibao Era (kai bao ben cao). It is the feces of Trogopterus xanthipes MilneEdwards of the Petauristidae family. It is collected in whole year; after impurities are removed, it is dried under the sun for use, or processed with vinegar or wine for use

Bitter, salty, sweet, warm; act on the liver channel

Invigorate blood and relieve pain, dissolve stasis, and stanch bleeding

Indicated for the treatment of pain caused by static blood obstruction, chest bì and precordial pain, pain in the stomach cavity and abdomen, dysmenorrhea, postpartum abdominal pain due to blood stasis, bone fracture with swelling and pain, and bleeding due to internal obstruction of static blood. Normally, 3–10 g is wrapped first and decocted with water as an oral dose

Its use is cautious in pregnant women and patients with blood deficiency and no blood stasis, and not suited to use together with Radix et Rhizoma Ginseng (ren shen)

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TABLE 12.1 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Relieve Pain (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Decumbent Corydalis Rhizome (xia tian wu) (Rhizoma Corydalis Decumbentis)

Initially recorded in Commonly Used Folk Medicinals in Zhejiang (zhe jiang min jian chang yong zhong cao yao). It is the dried tuber of Corydalis decumbens (Thunb.) Pers. of the Papaveraceae family. It is collected in spring or early summer; after stem, leaf, and fibrous root are removed, it is washed clean and dried

Bitter, slightly acrid, warm; act on the liver channel

Invigorate blood and relieve pain, relax the sinews and quicken the collaterals, dispel wind, and eliminate dampness

Indicated for the treatment of windstrike with hemiplegia (half-body paralysis), headache, injury from falling down, pain with blood stasis, painful bì syndrome due to wind-damp, spasms of joints, low back pain, and leg pain. Normally, 6–12 g is decocted with water or 1–3 g is ground into powder as an oral dose. Or an appropriate amount is made into pills for oral taking

Its use is cautious in pregnant women

Beautiful Sweetgum Resin (feng xiang zhi) (Resina Liquidambaris)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried resina of Liquidambar formosana Hance of the Hamamelidaceae family. During July to August, trunk is cut up to make resina flow out, then resina is collected from October to the next April, and then dried in the shade

Acrid, slightly bitter, neutral; act on the lung and spleen channels

Invigorate blood and relieve pain, resolve toxins and engender flesh, cool the blood, and stanch bleeding

Indicated for the treatment of painful bì syndrome due to winddamp, injury from falling down, incised wound, bleeding from external injury, pain with blood stasis, spitting of blood and nosebleed due to blood heat, scrofula, swollen carbuncleabscess with pain, and shank sore lasting for a long time. Normally, 1–3 g is often made into pills or powder as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in pregnant women

(Continued )

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TABLE 12.1 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Relieve Pain (cont.) Name of Medicinal Shiny Pricklyash (liang mian zhen) (Radix Zanthoxyli)

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Initially recorded in Seeking Origins in the Materia Medica (ben cao qiu yuan). It is the dried root of Zanthoxylum nitidum (Roxb.) DC. of the Rutaceae family. It is collected in whole year, and then washed clean, cut into pieces or segments and dried under the sun

Bitter, acrid, neutral, slightly poisonous; act on the liver and stomach channels

Invigorate blood and dissolve stasis, move qi and relieve pain, dispel wind and unblock the collaterals, resolve toxins, and relieve swelling

Indicated for the treatment of injury from falling down, bone fracture, stomachache, toothache, swelling and pain of throat, painful bì syndrome due to wind-damp, sores and carbuncles, scrofula and phlegm node, thanatophidia bite, burn and scald. Normally, 5–10 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder for applying or decocted with water for washing the affected area

Its use is prohibited in pregnant women. It cannot be taken over dose, and should be avoided taking together with sour taste food

Ginkgo Leaf Initially recorded in Essentials of Materia (yin xing ye) Medica Distinctions (ben cao pin hui (Folium Ginkgo) jing yao). It is the dried leaf of Ginkgo biloba L. of the Ginkgoaceae family. It is collected when leaf is still green in autumn, and then dried in time

Sweet, bitter, astringent, neutral; act on the heart and lung channels

Invigorate blood and dissolve stasis, unblock the collaterals and relieve pain, astringe the lung and relieve panting, remove turbidity, and reduce blood fat

Indicated for the treatment of pectoral stuffiness pain or precordial pain, windstrike with hemiplegia (half-body paralysis) with a pattern of obstruction of collaterals by blood stasis, cough and panting due to lung deficiency, diarrhea and dysentery, white abnormal vaginal discharge, and high blood fat disease (hyperlipidemia) or high blood pressure. Normally, 9–12 g is decocted with water as an oral dose, or made into pills or powder

Its use is cautious in pregnant women, and prohibited in patients with excess pathogen

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2. Attached herbs (Table 12.2) TABLE 12.2 Introduction to Attached Herbs That Invigorate Blood and Relieve Pain Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chinese Hawthorn Leaf (shan zha ye) (Folium Crataegi)

It is the dried leaf of Crataegus pinnatifida Bge. var. major N. E. Br. or Crataegus pinnatifida Bge. of the Rosaceae family. It is collected in summer and autumn, and then dried in the shade

Sour, neutral; act on the liver channel

Invigorate blood and dissolve stasis, rectify qi and unblock the vessel, remove turbidity, and reduce blood fat

Indicated for the treatment of pectoral stuffiness pain or precordial pain due to qi stagnation and blood stasis, chest oppression and breath-holding, palpitation, and forgetfulness, dizziness and tinnitus, and hyperlipidemia. Normally, 3–10 g is decocted with water as an oral dose, or made into tea for drinking

Its use is cautious in pregnant women

Juncus (deng zhan xi xin) (Herba Erigerontis)

It is the dried entire plant of Erigeron breviscapus (Vant.) Hand.-Mazz. of the Compositae family. It is collected in summer and autumn; after impurities are removed, it is dried under the sun

Acrid, slightly bitter, warm; act on the heart and liver channels

Invigorate blood and unblock the collaterals and relieve pain, dispel wind, and dissipate cold

Indicated for the treatment of wind-strike with hemiplegia (half-body paralysis), precordial pain and pectoral stuffiness pain, painful bì syndrome due to winddamp, headache, and toothache. Normally, 9–15 g is decocted with water as an oral dose, or ground into powder and steamed with egg for eating. Or an appropriate amount is used externally

Its use is cautious in pregnant women

Peach Twig (tao zhi) (Ramulus Persicae)

It is dried branch of Prunus persica (L.) Batsch of the Rosaceae family. It is collected in summer, and then cut into segments, and dried under the sun

Bitter, neutral; act on the heart and liver channels

Invigorate blood and unblock the collaterals, resolve toxins, and kill worms

Indicated for the treatment of stabbing pain in the epigastrium and abdomen, painful bì syndrome due to wind-damp, injury from falling down, and sores and tinea. Normally, 9–15 g is decocted with water as an oral dose. Or an appropriate amount is decocted with water for washing the affected area

Its use is prohibited in pregnant women

Eggplant (qie zi) (Solanum melongena)

It is the fruit of Solanum melongena L. of the Solanaceae family. It is collected when matured in summer and autumn

Sweet, cool; act on the spleen, stomach, and large intestine channels

Clear heat, invigorate blood, relieve pain, and swelling

Indicated for the treatment of intestinal wind (i.e., bloody stool), sores and carbuncles due to heat toxin, and ulcer of skin. Normally, 15–30 g is decocted with water as an oral dose. Or an appropriate amount is pounded for applying the affected area

Don’t eat too much; otherwise pertinacious illness is easy to be evoked

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3. Herb differentiation (Table 12.3)

TABLE 12.3 Differentiation Between Similar Efficacy Herbs That Invigorate Blood and Relieve Pain Name of Medicinal

Similarity

Differences

Nutgrass Galingale Rhizome (xiang fu) (Rhizoma Cyperi)

Both are acrid and bitter in flavor, act on the liver channel, can soothe the liver and resolve constraint, move qi and relieve pain. Both can be used for the treatment of liver constraint and qi stagnation

It is acrid in flavor and fragrant and partial to warm in nature, specializes in qi aspect, and is good at soothing the liver and rectifying qi, regulating menstruation and relieving pain so as to treat pain syndromes or menstrual irregularities due to constraint and stagnation of the liver qi. It is an essential medicinal that can rectify qi in internal medicine and regulate menstruation in gynecology

Turmeric Root Tuber (yu jin) (Radix Curcumae) Common Turmeric Rhizome (jiang huang) (Rhizoma Curcumae Longae) Turmeric Root Tuber (yu jin) (Radix Curcumae)

It is acrid and bitter in flavor and cold in nature, act on both the blood and qi aspects, and is good at invigorating blood and relieving pain, moving qi and resolving constraint so as to treat pain syndromes due to qi stagnation and blood stasis Both are the different medicament portions from the same plant. Both can invigorate blood and dissipate blood stasis, move qi and relieve pain, and are used for the treatment of chest and hypochondrium pain, menstrual block, painful menstruation, concretions and conglomerations (zhēng jia˘ ) with abdominal pain due to qi stagnation and blood stasis

It is the medicinal rhizome, is acrid and warm in nature, and has the effects of moving and dispersing and a strong action of dispelling stasis. It is quite suitable for the treatment of cold congealing and qi stagnation and blood stasis It is the medicinal root tuber, is bitter and cold in nature, has the effects of descending and discharging, and a strong action of moving qi, also can cool the blood, and is best for the treatment of blood stasis and qi stagnation with fever

SECTION 2  HERBS THAT INVIGORATE BLOOD AND REGULATE MENSTRUATION Outline Chinese herbal medicinals that mainly can smooth the blood vessels and regulate menstruation and relieve pain are called “Herbs That Invigorate Blood and Regulate Menstruation.” Most medicinals in this section have the characteristic of acridity-opening and bitterness-discharging, mainly act on the liver channel and blood aspect, have the effects of invigorating blood and dissipating blood stasis, are especially good at smoothing the vessel to regulate menstruation, and mainly used for the treatment of menstrual irregularities, painful menstruation and menstrual block caused by unsmooth blood movement, and postpartum abdominal pain due to blood stasis and stagnation. They are also commonly used for the treatment of pain syndrome due to blood stasis, concretions and conglomerations (lower abdominal masses; zhēng jiă), injury from falling down, swollen sores, and carbuncles. The stasis and stagnation syndromes of female menstruation and childbirth are more related to disorderly liver qi flow, so when using these herbs, doctors often select herbs that soothe the liver and rectify qi to combine.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 12.4)

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TABLE 12.4 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Regulate Menstruation Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Danshen Root (dan shen) (Radix et Rhizoma Salviae Miltiorrhizae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root and rhizome of Salvia miltiorrhiza Bge. of the Lamiaceae family. It is collected in spring and autumn; after sediment is removed, it is dried under the sun

Bitter, slightly cold; act on the heart and liver channels

Invigorate blood and dispel stasis, promote menstruation and relieve pain, clear heart heat and relieve vexation, cool the blood and relieve carbuncle

Indicated for the treatment of menstrual irregularities, menstrual block, painful menstruation, postpartum abdominal pain due to blood stasis, precordial pain and pectoral stuffiness pain, pain in the stomach cavity and abdomen, ribside pain, concretions and conglomerations (zhēng jia˘ ), heat bì syndrome with pain, vexation, insomnia, swollen sores and ulcers. Normally, 10–15 g is decocted with water as an oral dose

Its use is cautious in pregnant women. It should not be used together with Radix et Rhizoma Veratri Nigri (li lu)

Safflower (hong hua) (Flos Carthami)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried flower of Carthamus tinctorius L. of the Compositae family. It is collected when flower turns red from yellow in summer, and then dried in the shade or sun

Acrid, warm; act on the heart and liver channels

Invigorate blood and promote menstruation, dissipate blood stasis, and relieve pain

Indicated for the treatment of menstrual block, dysmenorrhea and postpartum abdominal pain due to blood stasis, concretions and conglomerations (zhēng jia˘) or accumulations and gatherings (jī jù), abdominal mass, chest bì and precordial pain, stabbing pain in the chest and ribside, injury from falling down, swollen sores and ulcers, and dark macules and papules due to blood stasis. Normally, 3–10 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in pregnant women, and cautious in patients with hemorrhagic tendency

Saffron (xi hong hua) (Stigma Croci)

Initially recorded in Essentials of Materia Medica Distinctions (ben cao pin hui jing yao). It is the dried stigma of Crocus sativus L. of the Iridaceae family

Sweet, neutral; act on the heart and liver channels

Invigorate blood and dissolve stasis, cool the blood and resolve toxins, resolve constraint, and calm the mind

Indicated for the treatment of menstrual block, concretions and conglomerations (zhēng jia˘ ), postpartum static blood obstruction, macules caused by pestilential toxin, constraint syndrome, pĭ syndrome and oppression, palpitation, and mania. Normally, 1–3 g is decocted with water as an oral dose or taken infused with boiling water

Its use is prohibited in pregnant women

(Continued )

238 PART | I Chinese Materia Medica

TABLE 12.4 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Regulate Menstruation (cont.)

Source and Collection

Property, Channel Entry

Peach Kernel (tao ren) (Semen Persicae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured seed of Prunus persica (L.) Batsch or Prusua davidiana (Carr.) Franch. of the Rosaceae family. After matured, the fruit is collected; after sarcocarp and hardcore putamen are removed, the seed is taken out, and dried under the sun

Motherwort (yi mu cao) (Herba Leonuri)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the fresh or dried aerial part of Leonurus japonicus Houtt. of the Lamiaceae family. The fresh one is collected during seedling stage in spring to preflower stage in early summer; the dried one is collected when stem and leaf are flourishing, before blooming or early blooming in summer, and then cut into segments and dried under the sun

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Bitter, sweet, neutral, slightly poisonous; act on the heart, liver, and large intestine channels

Invigorate blood and dispel stasis, moisten the intestines to promote defecation, relieve cough and calm panting

Indicated for the treatment of menstrual block, dysmenorrhea, postpartum abdominal pain, concretions and conglomerations (zhēng jia˘ ), and abdominal mass due to static blood obstruction, injury from falling down, lung abscess and intestinal abscess, constipation due to intestinal dryness, cough and panting. Normally, 5–10 g is pounded to pieces and decocted with water as an oral dose

Its use is prohibited in pregnant women, and cautious in patients with loose stool. Due to its toxicity, overdose should be avoided

Bitter, acrid, slightly cold; act on the liver, pericardium, and bladder channels

Invigorate blood and regulate menstruation, promote urination and relieve edema, clear heat and resolve toxins

Indicated for the treatment of menstrual block, dysmenorrhea, inhibited menstruation, postpartum persistent flow of lochia and abdominal pain due to static blood obstruction, edema and scanty urine, injury from falling down, swollen sores and carbuncles, skin urticant eruptions. Normally, 9–30 g is decocted with water as an oral dose, or decocted to paste, or made into pills for oral taking. The fresh one can be used at the dose of 12–40 g

Its use is cautious in pregnant women, and prohibited in patients with yin deficiency and insufficiency of blood or no blood stasis

Caution for Use

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TABLE 12.4 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Regulate Menstruation (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Hirsute Shiny Bugleweed Herb (ze lan) (Herba Lycopi)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried aerial part of Lycopus lucidus Turcz. var. hirtus Regel of the Lamiaceae family. It is collected when stem and leaf are flourishing in summer and autumn, and then dried under the sun

Bitter, acrid, slightly warm; act on the liver and spleen channels

Invigorate blood and regulate menstruation, dispel stasis and relieve carbuncle, promote urination and relieve edema

Indicated for the treatment of menstrual irregularities, menstrual block, dysmenorrhea and postpartum abdominal pain due to static blood obstruction, injury from falling down, pain with blood stasis, swollen sores and carbuncles, edema and ascites. Normally, 6–12 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is cautious in patients with blood deficiency and no blood stasis

Two-toothed Achyranthes Root (niu xi) (Radix Achyranthis Bidentatae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Achyranthes bidentata Bl. of the Amaranthaceae family. It is collected when stem and leaf are withered in winter; after fibrous root and sediment are removed, it is packaged into a wisp and exposed under the sun until kraurosis, then cut in good order, and dried under the sun

Bitter, sweet, sour, neutral; act on the liver and kidney channels

Expel stasis and promote menstruation, supplement the liver and kidney, strengthen the sinew and bone, promote urination and relieve strangury, and guide proper downward flow of blood

Indicated for the treatment of menstrual block, dysmenorrhea, retention of the placenta, postpartum abdominal pain and injury from falling down due to static blood obstruction, soreness and pain of waist and knees, flaccid lower limbs, strangury, edema, difficulty in micturition, headache, dizziness, toothache, sore in mouth and tongue, spitting of blood and nosebleed. Normally, 5–12 g is decocted with water as an oral dose

Its use is prohibited in pregnant women or female with profuse menstruation, and cautious in patients with diarrhea due to spleen deficiency or nocturnal emission due to kidney qi insecurity

(Continued )

240 PART | I Chinese Materia Medica

TABLE 12.4 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Regulate Menstruation (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Cyathula Root (chuan niu xi) (Radix Cyathulae)

Initially recorded in Master Lei’s Explanation of the Properties of Processed Medicinals (lei gong pao zhi yao xing jie). It is the dried root of Cyathula offinalis Kuan of the Amaranthaceae family. It is collected in autumn and winter; after basal part of stem, fibrous root, and sediment are removed, it is baked or dried under the sun until 50% is dry, then piled up to back to moistening, and then baked or dried under the sun

Sweet, slightly bitter, neutral; act on the liver and kidney channels

Expel stasis and promote menstruation, smooth movement of joints, promote urination and relieve strangury

Indicated for the treatment of menstrual block, concretions and conglomerations (zhēng jia˘ ), retention of the placenta, injury from falling down due to static blood obstruction, painful bì syndrome due to wind-damp, pain of waist and knees, flaccid feet with spasms of the sinews, bloody urine and blood strangury. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder or steeped in wine for oral taking

Its use is prohibited in pregnant women or female with profuse menstruation, or male with nocturnal emission or spontaneous seminal emission

Suberect Spatholobus Stem (ji xue teng) (Caulis Spatholobi)

Initially recorded in Supplement to ‘The Grand Compendium of Materia Medica’ (ben cao gang mu shi yi). It is the rattan of Spatholobus suberectus Dunn of the Leguminosae family. It is collected in autumn and winter; after branch and leaf are removed, it is cut into pieces and dried under the sun

Bitter, sweet, warm; act on the liver and kidney channels

Invigorate blood and supplement blood, promote menstruation and relieve pain, relax the sinews, and quicken the collaterals

Indicated for the treatment of menstrual irregularities, dysmenorrhea, and menstrual block due to blood stasis, painful bì syndrome due to winddamp, numbness of hands and feet, paralysis, and withered-yellow complexion due to blood deficiency. Normally, 9–15 g is decocted with water as an oral dose, or steeped in wine, or decocted to paste for oral taking

Its use is cautious in patients with vigorous fire due to yin deficiency

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TABLE 12.4 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Regulate Menstruation (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Cowherb Seed (wang bu liu xing) (Semen Vaccariae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured seed of Vaccaria segetalis (Neck.) Garcke of the Caryophyllaceae family. The plant is collected when fruit is matured and before pericarp is split in summer, and dried under the sun; then the seed is stroked to separate; after impurities are removed, it is dried under the sun again

Bitter, neutral; act on the liver and stomach channels

Invigorate blood and promote menstruation, promote lactation and relieve swelling, promote urination, and relieve strangury

Indicated for the treatment of menstrual block and dysmenorrhea due to blood stasis, difficult delivery, postpartum inhibited lactation, mammary abscess with swelling and pain, swollen carbuncles, heat strangury, blood strangury or stony strangury with difficult and painful urination. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder for oral use. Or an appropriate amount is ground into powder for applying

Its use is cautious in pregnant women, and prohibited in patients with blood loss or flooding and spotting (uterine bleeding)

Chinese Rose Flower (yue ji hua) (Flos Rosae Chinensis)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried flower of Rosa chinensis Jacq. of the Rosaceae family. It is collected when slightly blooming in whole year, and then dried in the shade or lower temperature

Sweet, warm; act on the liver channel

Invigorate blood and regulate menstruation, soothe the liver, and resolve constraint

Indicated for the treatment of menstrual irregularities, dysmenorrhea, and menstrual block, and distending pain in the chest and hypochondrium due to liver constraint and blood stagnation, injury from falling down, pain with blood stasis, swollen carbuncleabscess, and scrofula. Normally, 3–6 g is decocted with water or taken infused or ground into powder as an oral dose. Or an appropriate amount is used externally

Its use is cautious in pregnant women. Its dosage should not be too large. If taking too much or longterm use may cause abdominal pain, loose stool and diarrhea. It should not be decocted for a long time

(Continued )

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TABLE 12.4 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Regulate Menstruation (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Trumpet Creeper Flower (ling xiao hua) (Flos Campsis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried flower of Campsis grandiflora (Thunb.) K. Schum. or Campsis radicans (L.) Seem. of the Bignoniaceae family. It is collected when blooming in summer and autumn, and then dried

Sweet, sour, cold; act on the liver and pericardium channels

Invigorate blood and promote menstruation, cool the blood and dispel wind

Indicated for the treatment of menstrual irregularities, menstrual block, concretions and conglomerations (zhēng jia˘ ) due to blood stasis, injury from falling down, postpartum mammary swelling, redness of rubella, tinea, itch of skin, acne, bloody stool and flooding and spotting (uterine bleeding). Normally, 5–9 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in pregnant women or patients with weakness of qi and blood

Leonurus Fruit (chong wei zi) (Fructus Leonuri)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured fruit of Leonurus japonicus Houtt. of the Lamiaceae family. The aerial part is collected when fruit is matured in autumn, and dried under the sun; then the fruit is stroked to separate, and then impurities are removed

Acrid, bitter, slightly cold; act on the pericardium and liver channels

Invigorate blood and regulate menstruation, clear liver heat and improve vision

Indicated for the treatment of menstrual irregularities, menstrual block, dysmenorrhea, flooding (profuse uterine bleeding), abnormal vaginal discharge, postpartum body pain due to static blood obstruction, red eye with nebula (keratoconjunctivitis), dizziness and head distending pain due to liver heat. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder; or the fresh one is pounded to extract the juice for use

Its use is prohibited in pregnant women or patients with insufficiency of liver blood or mydriasis

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2. Attached herbs (Table 12.5)

TABLE 12.5 Introduction to Attached Herbs That Invigorate Blood and Regulate Menstruation Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Wild Achyranthes Root (tu niu xi) (Radix Achyranthis Sylvestris)

It is the dried root and rhizome of Achyranthes bidentata Blume, Achyranthes aspera L. or Achyranthes aspera L. var. indica L. of the Amaranthaceae family. It is collected between winter and spring or in autumn; after stem, leaf, and fibrous root are removed, it is washed clean and dried under the sun

Sweet, slightly bitter, slightly sour, cold; act on the liver and kidney channels

Invigorate blood and dissipate blood stasis, regulate menstruation, dispel dampness and promote urination, clear heat, and resolve toxins

Indicated for the treatment of menstrual block, injury from falling down, strangury, bloody urine, concretions and conglomerations (zhēng jia˘), joint pain due to wind-damp, edema, dysentery, malaria, diphtheria, and swollen carbuncles. Normally, 9–15 g of the dried one or 30–60 g of the fresh one is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in pregnant women

Interius Kadura Stem (dian ji xue teng) (Caulis Kadsurae Interioris)

It is the dried rattan of Kadsura interior A. C. Smith of the Magnoliaceae family. It is collected in autumn; after branch and leaf are removed, it is cut into pieces and dried under the sun

Bitter, sweet, warm; act on the liver and kidney channels

Invigorate blood and supplement blood, regulate menstruation and relieve pain, relax the sinews, and unblock the collaterals

Indicated for the treatment of menstrual irregularities, painful menstruation, infertility due to deficiency, leucorrhea with red and white discharge, numbness, paralysis, painful bì syndrome due to wind-damp, and syndrome of qi and blood weakness. Normally, 15–30 g is decocted with water as an oral dose

Its use is cautious in pregnant women

Dried Lacquer (gan qi) (Resina Toxicodendri)

It is the dried processed product of resina of Toxicodendron vernicifluum (Stokes) F. A. Barkl. of the Anacardiaceae family. Generally, the lacquer remained in the bottom of the lacquer container is collected, and dried

Acrid, warm, poisonous; act on the liver and spleen channels

Break up stasis and promote menstruation, disperse accumulation, and kill worms

Indicated for the treatment of menstrual block, concretions and conglomerations (zhēng jia˘ ) or accumulations and gatherings (jī jù) due to blood stasis, and abdominal pain due to worm accumulation. Normally, 2–5 g is decocted with water as an oral dose

Its use is prohibited in pregnant women and the allergic person to lacquer

Spikemoss (juan bai) (Herba Selaginellae)

It is the dried entire plant of Selaginella tamariscina (Beauv.) Spring or Selaginella pulvinata (Hook. et Grev.) Maxim. of the Selaginellaceae family. It is collected in whole year; after fibrous root and sediment are removed, it is dried under the sun

Acrid, neutral; act on the liver and heart channels

Invigorate blood and promote menstruation

Indicated for the treatment of menstrual block, painful menstruation, pĭ syndrome, concretions and conglomerations (zhēng jia˘ ), and injury from falling down. Normally, 5–10 g is decocted with water as an oral dose. The charred one can dissolve stasis and stanch bleeding, and is used for the treatment of spitting of blood, flooding and spotting (uterine bleeding), bloody stool, and anal prolapse

Its use is cautious in pregnant women

Common Sinopodophyllum Fruit (xiao ye lian) (Fructus Podophylli)

It is the dried matured fruit of Sinopodophyllum hexandrum (Royle) Ying of the Berberidaceae family. It is a habitually used medicinal in Tibetan nationality, collected when matured in autumn; after impurities are removed, it is dried

Sweet, neutral, and slightly poisonous

Regulate menstruation and invigorate blood

Indicated for the treatment of menstrual block due to blood stasis, difficult delivery, retention of dead fetus, or retention of the placenta. Normally, 3–9 g is made into pills or powder as an oral dose

Overdose may cause vomiting, respiratory stimulation, abnormal involuntary movements and coma

(Continued )

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TABLE 12.5 Introduction to Attached Herbs That Invigorate Blood and Regulate Menstruation (cont.) Name of Medicinal Fennel Flower Seed (hei zhong cao zi) (Semen Nigellae)

Source and Collection It is the dried matured seed of Nigella glandulifera Freyn et Sint. of the Ranunculaceae family. It is a habitually used medicinal in Uygur nationality. The plant is collected when fruit is matured in summer and autumn, and then dried under the sun; the seed is separated; after impurities are removed, the seed is dried under the sun

Property, Channel Entry Sweet, acrid, and warm

Efficacy and Action Supplement the kidney and fortify the brain, promote menstruation and lactation, and promote urination

Clinical Application and Usage

Caution for Use

Indicated for the treatment of tinnitus and forgetfulness, menstrual block, reduced or absent lactation, heat strangury, and stony strangury. Normally, 2–6 g is decocted with water as an oral dose

Its use is prohibited in pregnant women and patients suffering from pathogenic heat

3. Herb differentiation (Table 12.6)

TABLE 12.6 Differentiation Between Similar Efficacy Herbs That Invigorate Blood and Regulate Menstruation Name of Medicinal

Similarity

Differences

Peach Kernel (tao ren) (Semen Persicae)

Both can invigorate blood and promote menstruation, dispel stasis, and relieve pain, are used for the treatment of menstrual block, dysmenorrhea due to stagnation of blood stasis, injury with pain from falling down. Both are the commonly used medicinals for regulating menstruation and relieving trauma pain

It is bitter and sweet in flavor and neutral in nature. Its effect of breaking up stasis is stronger than that of Flos Carthami (hong hua). It is good at dispersing internal abscess, such as lung abscess with chest pain and pyemesis, intestinal abscess with abdominal pain, and also can moisten the intestines to promote defecation, relieve cough and calm panting, and used for the treatment of constipation due to intestinal dryness, cough and panting

Both can invigorate blood and promote menstruation, and treat menstrual block, dysmenorrhea, inhibited menstrual flow, menstrual irregularities, postpartum abdominal pain and retention of lochia due to blood stasis, and injury from falling down

It is an essential medicinal for the treatment of gynecological blood stasis syndromes about menstruation and childbirth. It is slightly cold in nature, so especially suited to treat patients with a pattern of blood heat and blood stasis

Both names are similar in Chinese, have the effects of promoting urination and relieving edema, and can be used for the treatment of edema and difficulty in micturition

It is bitter and acrid and slightly warm. Its efficacy of promoting urination and relieving edema is less than that of Rhizoma Alismatis (ze xie). It is good at invigorating blood and dissolving stasis to regulate menstruation, and mainly indicated for the treatment of menstrual block, dysmenorrhea due to blood stasis, and postpartum abdominal pain due to blood stasis

Safflower (hong hua) (Flos Carthami)

Motherwort (yi mu cao) (Herba Leonuri) Sichuan Lovage Root (chuan xiong) (Rhizoma Chuanxiong)

Hirsute Shiny Bugleweed Herb (ze lan) (Herba Lycopi) Water Plantain Rhizome (ze xie) (Rhizoma Alismatis)

Its pungent taste has dispersing effect and warm property has unblocking effect, so the effects of invigorating blood and promoting menstruation, dispelling stasis, and relieving pain are strong. It can be used for the treatment of dark macules and papules due to heat constraint and blood stagnation

It can both invigorate blood and move qi, also is a herb that moves qi, so mainly used for the treatment of various pain caused by qi stagnation and blood stasis

It is sweet, bland, and cold, and good at promoting urination and percolating dampness, and used for the treatment of edema and difficulty in micturition, also can discharge heat, and especially specializes in discharging kidney heat and bladder heat so as to treat damp-heat in the lower jiao

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TABLE 12.6 Differentiation Between Similar Efficacy Herbs That Invigorate Blood and Regulate Menstruation (cont.) Name of Medicinal

Similarity

Differences

Hirsute Shiny Bugleweed Herb (ze lan) (Herba Lycopi)

Both can invigorate blood and regulate menstruation, promote urination and relieve edema, and treat menstrual block, dysmenorrhea, and postpartum blood stasis syndromes

It is slightly warm and moderate in nature, can soothe the liver and harmonize the nutrient aspect, invigorate blood and regulate menstruation, so is more suited to treat syndromes of stagnation of blood stasis about menstruation and childbirth complicated by liver constraint pattern, and also can treat postpartum edema and difficulty in micturition

Both have the effects of invigorating blood and promoting menstruation, and can treat menstrual block, dysmenorrhea, menstrual irregularities, and postpartum abdominal pain with a pattern of stagnation of blood stasis, or injury from falling down

It is bitter, sweet, and sour in flavor and neutral in nature, partial to invigorating blood and promoting menstruation, and often used for the treatment of blood stasis syndromes in gynecology. It also can supplement the liver and kidney, strengthen the sinew and bone, promote urination and relieve strangury, and ensure proper downward flow of blood or fire, and can treat low back pain due to kidney deficiency, soreness and pain of waist and knees, strangury, edema and difficulty in micturition, or headache and dizziness, spitting of blood and nosebleed due to yin deficiency with yang hyperactivity

Motherwort (yi mu cao) (Herba Leonuri) Two-toothed Achyranthes Root (niu xi) (Radix Achyranthis Bidentatae)

Common Turmeric Rhizome (jiang huang) (Rhizoma Curcumae Longae)

Cyathula Root (chuan niu xi) (Radix Cyathulae)

Two-toothed Achyranthes Root (niu xi) (Radix Achyranthis Bidentatae) Wild Achyranthes Root (tu niu xi) (Radix Achyranthis Sylvestris) Raw Two-toothed Achyranthes Root (sheng niu xi)

Wine-fried Two-toothed Achyranthes Root (jiu niu xi) Salt-fried Two-toothed Achyranthes Root (yan niu xi)

It is partial to cold in nature, and better for the treatment of heat binding blood stasis. Its efficacy of promoting urination is stronger than that of Herba Lycopi (ze lan), so it is extensively used for edema disease

Its acrid taste has dispersing effect, bitter taste has discharging effect and warm property has unblocking effect. It can invigorate blood and dispel stasis, move qi, and relieve pain, and is often used for the treatment of pain in the chest, hypochondrium, stomach cavity, and abdomen, menstrual block, dysmenorrhea, menstrual irregularities, concretions and conglomerations (zhēng jia˘ ) or accumulations and gatherings (jī jù) caused by qi stagnation and blood stasis. It also specializes in invigorating blood to relieve painful bì syndrome so as to treat bì syndrome with shoulder and arm pain due to wind-cold All three medicinals are the roots of different Amaranthaceae plants. They are sweet and bitter in flavor, can expel blood stasis and regulate menstruation, promote urination and relieve strangury, and are often used for the treatment of menstrual block and dysmenorrhea due to blood stasis, strangury, and edema.

It is the root of Cyathula offinalis Kuan, and good at guiding proper downward flow of blood, invigorating blood and promoting menstruation, smoothing joint movement, relieving swelling and pain, and more used for the treatment of menstrual irregularities, abdominal pain due to blood stasis, difficult labor, retention of placenta and injury from falling down

All three medicinals are the different processed products of root of Achyranthes bidentata Bl. of the Amaranthaceae family. They all can invigorate blood and regulate menstruation, promote urination and relieve strangury in different degrees

The raw one is good at invigorating blood and promoting menstruation, ensuring proper downward flow of fire or blood, and more used for the treatment of menstrual irregularities, menstrual block, dysmenorrhea and retention of placenta caused by stagnation of blood stasis, and postpartum abdominal pain, or toothache, oral ulcer, headache and dizziness due to yin deficiency with yang hyperactivity

It is the root of Achyranthes bidentata Bl., and good at supplementing the liver and kidney, and strengthening the sinew and bone, and more used for the treatment of soreness and weakness of waist and knees due to insufficiency of the liver and kidney, or long-term painful bì syndrome due to wind-damp, accompanied by deficiency of both the liver and kidney It is the root of Achyranthes bidentata Blume, Achyranthes aspera L. or Achyranthes aspera L. var. indica L., and good at clearing heat and draining fire and resolving toxins, relieving strangury and promoting urination, and more used for the treatment of swelling and pain of the throat, sore in mouth and tongue, strangury, bloody urine, and carbuncle-abscess

After Radix Achyranthis Bidentatae (niu xi) is stir-fried with wine, its effects of invigorating blood and dispelling stasis, promoting menstruation and relieving pain are reinforced, so it is more used for the treatment of painful bì syndrome due to wind-damp, accompanied by inconvenient limb movement After Radix Achyranthis Bidentatae (niu xi) is processed with salt-water, it can guide the effects of other herbs to kidney channel and strengthen the effects of supplementing the liver and kidney, strengthening the sinews and bones, promoting urination and relieving strangury, and is more used for the treatment of low back pain due to kidney deficiency, and joint pain with a pattern of damp-heat pouring downward

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SECTION 3  HERBS THAT INVIGORATE BLOOD AND CURE INJURY Outline Chinese herbal medicinals that mainly can invigorate blood to cure injury and mainly treat diseases from department of fractures and wounds are called “Herbs That Invigorate Blood and Cure Injury.” Medicinals in this section are more acrid, bitter, and salty in flavor, act on the liver and kidney channels, are good at invigorating blood and dissolving stasis, relieving swelling and pain, promoting reunion of tendon and bone, stanching bleeding, engendering flesh and closing sore, and mainly used for the treatment of injury from falling down, swelling and pain due to blood stasis, fracture and injury of tendon and muscle, and incised wound with bleeding. They also can be used for other common syndrome of blood stasis. The diseases and syndromes about fracture and tendon injury are more related to liver and kidney, so when using these medicinals, doctors should select herbs that supplement the liver and kidney and strengthen the sinew and bone to combine in order to promote the healing or recovery of fracture or trauma.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 12.7)

TABLE 12.7 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Cure Injury Name of Medicinal Ground Beetle (tu bie chong) (Eupolyphaga seu Steleophaga)

Source and Collection Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried female body of Eupolyphaga Sinesis Walker or Steleophaga plancyi (Boleny) of the Corydiidae family. It is caught and scalded to death with boiling water, then dried under the sun or by baking

Property, Channel Entry Salty, cold, slightly poisonous; act on the liver channel

Efficacy and Action

Clinical Application and Usage

Caution for Use

Break up blood and expel stasis, and promote reunion of tendon and bone

Indicated for the treatment of injury from falling down, injury of tendon and muscle, bone fracture, menstrual block due to blood stasis, postpartum abdominal pain, concretions and conglomerations (zhēng jia˘) or abdominal mass due to static blood obstruction. Normally, 3–10 g is decocted with water as an oral dose, or 1–1.5 g is ground into powder and taken with yellow rice wine. Or an appropriate amount is used externally

Its use is prohibited in pregnant women

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TABLE 12.7 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Cure Injury (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Nux Vomica Seed (ma qian zi) (Semen Strychni)

Initially recorded in The Grand Compendium of Materia Medica (ben cao gang mu). It is the dried matured seed of Strychnos nux-vomica L. of the Loganiaceae family. The matured fruit is collected in winter; then seed is taken out, dried under the sun, and then processed for use

Bitter, warm, extremely poisonous; act on the liver and spleen channels

Unblock the collaterals and relieve pain, dissipate masses, and relieve swelling

Indicated for the treatment of injury from falling down, bone fracture with swelling and pain, obstinate painful bì syndrome due to winddamp, spasms with pain, numbness and paralysis, swollen carbuncleabscess and sores, and swelling and pain of the throat; and also for the treatment of facial nerve palsy or myasthenia gravis. Normally, 0.3–0.6 g is processed first and then made into pills or powder as an oral dose. Or an appropriate amount is ground into powder for applying the affected area

Its use is prohibited in the weak and pregnant women, and cautious in athletes. It is not suitable for large area application because its poisonous ingredients can be absorbed by skin. The raw one is not suitable for overdose or long-term use

Pyrite (zi ran tong) (Pyritum)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the natural pyrite of the Pyrite family of the sulfides minerals. It mainly contains iron disulfide (FeS2). It is collected and then the mixed stone is removed

Acrid, neutral; act on the liver channel

Dissipate stasis and relieve pain, and promote reunion of tendon and bone

Indicated for the treatment of injury from falling down, fracture of bone and injury of tendon, and pain with blood stasis. Normally, 10–15 g is decocted first with water as an oral dose. But it is often made into pills or powder, or quenched with vinegar and ground into powder for oral taking with 0.3 g each time. Or an appropriate amount is ground into powder for applying the affected area

It is not suitable for oral taking for a long time, and its use is also cautious in patients with blood deficiency and no blood stasis, or vigorous fire due to yin deficiency

(Continued )

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TABLE 12.7 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Cure Injury (cont.)

Source and Collection

Property, Channel Entry

Sappan Wood (su mu) (Lignum Sappan)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried heart wood of Caesalpinia sappan L. of the Leguminosae family. It is usually collected in autumn; after white sapwood is removed, it is dried

Drynaria Rhizome (gu sui bu) (Rhizoma Drynariae)

Initially recorded in Treatise on Medicinal Properties (yao xing lun). It is the dried rhizome of Drynaria fortunei (Kunze) J. Sm. of the Polypodiaceae family. It is collected in whole year; after sediment is removed, it is dried (or then fuzz is singed)

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sweet, salty, neutral; act on the heart, liver, and spleen channels

Invigorate blood and dispel stasis, relieve swelling and pain, and promote menstruation

Indicated for the treatment of injury from falling down, fracture of bone and injury of tendon, pain with blood stasis, menstrual block and dysmenorrhea and postpartum abdominal pain due to static blood obstruction, stabbing pain in the chest and abdomen, swollen carbuncles and sores with pain. Normally, 3–9 g is decocted with water as an oral dose, or ground into powder for taking orally. Or an appropriate amount is used externally

Its use is prohibited in pregnant women or female with profuse menstruation or patients with blood deficiency and no blood stasis

Bitter, warm; act on the liver and kidney channels

Cure the injury and relieve pain, supplement the kidney and strengthen the bone; external treatment: disperse wind and dispel macula

Indicated for the treatment of injury from falling down or trauma, sudden sprain and contusion, fracture of bone and injury of tendon, pain with blood stasis, low back pain and weak foot due to kidney deficiency, flaccid sinews and bones, tinnitus and deafness, and looseness of teeth; also for the external treatment of alopecia areata and vitiligo. Normally, 3–9 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is cautious in patients with vigorous fire due to yin deficiency, or blood deficiency and wind-dryness

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249

TABLE 12.7 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Cure Injury (cont.)

Source and Collection

Property, Channel Entry

Dragon’s Blood (xue jie) (Sanguis Draconis)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the processed resina effused from fruit of Daemonorops draco Bl. of the Trachycarpaceae family

Black Cutch (er cha) (Catechu)

Initially recorded in Principles of Correct Diet (yin shan zheng yao). It is the dried soft extract of the decorticated branch and trunk of Acacia catechu (L. f.) Willd. of the Leguminosae family. The branch and trunk are collected in winter; after outer bark is removed, they are cut into hunk, decocted with water, then concentrated and dried

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sweet, salty, neutral; act on the heart and liver channels

Invigorate blood and relieve pain, dissolve stasis and stanch bleeding, engender flesh and close sore

Indicated for the treatment of injury from falling down, pain in the epigastrium and abdomen due to blood stasis, bleeding from external injury, and sores and ulcers without being astringed. Normally, 1–2 g is ground into powder or made into pills as an oral dose. Or an appropriate amount is ground into powder for applying or made into plaster for external use

Its use is prohibited in pregnant women and female patients during the periods of menstruation, and it is not suitable for patients without blood stasis

Bitter, astringent, slightly cold; act on the lung and heart channels

Invigorate blood and relieve pain, stanch bleeding and engender flesh, eliminate dampness and close sore, clear lung heat, and dissolve phlegm

Indicated for the treatment of injury from falling down, bleeding from external injury, spitting of blood and nosebleed, sores and ulcers without being astringed, eczema, ulcerative gingivitis, chancre, hemorrhoids, and cough due to lung heat. Normally, 1–3 g is wrapped first and decocted with water as an oral dose. But it is often made into pills or powder for oral taking. Or an appropriate amount is used externally

Its use is cautious in pregnant women

(Continued )

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TABLE 12.7 Properties, Actions, and Application of Common Herbs That Invigorate Blood and Cure Injury (cont.) Name of Medicinal Artemisia (liu ji nu) (Herba Artemisiae Anomalae)

Property, Channel Entry

Source and Collection Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried entire plant of Artemisia anomala S. Moore of the Compositae family. The aerial part is collected during August to September; after earth is removed, it is dried under the sun and cut into segments for use

Bitter, warm; act on the heart, liver and spleen channels

Efficacy and Action

Clinical Application and Usage

Caution for Use

Dissipate stasis and relieve pain, cure the injury and stanch bleeding, break up blood and promote menstruation, promote digestion and remove accumulation

Indicated for the treatment of injury from falling down, swelling and pain and bleeding, menstrual block and postpartum abdominal pain due to blood stasis, or abdominal pain due to food accumulation, and dysentery with red and white feces. Normally, 3–10 g is decocted with water as an oral dose. Or an appropriate amount of the dried one is ground into powder for spreading, or an appropriate amount of the fresh one is pounded for applying the affected area externally

Its use is cautious in pregnant women, and it is not suitable for patients with weakness of qi and blood, or diarrhea due to spleen deficiency

2. Attached herbs (Table 12.8) TABLE 12.8 Introduction to Attached Herbs That Invigorate Blood and Cure Injury

Source and Collection

Property, Channel Entry

Artemisiae Anomale (bei liu ji nu) (Herba Siphonostegiae)

It is the dried entire plant of Siphonostegia chinensis Benth. of the Scrophulariaceae family. It is collected in autumn; after impurities are removed, it is dried under the sun

Bitter, cold; act on the spleen, stomach, liver, and gallbladder channels

Invigorate blood and dispel stasis, promote menstruation and relieve pain, cool the blood and stanch bleeding, clear heat and drain dampness

Indicated for the treatment of injury from falling down, bleeding from external injury, menstrual block due to blood stasis, menstrual irregularities, postpartum abdominal pain due to blood stasis, concretions and conglomerations (zhēng jia˘) or accumulations and gatherings (jī jù), red dysentery, blood strangury, jaundice due to damp-heat, edema, and leukorrhagia. Normally, 6–9 g is decocted with water for oral use. Or an appropriate amount is used externally

Its use is cautious in pregnant women

Cissampelos (ya hu nu) (Herba Cissampelotis)

It is the dried whole plant of Cissampelos pareira (Buch. ex DC.) Forman of the Menispermaceae family. It is a habitually used medicinal in Dai nationality, collected in spring or summer; after sediment is removed, it is dried under the sun

Sweet, bitter, warm; act on the liver and spleen channels

Relieve swelling, relieve pain, stanch bleeding, and engender flesh

Indicated for the treatment of external injury with swelling and pain, bleeding from crush injury and wound, low back pain, and pain from rheumatism. Normally, 9–15 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder for applying the affected area. Now, its extract cissampeline is as the muscle relaxant for operative anesthesia

Its use is prohibited in patients with myasthenia gravis (MG)

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Caution for Use

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TABLE 12.8 Introduction to Attached Herbs That Invigorate Blood and Cure Injury (cont.) Name of Medicinal Nux Vomica Powder (ma qian zi fen) (Semen Strychni Pulveratum)

Source and Collection It is the processed product of matured seed of Strychnos nux-vomica L. of the Loganiaceae family. The seed is crushed into fine powder; after its strychnine is assayed, the starch is added in order to in line with regulation, and then it is mixed evenly

Property, Channel Entry Bitter, warm, extremely poisonous; act on the liver and spleen channels

Efficacy and Action Unblock the collaterals and relieve pain, dissipate masses, and relieve swelling

Clinical Application and Usage Indicated for the treatment of injury from falling down, bone fracture with swelling and pain, obstinate bì syndrome due to wind-damp, numbness and paralysis, carbuncleabscess and sores, and swelling and pain of the throat. Normally, 0.3–0.6 g is made into pills or powder as an oral dose

Caution for Use Its use is prohibited in the weak and pregnant women, and it is not suitable for overdose or long-term use or large area application, and cautious in athletes

3. Herb differentiation (Table 12.9) TABLE 12.9 Differentiation between Similar Efficacy Herbs That Invigorate Blood and Cure Injury Name of Medicinal

Similarity

Differences

Sappan Wood (su mu) (Lignum Sappan)

Both have the effects of invigorating blood and curing injury, and can be used for the treatment of injury from falling down, swelling and pain due to blood stasis

It also can invigorate blood and dispel stasis and promote menstruation, and is indicated for the treatment of menstrual block and dysmenorrhea due to blood stasis, postpartum abdominal pain due to blood stasis, pain in the epigastrium and abdomen due to blood stasis, swollen carbuncles and sores

Drynaria Rhizome (gu sui bu) (Rhizoma Drynariae)

Ground Beetle (tu bie chong) (Eupolyphaga seu Steleophaga) Pyrite (zi ran tong) (Pyritum)

It also can promote reunion of tendon and bone, supplement the kidney and strengthen the bone, and is mainly used for the treatment of injury from falling down, sudden sprain and contusion, incised wound, injury of tendon and bone, and can also treat low back pain and weak foot, tinnitus and deafness, toothache and chronic diarrhea due to kidney deficiency Both have the effects of invigorating blood and dispelling stasis, promoting reunion of tendon and bone, and are often used for the treatment of injury from falling down, tendon injury, and bone fracture, and pain with blood stasis. Both are the commonly-used medicinals for fractures and wounds

It is good at breaking up blood and expelling stasis, often used for the treatment of menstrual block due to blood stasis, postpartum abdominal pain, concretions and conglomerations (zhēng jia˘ ) or accumulations and gatherings (jī jù) with a pattern of severe blood stasis It is partial to dissipating blood stasis and relieving pain, promoting reunion of bone and curing injury, and mainly used for the treatment of injury from falling down, bone fracture, and tendon broken, and pain with blood stasis

SECTION 4  HERBS THAT BREAK UP BLOOD STASIS AND RESOLVE MASSES Outline Chinese herbal medicinals that are drastic in nature and can break up stasis and expel stasis are called “Herbs That Break Up Blood Stasis and Resolve Masses.” Medicinals in this section are more acrid with bitter and salty in flavor, and act on the liver channel. Majorities are vermin and their properties are drastic. They can break up stagnant blood and expel static blood, disperse concretions (zhēng), and dissipate accumulations (jī). They are mainly used for the treatment of severe concretions and conglomerations (zhēng jiă) or accumulations and gatherings (jī jù) due to a long-term blood stasis. They also can be used for the treatment of menstrual block due to blood stasis, swelling, pain, and hemiplegia (half-body paralysis) due to blood stasis. When using these medicinals in this section, doctors often combine herbs that move qi to strengthen the efficacy of breaking up blood stasis and resolving masses, or combine herbs that drain downward to reinforce the efficacy

252 PART | I Chinese Materia Medica

of purging and expelling stagnant blood. Most medicinals in this section are poisonous and easy to consume qi and cause bleeding and damage yin, so their application should be cautious or prohibited in patients with bleeding syndromes, yinblood (blood and body fluids) depletion, qi deficiency and weak body, and pregnant women.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 12.10)

TABLE 12.10 Properties, Actions, and Application of Common Herbs That Break up Blood Stasis and Resolve Masses Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Common Burr Reed Tuber (san leng) (Rhizoma Sparganii)

Initially recorded in Supplement to “The Materia Medica” (ben cao shi yi). It is the dried tuber of Sparganiuum stoloniferum Buch.-Ham. of the Sparaganiaceae family. It is collected during winter to the next spring, and then washed clean; after outer bark is shaved, it is dried under the sun

Acrid, bitter, neutral; act on the liver and spleen channels

Break up blood and move qi, disperse accumulation and relieve pain

Indicated for the treatment of concretions and conglomerations (zhēng jia˘ ), abdominal mass, dysmenorrhea, menstrual block and postpartum abdominal pain due to blood stasis, pectoral stuffiness pain and precordial pain, distending pain due to food accumulation, injury from falling down, and swollen and hard sores. Normally, 5–10 g is decocted with water as an oral dose

Its use is prohibited in pregnant women or patients with profuse menstruation, and not suited to use together with Natrii Sulfas (mang xiao) or Natrii Sulfas Exsiccatus (xuan ming fen)

Zedoary Rhizome (e zhu)(Rhizoma Curcumae)

Initially recorded in Treatise on Medicinal Properties (yao xing lun). It is the dried rhizome of Curcuma phaeocaulis Val., Curcuma kwangsiensis S. G. Lee et C. F. Liang or Curcuma wenyujin Y. H. Chen et C. Ling of the Zingiberaceae family. When stem and leaf are withered in winter, it is collected and washed clean, fully steamed or decocted to the heart, dried under the sun or at low temperature, then fibrous root and impurities are removed

Acrid, bitter, warm; act on the liver and spleen channels

Move qi and break up blood, disperse accumulation, and relieve pain

Indicated for the treatment of concretions and conglomerations (zhēng jia˘ ) or accumulations and gatherings (jī jù), abdominal mass, menstrual block due to blood stasis, pectoral stuffiness pain and precordial pain, abdominal pain due to blood stasis, or distending pain in the stomach cavity and abdomen due to food accumulation, injury from falling down, and pain with blood stasis. Normally, 6–9 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in pregnant women or patients with profuse menstruation

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TABLE 12.10 Properties, Actions, and Application of Common Herbs That Break up Blood Stasis and Resolve Masses (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Leech (shui zhi) (Hirudo)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried entire body of Whitmania pigra Whitman, Hirudo nipponica Whitman or Whitmania acranulata Whitman of the Hirudinidae family. It is caught in summer and autumn, and scalded to death with boiling water, then dried under the sun or at low temperature

Salty, bitter, neutral, slightly poisonous; act on the liver channel

Break up blood and promote menstruation, expel stasis and disperse concretions (zhēng)

Indicated for the treatment of menstrual block due to blood stasis, concretions and conglomerations (zhēng jia˘ ), abdominal mass, pain in the epigastrium and abdomen, windstrike with paralysis, and injury from falling down. Normally, 1–3 g is decocted with water or 0.3–0.5 g is ground into powder as an oral dose. But being made into pills or powder for oral taking is quite advisable

Its use is prohibited in pregnant women or patients with profuse menstruation or hemorrhagic tendency

Gradfly (meng chong) (Tabanus)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried female body of Tabanus bivittatus Matsumura of the Tabanidae family. It is caught during May to June, scalded with boiling water or slightly steamed, and dried under the sun; after wing and foot are removed, it is slightly dry-fried for use

Bitter, slightly cold, slightly poisonous; act on the liver channel

Break up blood and expel stasis, dissipate accumulations (jī) and disperse concretions (zhēng)

Indicated for the treatment of menstrual block due to blood stasis, blood-retention in the lower abdomen, retention of lochia after childbirth, concretions and conglomerations (zhēng jia˘ ) or accumulations and gatherings (jī jù), injury from falling down, pain with blood stasis, or emaciation due to chronic blood stasis. Normally, 1–1.5 g is decocted with water or 0.3 g is ground into powder as an oral dose

Its use is prohibited in pregnant women, the weak without blood stasis, or patients with diarrhea

(Continued )

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TABLE 12.10 Properties, Actions, and Application of Common Herbs That Break up Blood Stasis and Resolve Masses (cont.)

Source and Collection

Property, Channel Entry

Cantharis (ban mao) (Mylabris)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried body of Mylabris phalerata Pallas or Mylabris cichorii Linnaeus of the Meloidae family. It is caught in summer and autumn, and then suffocated or scalded to death, and dried under the sun

Pangolin Scales (chuan shan jia) (Squama Manitis)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried scale of Manis pentadactylayla Linnaeus of the Manidae family. It is collected and then washed clean and dried under the sun

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Acrid, hot, extremely poisonous; act on the liver, stomach, and kidney channels

Break up blood and expel stasis, dissipate masses and disperse concretions (zhēng), eliminate toxins and erode sore

Indicated for the treatment of concretions and conglomerations (zhēng jia˘ ), menstrual block, stubborn dermatitis, scrofula, cutaneous tubercle, carbuncle-abscess, and ulcers with necrotic flesh. Normally, 0.03–0.06 g is processed and made into pills or powder as an oral dose. Or an appropriate amount is ground into powder or steeped in wine or vinegar for applying the affected area

It is not suitable for large area application. Due to its strong toxicity, its use should be cautious for oral taking, and prohibited in pregnant women

Salty, slightly cold; act on the liver and stomach channels

Invigorate blood and disperse concretions (zhēng), promote menstruation and lactation, relieve swelling and evacuate pus, remove wind and unblock the collaterals

Indicated for the treatment of menstrual block, concretions and conglomerations (zhēng jia˘ ), postpartum inhibited lactation, swollen carbuncles and sores, scrofula, painful bì syndrome due to wind-damp, wind-strike with paralysis, numbness and spasm. Normally, 5–10 g is decocted with water as an oral dose, or ground into powder for swallowing intact with 1–1.5 g each time

Its use is cautious in pregnant women, and prohibited in patients with ulcerated carbuncles

Caution for Use

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TABLE 12.10 Properties, Actions, and Application of Common Herbs That Break up Blood Stasis and Resolve Masses (cont.) Name of Medicinal Euonymi Twig (gui jian yu) (Ramulus Euonymi)

Property, Channel Entry

Source and Collection Initially recorded in Ri Hua-zi’s Materia Medica (ri hua zi ben cao). It is the dried aliform branch or appendix of Euonymus alatus (Thunb.) Sieb. of the Celastraceae family. The branch is collected in whole year; after twig and leaf is removed, it dried under the sun; or aliform appendix is collected and dried under the sun

Bitter, acrid, cold; act on the liver and spleen channels

Efficacy and Action

Clinical Application and Usage

Break up blood and promote menstruation, resolve toxins and relieve swelling, and kill worms

Indicated for the treatment of concretions and conglomerations (zhēng jia˘ ), pain in the epigastrium and abdomen, menstrual block, dysmenorrhea, flooding and spotting (uterine bleeding), postpartum abdominal pain due to blood stasis, retention of lochia, or painful bì syndrome, swollen sores, injury from falling down, or abdominal pain due to worm accumulation syndrome, scald and burn. Normally, 4–9 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Caution for Use Its use is prohibited in pregnant women or patients with flooding and spotting (uterine bleeding) due to qi deficiency

2. Attached herbs (Table 12.11)

TABLE 12.11 Introduction to Attached Herbs That Break-Up Blood Stasis and Resolve Masses Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Princes-feather Fruit (shui hong hua zi) (Fructus Polygoni Orientalis)

It is the dried matured fruit of Polygonum orientale L. of the Polygonaceae family. The fruit cluster is collected when fruit is matured in autumn, and dried under the sun; then the fruit is stroked to separate, and impurities are removed

Salty, slightly cold; act on the liver and stomach channels

Dissipate blood stasis and disperse accumulation, relieve pain, promote urination, and relieve edema

Indicated for the treatment of concretions and conglomerations (zhēng jia˘ ), abdominal mass, goiter, food accumulation and indigestion, distending pain in the stomach cavity, edema and ascites. Normally, 15–30 g is decocted with water as an oral dose. Or an appropriate amount is decocted to a paste for applying the affected area

Its use is cautious in patients with deficiency-cold of the spleen and stomach or no blood stasis

Garden Balsam Seed (ji xing zi) (Semen Impatientis)

It is the dried matured seed of Impatiens balsamina L. of the Balsaminaceae family. It is collected when fruit is ready to mature in summer and autumn, and dried under the sun, then pericarp and impurities are removed

Slightly bitter, acrid, warm, slightly poisonous; act on the lung and liver channels

Break up blood, soften hard masses and disperse accumulation

Indicated for the treatment of concretions and conglomerations (zhēng jia˘ ), pĭ syndrome (abdominal mass), menstrual block, and dysphagia. Normally, 3–5 g is decocted with water as an oral dose

Its use is cautious in pregnant women

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3. Herb differentiation (Table 12.12)

TABLE 12.12 Differentiation Between Similar Efficacy Herbs That Break-Up Blood Stasis and Resolve Masses Name of Medicinal

Similarity

Differences

Zedoary Rhizome (e zhu) (Rhizoma Curcumae)

Both have the effects of breaking up blood and moving qi, dispersing accumulation, and relieving pain, and can be used for the treatment of concretions and conglomerations (zhēng jia˘ ) or accumulations and gatherings (jī jù), and menstrual block caused by qi stagnation and blood stasis, pain in the epigastrium and abdomen due to blood stasis, distending pain in the stomach cavity and abdomen due to food accumulation and qi stagnation, injury from falling down, and other pain and swelling due to blood stasis. If processed with vinegar, effect of relieving pain will be strengthened

Its acrid taste has dispersing effect and warm property has unblocking effect; its effect of breaking stagnant qi is strong; and it is partial to breaking stagnant qi and dispersing accumulation

Common Burr Reed Tuber (san leng) (Rhizoma Sparganii)

It is neutral in nature, and its bitter taste has discharging effect; its effect of breaking up blood is strong; and it is partial to breaking up blood and dispelling stasis

Chapter 13

Herbs That Dissolve Phlegm, Relieve Cough, and Calm Panting Chapter Outline Section 1  Herbs That Warm and Dissolve Cold-phlegm Outline Specific Application Knowledge of Herbs Section 2  Herbs That Clear and Dissolve Hot Phlegm Outline Specific Application Knowledge of Herbs

258 258 258 266 266 266

Section 3  Herbs That Relieve Cough and Calm Panting Outline Specific Application Knowledge of Herbs

281 281 281

ABSTRACT Chinese herbal medicinals that can dispel phlegm or disperse phlegm and mainly treat phlegm syndrome are called “Herbs that Dissolve Phlegm”; and that mainly can stop or relieve cough and panting are called “Herbs that Relieve Cough and Calm Panting.” Herbs that dissolve phlegm are indicated for the treatment of syndromes related to phlegm. Herbs that relieve cough and calm panting are used for the treatment of coughing and gasping for breathing caused by external contraction or internal damage. Herbs that dissolve phlegm, relieve cough, and calm panting can be divided into three categories: herbs that warm and dissolve cold-phlegm, herbs that clear and dissolve hotphlegm, and herbs that relieve cough and calm panting. Keywords: herbs that dissolve phlegm; relieve cough and calm panting; herbs that warm and dissolve cold-phlegm; herbs that clear and dissolve hot phlegm; herbs that relieve cough and calm panting; dry dampness and dissolve phlegm; warm the lung and dissolve phlegm; direct qi downward and dissolve phlegm; clear heat and dissolve phlegm; moisten the lung and relieve cough; direct qi downward and dissolve phlegm; relieve cough and calm panting

Chinese herbal medicinals that can dispel phlegm or disperse phlegm and mainly treat phlegm syndrome are called “Herbs That Dissolve Phlegm”; and that mainly can stop or relieve cough and panting are called “Herbs That Relieve Cough and Calm Panting.” Because “herbs that dissolve phlegm” often combine the effects of relieving cough and calming panting, and “herbs that relieve cough and calm panting” also combine the effect of dissolving phlegm, moreover, in syndromes of phlegm, cough, and panting are intermingled with each other, these two kinds of medicinals are usually combined and called “Herbs that Dissolve Phlegm, Relieve Cough, and Calm Panting.” Herbs that dissolve phlegm are indicated for the treatment of syndromes related to phlegm. Phlegm is not only the pathological product, but also the etiological factor. It can follow the qi to ascend or descend and reach anywhere. So there are quite a lot of diseases and syndromes caused by phlegm, such as cough and panting with profuse phlegm due to phlegm obstructing the lung, fainting and epilepsy due to phlegm clouding the heart orifices, vertigo due to phlegm obstructing the clear yang, restless sleep due to phlegm harassing the heart spirit, wind-strike and convulsion due to liver wind complicated by phlegm, numbness of limbs and hemiplegia (half-body paralysis), wry eye and mouth due to phlegm obstructing the channels and collaterals, scrofula and goiter due to binding of phlegm, and fire, dorsal furuncle, and multiple abscesses due to phlegm coagulation in the muscle invading joint. All these conditions can be treated with herbs that dissolve phlegm. Herbs that relieve cough and calm panting are used for the treatment of coughing and gasping for breathing caused by external contraction or internal damage.

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258 PART | I Chinese Materia Medica

When using herbal medicinals in this chapter, doctors should specifically select the corresponding herbs that dissolve phlegm or herbs that relieve cough and calm panting according to the different diseases and syndromes; should know that cough and panting are usually complicated by phlegm and excessive phlegm is easy to induce cough; often select herbs that dissolve phlegm, herbs that relieve cough, and herbs that calm panting to use together; and also should combine with other herbs according to the different etiological factors and pathogeneses of phlegm, cough, and panting in order to treat the root or treat the root and branch simultaneously. So if phlegm, cough, and panting are caused by external contraction, herbs that release the exterior and dissipate pathogen should be selected to combine; if caused by fire-heat, herbs that clear heat and drain fire should be selected to combine; if caused by interior cold, herbs that warm the interior and dissipate cold should be selected to combine; if caused by deficiency-consumption (xu lao), herbs that supplement deficiency should be selected to combine. In addition, for the treatment of epilepsy, convulsion, vertigo or coma, herbs that calm the liver and extinguish wind, herbs that open the orifices or herbs that calm the mind should be selected respectively to combine; for treating phlegm nodule, scrofula or goiter, herbs that soften hardness and dissipate masses should be selected to combine; for treating dorsal furuncle and multiple abscesses, herbs that warm yang and unblock stagnation and dissipate masses should be selected to combine. Treat phlegm syndrome, doctors should besides distinguish the patterns to select the herbs that dissolve phlegm, also should administer herbs by ascertaining the causes of phlegm formed. “The spleen is the source of phlegm production”; spleen deficiency may cause body fluids failing to transform regularly and dampness gathering to produce phlegm, so herbs that dissolve phlegm often combine with herbs that fortify the spleen and dry dampness to use in order to treat the root and branch simultaneously. Because phlegm is easy to obstruct qi movement, “qi stagnation accelerates phlegm coagulation,” “qi flow promotes phlegm dispersion,” they also often combine with herbs that rectify qi in order to strengthen the efficacy of dissolving phlegm. Since some stimulatory herbs that dissolve phlegm have the intense warm and dry properties, patients with bloodstained phlegm or hemorrhagic tendency should cautiously select them to use. Patients with measles in initial phase accompanied by cough due to exterior pathogen should not suited to just use herbs that relieve cough, should combine herbs that clear pathogen or diffuse the lung, in order to avoid the lingering pathogens causing panting to last and obstructing eruption of measles, and especially not select herbs that astringe or herbs with warm and dry properties. According to the differences of medicinal-nature and effects and clinical application, herbs that dissolve phlegm, relieve cough and calm panting can be divided into three categories: (1) herbs that warm and dissolve cold-phlegm, (2) herbs that clear and dissolve hot-phlegm, and (3) herbs that relieve cough and calm panting. The modern pharmacological research indicates the herbs that dissolve phlegm, relieve cough, and calm panting generally have the actions of expelling phlegm, prevention of cough, antiasthma, bacteriostasis, antivirus, antiinflammation, and diuresis. Some medicinals also have the effects of sedation, analgesia, anticonvulsion, amelioration of blood circulation, and regulation of immune.

SECTION 1  HERBS THAT WARM AND DISSOLVE COLD-PHLEGM Outline Most medicinals in this section are acrid and bitter in flavor, warm and dry in nature, act on the lung, spleen, and liver channels, have the effects of warming the lung and dispelling cold, drying dampness, and dissolving phlegm. Some medicinals have the actions of relieving swelling and pain when used externally. Herbs that warm and dissolve coldphlegm are indicated for the treatment of cold-phlegm and damp-phlegm syndromes (cough and shortness of breath, excessive white phlegm and greasy coating) and conditions of dizziness, numbness of limbs, dorsal furuncle and multiple abscesses, swollen sores and carbuncles caused by cold-phlegm or damp-phlegm. When applied clinically, they often combine with herbs that warm and dissipate cold pathogen, and herbs that dry dampness and fortify the spleen. Some herbs in this section with strong warm and dry properties are not suitable for the treatment of heat-phlegm and drynessphlegm syndromes.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 13.1)

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TABLE 13.1 Properties, Actions, and Application of Common Herbs That Warm and Dissolve Cold-Phlegm

Source and Collection

Property, Channel Entry

Pinellia Rhizome (ban xia) (Rhizoma Pinelliae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried tuber of Pinellia ternata (Thunb.) Breit. of the Araceae family. It is collected in summer and autumn, and then washed clean; after outer bark and fibrous root are removed, it is dried under the sun

Jackinthepulpit Tuber (tian nan xing) (Rhizoma Arisaematis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried tuber of Arisaema erubescens (Wall.) Schott, Arisaema heterophyllum B1. or Arisaema amurense Maxim. of the Araceae family. It is collected when stem and leaf are withered; after fibrous root and outer coating are removed, it is dried under the sun

Name of Medicinal

Efficacy and Action

Clinical Application and Usage

Acrid, warm, poisonous; act on the spleen, stomach, and lung channels

Dry dampness and dissolve phlegm, direct counterflow downward and arrest vomiting, disperse pĭ, and dissipate masses

Indicated for the treatment of dampphlegm, cold-phlegm, cough, and panting with excessive phlegm, dizziness due to phlegm rheum, headache due to phlegm syncope, vomiting, epigastric pĭ, chest bind syndrome, plum-stone qi (globus hystericus), swollen carbuncles, and phlegm node. Normally, 3–9 g is processed first and decocted with water as an oral dose. Or an appropriate amount is used externally

It is not suited to combine with Radix Aconiti (chuan wu), Radix Aconiti Kusnezoffii (cao wu), and Radix Aconiti Lateralis Praeparata (fu zi). For oral taking, use of the raw one should be cautious

Bitter, acrid, warm, poisonous; act on the lung, liver, and spleen channels

Dry dampness and dissolve phlegm, dispel wind and arrest convulsion, dissipate masses, and relieve swelling

Indicated for the treatment of dampphlegm, cold-phlegm, cough, and panting with excessive phlegm and chest oppression, dizziness due to windphlegm, wind-strike, epilepsy, tetanus, carbuncle-abscess with swelling and pain, snake or insect bite. Normally, 3–10 g is processed first and decocted with water as an oral dose. Or an appropriate amount of the raw one is ground into powder and mixed with vinegar or wine for applying the affected area

Its use is prohibited in pregnant women or patients with yin deficiency and drynessphlegm. For oral taking, the raw one should be used cautiously

Caution for Use

(Continued )

260 PART | I Chinese Materia Medica

TABLE 13.1 Properties, Actions, and Application of Common Herbs That Warm and Dissolve Cold-Phlegm (cont.)

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Typhonium Rhizome (bai fu zi) (Rhizoma Typhonii)

Initially recorded in Records of Chinese Medicinals (zhong yao zhi). It is the dried tuber of Typhonium giganteum Engl. of the Araceae family. It is collected in autumn; after fibrous root and outer coating are removed, it is dried under the sun

Acrid, warm, poisonous; act on the stomach and liver channels

Dispel windphlegm, arrest convulsion, resolve toxins and dissipate masses, and relieve pain

Indicated for the treatment of windstrike due to phlegm obstruction, wry eye and mouth, sluggish speech, infantile convulsion, epilepsy, tetanus, headache due to phlegm syncope, migraine or general headache, scrofula, phlegm node, and thanatophidia bite. Normally, 3–6 g is processed first and decocted with water as an oral dose. Or an appropriate amount is used externally

It is not suitable for pregnant women and patients with yin or blood deficiency generating wind or exuberant heat stirring wind. For oral taking, the raw one should be used cautiously

White Mustard Seed (bai jie zi) (Semen Sinapis)

Initially recorded in Newly Revised Materia Medica (xin xiu ben cao). It is the dried seed of Sinapi alba L. of the Cruciferae family. The whole plant is collected when fruit is matured in late summer and early autumn, and then dried under the sun, stroked to separate the seed. The raw or dry-fried seed is used

Acrid, warm; act on the lung and stomach channels

Warm the lung and dissolve phlegm, promote qi movement, dissipate masses, and relieve swelling

Indicated for the treatment of panting and cough due to coldphlegm obstructing the lung, pleural rheum, cold wheezing, dorsal furuncle and multiple metastatic abscess, numbness of limbs, and swelling and pain of joints. Normally, 3–6 g is decocted with water as an oral dose. Or an appropriate amount is ground into powder and mixed with vinegar for applying the affected area or for vesiculation therapy

Its use is prohibited in patients with chronic cough due to lung deficiency, vigorous fire due to yin deficiency, or digestive tract ulcer and bleeding or skin allergy. Dosage should not be too large

Name of Medicinal

Caution for Use

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TABLE 13.1 Properties, Actions, and Application of Common Herbs That Warm and Dissolve Cold-Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Chinese Honeylocust Fruit (zao jia) (Fructus Gleditsiae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried fruit of Gleditsia sinensis Lam. of the Leguminosae family. It is collected when matured, and then dried under the sun, and cut into pieces or dry-fried for use

Acrid, salty, warm, slightly poisonous; act on the lung and large intestine channels

Dispel obstinate phlegm, unblock the orifices (induce resuscitation), dispel wind, and kill worms

Indicated for the treatment of cough with counterflow qi ascent, and panting with excessive thick phlegm due to obstinate phlegm obstructing the lung, wind-strike, phlegm syncope, epilepsy, throat bì (pharyngitis) with a pattern of excessive phlegm-drool obstruction, swollen sores without ulceration, skin tinea, and constipation. Normally, 1–1.5 g is ground into powder or 1.5–5 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is cautious in patients without excess obstinate phlegm and strong body, and prohibited in pregnant women and patients with qi and yin deficiency or hemorrhagic tendency

Inula Flower (xuan fu hua) (Flos Inulae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried capitulum of Inula japonica Thunb. or Inula britannica L. of the Compositae family. It is collected when blooming in summer and autumn; after impurities are removed, it is dried in the shade or sun

Bitter, acrid, salty, slightly warm; act on the lung, spleen, stomach, and large intestine channels

Direct qi downward, disperse phlegm, move water (promote urination), and arrest vomiting

Indicated for the treatment of cough due to wind-cold, phlegm rheum accumulation, pĭ and oppression in the chest and diaphragm, cough and panting with excessive phlegm, vomiting and ructation due to phlegm-turbidity obstructing the center and stomach qi ascending counterflow, and epigastric fullness and rigidity. Normally, 3–9 g is wrapped first and decocted with water as an oral dose

Its use is prohibited in patients with over-strained cough due to yin deficiency and dry cough due to fluid consumption

(Continued )

262 PART | I Chinese Materia Medica

TABLE 13.1 Properties, Actions, and Application of Common Herbs That Warm and Dissolve Cold-Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Cynanchum Root and Rhizome (bai qian) (Rhizoma et Radix Cynanchi Stauntonii)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried rhizome and root of Cynanchum stauntonii (Decne.) Setltr. ex Lév1. or Cynanchum glaucescens (Decne.) Hand.-Mazz. of the Asclepiadaceae family. It is collected in autumn, and washed clean and dried under the sun

Acrid, bitter, slightly warm; act on the lung channel

Direct qi downward and dissolve phlegm, and relieve cough

Indicated for the treatment of new or chronic cough with excessive phlegm, fullness in the chest and dyspnea with rapid respiration due to excess lung qi obstruction, especially cough and panting caused by phlegm-damp or coldphlegm obstructing the lung. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder for oral taking

Its use is cautious in patients with panting and cough due to lung deficiency. If dose of the raw one is too large, it may stimulate the stomach in a certain degree

Catclaw Buttercup Root (mao zhua cao) (Radix Ranunculi Ternati)

Initially recorded in Handbook of Chinese Medicinal Substances (zhong yao cai shou ce). It is the dried root tuber of Ranunculus terrnatus Thunb. of the Ranunculaceae family. It is collected in spring; after fibrous root and sediment are removed, it is dried under the sun

Sweet, acrid, warm; act on the liver and lung channels

Dissolve phlegm and dissipate masses, resolve toxins, and relieve swelling

Indicated for the treatment of scrofula and phlegm nodule due to binding constraint of phlegm-fire, furuncles and sores, snake or insect bite, malaria, migraine, and toothache. Normally, 15–30 g is decocted with water as an oral dose. If used singly, the dose can be at 120 g. Or an appropriate amount is pounded or ground into powder for applying the affected area or for vesiculation therapy

No special contraindications

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2. Attached herbs (Table 13.2)

TABLE 13.2 Introduction to Attached Herbs That Warm and Dissolve Cold-Phlegm Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Fermented Pinellia Rhizome (ban xia qu) (Rhizoma Pinelliae Fermentata)

It is the fermented medicine made by Rhizoma Pinelliae (ban xia), wheat flour and Succus Rhizomatis Zingiberis (sheng jiang zhi)

Acrid, bitter, neutral; act on the lung, spleen, and large intestine channels

Dissolve phlegm and relieve cough, promote digestion, and loosen the center

Indicated for the treatment of cough with counterflow qi ascent, chest oppression and panting, food accumulation syndrome, and diarrhea. Normally, 6–9 g is wrapped with carbasus and decocted with water as an oral dose

Its use is cautious in patients with excessive thirst due to internal heat

Whipformed Typhonium Tuber (shui ban xia) (Rhizoma Typhonii Flagelliformis)

It is the root tuber of Typhonium flagelliforme (Lodd.) BL. of the Araceae family. It is collected in late autumn, and then soaked in lime water for 24 h, stirred and decorticated, then dried under the sun or baked

Acrid, warm, poisonous; act on the lung and spleen channels

Dry dampness and dissolve phlegm, resolve toxins and relieve swelling, and stanch bleeding

Indicated for the treatment of cough with excessive phlegm, swollen carbuncles and sores and furuncles, unknown swelling, snake or insect bite, and bleeding from external injury. Normally, 3–9 g is processed first and then decocted with water as an oral dose, or made into pills or powder for oral taking. Or an appropriate amount is pounded or ground into powder for applying the affected area externally

Its use is cautious in pregnant women and patients with dry cough due to yin deficiency

Korean Monkshood Root (guan bai fu) (Radix Aconiti Coreani)

It is the tuber of Aconitum coreanum (Lév1.) Rapaics of the Ranunculaceae family. It is collected during August to September; after stubble, fibrous root, and earth are removed, it is washed clean and dried under the sun

Acrid, sweet, hot, poisonous; act on the stomach and liver channels

Dispel windphlegm, arrest convulsion, dissipate cold, and relieve pain

Indicated for the treatment of wind-strike with a pattern of phlegm obstructing, wry eye and mouth, epilepsy, hemilateral head wind (migraine), dizziness due to wind-phlegm, tetanus, infantile convulsion, painful bì syndrome due to wind-damp, sores and ulcers, and eczema with itching. Normally, 1.5–6 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is prohibited in pregnant women or patients with yin deficiency or exuberant heat. If over dose, toxic symptom may occur

(Continued )

264 PART | I Chinese Materia Medica

TABLE 13.2 Introduction to Attached Herbs That Warm and Dissolve Cold-Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Bile Arisaema (dan nan xing) (Arisaema cum Bile)

It is the processed product of fine powder of prepared Jackinthepulpit Tuber (zhi tian nan xing) and ox bile, sheep bile or pig bile; or the fermented product of fine powder of raw Jackinthepulpit Tuber (sheng tian nan xing) and ox bile, sheep bile or pig bile

Bitter, slightly acrid, cool; act on the lung, liver, and spleen channels

Clear heat and dissolve phlegm, extinguish wind, and arrest convulsion

Indicated for the treatment of cough due to phlegm-heat, expectoration of yellow and thick phlegm, wind-strike with phlegm confounding, infantile convulsion, epilepsy, mania, recurrent headache and dizziness, panting, and cough due to phlegmfire. Normally, 3–6 g is decocted with water as an oral dose

Its use is cautious in patients with cold-phlegm or deficiency-cold of the spleen and stomach

Inula (jin fei cao) (Herba Inulae)

It is the dried aerial part of Inula linariifolia Turcz. or Inula japonica Thunb. of the Compositae family. It is collected in summer and autumn, and then dried under the sun

Bitter, acrid, salty, warm; act on the lung and large intestine channels

Direct qi downward, disperse phlegm, move water, and relieve swelling

Indicated for the treatment of externallycontracted wind-cold syndrome, phlegmrheum accumulation, cough, and panting with excessive phlegm, pĭ, and fullness in the chest, and diaphragm, swollen sores and furuncles. Normally, 5–10 g is decocted with water for oral use. Or an appropriate amount is used externally

Its use is prohibited in patients with over-strained cough due to yin deficiency or dry cough due to warm heat

Few-Flower Lysionotus Herb (shi diao lan) (Herba Lysionoti Pauciflori)

It is the dried aerial part of Lysionotus pauciforus Maxim. of the Gesneriaceae family. It is collected when leaf is flourishing in summer and autumn; after impurities are removed, it is dried under the sun

Bitter, warm; act on the lung channel

Dissolve phlegm and relieve cough, soften hardness and dissipate masses

Indicated for the treatment of cough with excessive phlegm, scrofula and phlegm nodule. Normally, 9–15 g is decocted with water as an oral dose. Or an appropriate amount is pounded for applying or decocted with water for washing externally

Its use is prohibited in pregnant women

Common Perilla Fruit (bai su zi) (Fructus Perillae Albus)

It is the fruit of Perilla frutescens (L.) Britt. of the Labiatae family. The aerial part is collected when fruit is matured in autumn, and then stroked to separate the fruit; after impurities are removed, the fruit is dried

Acrid, warm; act on the lung, stomach, and large intestine channels

Direct qi downward and dissolve phlegm, and moisten the intestines to promote defecation

Indicated for the treatment of cough with counterflow qi ascent, phlegm panting with excess pattern, or cough with phlegm-rheum, and constipation due to qi stagnation. Normally, 5–10 g is decocted with water as an oral dose

It is not suitable for patients with chronic cough due to qi deficiency and loose stool due to spleen deficiency

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3. Herb differentiation (Table 13.3) TABLE 13.3 Differentiation Between Similar Efficacy Herbs That Warm and Dissolve Cold-Phlegm Name of Medicinal

Similarity

Differences

Cynanchum Root and Rhizome (bai qian) (Rhizoma et Radix Cynanchi Stauntonii)

Both are acrid and bitter in flavor and slightly warm in nature, act on the lung channel, can direct qi downward, and dissolve phlegm, and are used for the treatment of cough and panting with excessive phlegm, and fullness in the chest and dyspnea with rapid respiration

It has no fiercely dry property, and is good at dispelling phlegm and directing lung qi downward, can be used for the treatment of new or chronic cough with excessive phlegm, and panting with a pattern of cold or heat, external contraction, or internal damage

All five medicinals are the different processed products of dried tuber of Pinellia ternata (Thunb.) Breit. of the Araceae family. All have the effect of dissolving phlegm

It is the product of Rhizoma Pinelliae (ban xia) processed with alum solution, its acrid and dry properties are decreased, and it is good at dissolving damp-phlegm, and used for the treatment of the weak patients with excessive phlegm, or infants with retention of food and phlegm obstruction, but symptoms are mild

Inula Flower (xuan fu hua) (Flos Inulae)

Prepared Pinelliae Rhizome (qing ban xia)

It also acts on the stomach channel, not only direct lung qi downward, but direct stomach qi to arrest vomiting, and ructation, can treat ructation and vomiting, pĭ, and fullness in the stomach cavity caused by phlegm-turbidity obstructing the center and stomach qi ascending counterflow

Prepared Pinellia Tuber (fa ban xia)

It is the product of Rhizoma Pinelliae (ban xia) processed with Radix et Rhizoma Glycyrrhizae (gan cao) and quicklime, its warm property is poor, and it is good at dry dampness and harmonizing the stomach, and used for the treatment of spleen deficiency leading to damp encumbrance and spleen-stomach disharmony

Pinellia Rhizome in Ginger Juice (jiang ban xia)

It is the product of Rhizoma Pinelliae (ban xia) processed with ginger and alum, and good at directing counterflow downward and arresting vomiting, can warm the center and dissolve phlegm, and used for the treatment of vomiting due to phlegmrheum, pĭ, and fullness in the stomach

Fermented Pinellia Rhizome (ban xia qu)

It can dissolve phlegm, dry dampness, and fortify the spleen, promote digestion and arrest diarrhea, and is used for the treatment of spleen-stomach weakness, dampness obstruction or retention of food, greasy tongue coating, vomiting and nausea

Pinellia Rhizome in Bamboo Juice (zhu li ban xia)

It is the product of Rhizoma Pinelliae (ban xia) processed with bamboo juice, its warm and dry properties are greatly decreased, and it is used for the treatment of vomiting due to stomach heat, cough due to lung heat, internal blockage and wind-strike with aphasia due to phlegm-heat

Prepared Jackinthepulpit Tuber (zhi tian nan xing)

Bile Arisaema (dan nan xing)

Both can dissolve phlegm and arrest convulsion, and treat dizziness, cough and panting, wind-strike, epilepsy, and tetanus due to wind-phlegm

It is the product of Rhizoma Arisaematis (tian nan xing) processed with ginger juice and alum, its fiercely warm property is weakened, and it is good at drying dampness and dissolving phlegm, dispelling wind and arresting convulsion, and used for the treatment of damp-phlegm or cold-phlegm syndromes, with dizziness, wind-strike, epilepsy, and tetanus due to wind-phlegm It is the product of Rhizoma Arisaematis (tian nan xing) processed with ox bile. It is bitter, slightly acrid, and cool, can clear heat and dissolve phlegm, extinguish wind and arrest convulsion, and is used for the treatment of wind-strike, epilepsy, infantile convulsion, dizziness due to head wind, panting, and cough due to phlegm-fire (Continued )

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TABLE 13.3 Differentiation Between Similar Efficacy Herbs That Warm and Dissolve Cold-Phlegm (cont.) Name of Medicinal

Similarity

Differences

White Mustard Seed (bai jie zi) (Semen Sinapis)

Both are acrid in flavor and act on the lung and stomach channels, can dissolve phlegm, treat cough and panting with excessive phlegm and chest oppression, and often combine with each other

It is warm in nature, good at warming the lung and eliminating phlegm, can dissipate masses and unblock the collaterals and relieve pain, is indicated for the treatment of cough, panting or breathlessness due to cold-phlegm, painful bì syndrome with numbness, dorsal furuncle and multiple metastatic abscess due to phlegm stagnating in channels and collaterals

Radish Seed (lai fu zi) (Semen Raphani)

Pinellia Rhizome (ban xia) (Rhizoma Pinelliae)

It is neutral in nature, has the effects of directing qi downward and dissolving phlegm, promoting digestion, and relieving distention, is suited to treat cough and panting due to phlegm obstruction, chest oppression, and abdominal distention, belching and acid swallowing, diarrhea and dysentery due to food accumulation and qi stagnation Both are acrid in flavor and warm in nature and poisonous, can dry dampness and dissolve phlegm, and are good at treating damp-phlegm and cold-phlegm. After processed, they both can treat heat-phlegm and wind-phlegm

Jackinthepulpit Tuber (tian nan xing) (Rhizoma Arisaematis)

It mainly acts on the spleen and lung channels, is good at dispelling spleen and stomach damp-phlegm, and can direct counterflow downward and arrest vomiting, disperse pĭ and dissipate masses, is indicated for the treatment of dizziness due to phlegm rheum, phlegm-damp encumbering the spleen, epigastric pĭ (epigastric lumpy stiffness), chest bind syndrome, and vomiting Besides the spleen and lung channels, it also acts on the liver channel, and its dry and fierce properties are stronger than that of Rhizoma Pinelliae (ban xia). It is good at dispelling windphlegm and arresting convulsion, and indicated for the treatment of dizziness due to wind-phlegm, wind-strike, epilepsy, wry eye and mouth, and tetanus

SECTION 2  HERBS THAT CLEAR AND DISSOLVE HOT PHLEGM Outline Most medicinals in this section are cold and cool in nature, have the effects of clearing, and dissolving hot phlegm. Some medicinals are moistening and can moisten dryness. Some are salty in flavor and can soften hardness and dissipate masses. Herbs that clear and dissolve hot phlegm are indicated for the treatment of hot phlegm syndrome, such as cough and panting with yellow thick phlegm. For dryness-phlegm syndrome, such as thick phlegm with difficulty in expectoration as well as dry lips and tongue, herbs that have moistening property and can moisten dryness and dissolve phlegm should be selected. Other diseases or syndromes like epilepsy, wind-strike, convulsion, and goiter due to phlegm-heat, and scrofula due to phlegm-fire, herbs that clear and dissolve hot phlegm also can be selected to use. In clinic, when using medicinals in this section, they often combine with herbs that clear heat and drain fire or herbs that nourish yin and moisten the lung in order to obtain the effects of clearing and dissolving hot phlegm or clearing and moistening dryness phlegm, respectively. Herbs that clear and dissolve hot phlegm and herbs that moisten dryness and dissolve phlegm with cold-cool property are not suitable for the treatment of cold-phlegm syndrome and damp-phlegm syndrome.

Specific Application Knowledge of Herbs 1. Primary herbs (Table 13.4)

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TABLE 13.4 Properties, Actions, and Application of Common Herbs That Clear and Dissolve Hot Phlegm Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Tendrilled Fritillaria Bulb (chuan bei mu) (Bulbus Fritillariae Cirrhosae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried squamous bulb of Fritillaria cirrhosa D. Don, Fritillaria unibracteata Hsiao et K. C. Hsia, Fritillaria przewalskii Maxim. or Fritillar delavayi Franch. of the Liliaceae family. It is collected in summer and autumn or after snow is melted; after fibrous root, raw bark, and sediment are removed, it is dried under the sun or at lower temperature

Bitter, sweet, slightly cold; act on the lung and heart channels

Clear heat and dissolve phlegm, moisten the lung and relieve cough, dissipate masses, and relieve abscess (carbuncle)

Indicated for the treatment of dry cough with scanty phlegm due to lung heat, chronic cough due to internal damage, over-strained cough with bloodstained phlegm due to lung yin deficiency, scrofula due to binding constraint of phlegm and fire, mammary abscess (acute mastitis) and lung abscess due to heat toxin obstruction. Normally, 3–10 g is decocted with water as an oral dose, or 1–2 g each time is ground into powder and mixed with water for oral taking

It antagonizes Aconite strains. And it is not suitable for patients with deficiency-cold of the spleen and stomach and damp-phlegm

Ussuri Fritillary Bulb (ping bei mu) (Bulbus Fritillariae Ussuriensis)

Initially recorded in Records of Chinese Medicinals (zhong yao zhi). It is the dried squamous bulb of Fritillaria ussuriensis Maxim. of the Liliaceae family. It is collected in spring; after outer bark, fibrous root, and sediment are removed, it is dried under the sun or at lower temperature

Bitter, sweet, slightly cold; act on the lung and heart channels

Clear heat and dissolve phlegm, moisten the lung, and relieve cough

Indicated for the treatment of dry cough with scanty phlegm due to lung heat, over-strained cough due to lung yin deficiency, cough with blood-flecked phlegm, scrofula, and mammary abscess (acute mastitis). Normally, 3–9 g is decocted with water as an oral dose, or 1–2 g each time is ground into powder and mixed with water for oral taking

It antagonizes Aconite strains. And it is not suitable for patients with deficiency-cold of the spleen and stomach and damp-phlegm

(Continued )

268 PART | I Chinese Materia Medica

TABLE 13.4 Properties, Actions, and Application of Common Herbs That Clear and Dissolve Hot Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Thunberg Fritillary Bulb (zhe bei mu) (Bulbus Fritillariae Thunbergii)

Initially recorded in Treatise of Xuan Qi Relief and Corrections (xuan qi jiu zheng lun). It is the dried squamous bulb of Fritillaria thunbergii Miq. of the Liliaceae family. It is collected when the plant is withered in early summer, and then washed clean, stroked to remove outer bark, mixed with calcined shell powder to absorb juice, and finally cut into thick pieces or stroked to broken bits

Bitter, cold; act on the lung and heart channels

Clear heat and dissolve phlegm and relieve cough, resolve toxins, and dissipate masses and relieve carbuncle

Indicated for the treatment of cough due to wind-heat or phlegm-heat obstructing the lung, throat bì (pharyngitis), scrofula, goiter, swollen sores, and carbuncles, mammary abscess (acute mastitis), and lung abscess with expectoration of bloody pus. Normally, 5–10 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is ground into powder for applying the affected area externally

It antagonizes Aconite strains. And it is not suitable for patients with deficiency-cold of the spleen and stomach and damp-phlegm

Snakegourd Fruit (gua lou) (Fructus Trichosanthis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried matured fruit of Trichosanthes kirilowii Maxim. or Trichosanthes rosthornii Harms of the Cucurbitaceae family. The fruit with carpopodium is collected when matured in autumn, and dried in the shade in a ventilated place

Sweet, slightly bitter, cold; act on the lung, stomach, and large intestine channels

Clear heat and clear up phlegm, loosen the chest, and dissipate masses, moisten dryness and lubricate the intestines.

Indicated for the treatment of cough and panting with yellow thick phlegm due to phlegm-heat obstructing the lung, pectoral stuffiness pain due to binding of phlegm and qi, chest bind syndrome or fullness and stiffness in the chest, mammary abscess (acute mastitis), lung abscess and intestinal abscess, and constipation due to intestinal dryness. Normally, 9–15 g is decocted with water as an oral dose

It antagonizes Aconite strains. And its use is prohibited in patients with loose stool due to spleen deficiency or cold-phlegm or damp-phlegm syndrome

Trichosanthes Seed (gua lou zi) or (gua lou ren) (Semen Trichosanthis)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the dried matured seed of Trichosanthes kirilowii Maxim. or Trichosanthes rosthornii Harms of the Cucurbitaceae family. The matured fruit is collected in autumn, and then split; the seed is taken out and washed clean, and then dried under the sun

Sweet, cold; act on the lung, stomach, and large intestine channels

Moisten the lung and dissolve phlegm, and lubricate the intestines to promote defecation

Indicated for the treatment of cough with sticky phlegm due to phlegm-heat, dry cough due to lung deficiency, constipation due to intestinal dryness, swollen carbuncles and sores, and inhibited lactation. Normally, 9–15 g is decocted with water as an oral dose, or made into pills or powder. Or an appropriate amount is ground into powder for applying the affected area externally

It antagonizes Aconite strains. And its use is prohibited in patients with diarrhea due to deficiency-cold of the spleen and stomach

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TABLE 13.4 Properties, Actions, and Application of Common Herbs That Clear and Dissolve Hot Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Bamboo Shavings (zhu ru) (Caulis Bambusae in Taenia)

Initially recorded in Collected Commentaries on ‘Shen Nong’s Classic of the Materia Medica’ (ben cao jing ji zhu). It is the dried intermediate layer of stalk of Bambusa tuldoides Munro, Sinocalamus beecheyanus (Munro) McClure var. pubescens P. F. Li or Phyllostachys nigra (Lodd.) Munro var. henonis (Mitf.) Stapf ex Rendle of the Poaceae family. The fresh stem is collected in whole year; after outer bark is removed, the viridescent intermediate layer is scraped into strand or cut into slices, tied up into bundles, and then dried in the shade

Sweet, slightly cold; act on the lung, stomach, heart, and gallbladder channels

Clear heat and dissolve phlegm, relieve vexation and arrest vomiting, cool the blood and stanch bleeding

Indicated for the treatment of cough and panting due to lung heat, palpitation and inquietude, and vexation and insomnia due to phlegm-fire disturbing the heart, convulsive epilepsy, wind-strike, aphasia with stiff tongue and phlegmatic coma, vomiting and hiccup due to stomach heat, pernicious vomiting during pregnancy, restless fetus, spitting of blood, nosebleed, flooding and spotting (uterine bleeding). Normally, 5–10 g is decocted with water as an oral dose

Its use is prohibited in patients with cough and panting due to cold phlegm, vomiting due to stomach cold or diarrhea due to spleen deficiency

Bamboo Sap (zhu li) (Succus Bambusae)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the yellowish clarified liquid flowed from the fresh Phyllostachys nigra (Lodd.) Munro var. henonis (Mitf.) Stapf ex Rendle or Bambusa tuldoides Munro while being broiled

Sweet, cold; act on the heart, lung, and liver channels

Clear heat and eliminate phlegm, arrest convulsion, and open the orifices (resuscitate)

Indicated for the treatment of cough and panting accompanied by sticky phlegm with difficulty in expectoration, or obstinate phlegm coagulation due to phlegm-heat, wind-strike with phlegmatic coma, convulsion and epilepsy, depressive psychosis or mania, excessive thirst with high fever, and vexation during pregnancy. Normally, 30–50 g is taken infused as an oral dose

Its use is prohibited in patients with cold-phlegm syndrome or loose stool. And it is not suitable for long term store

(Continued )

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TABLE 13.4 Properties, Actions, and Application of Common Herbs That Clear and Dissolve Hot Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Tabasheer (tian zhu huang) (Concretio Silicea Bambusae)

Initially recorded in Materia Medica of Sichuan (shu ben cao). It is the dried block material of secretory juice of Bambusa textilis McClure or Schizostachyum chinese Rendle of the Poaceae family. It is collected in autumn and winter

Sweet, cold; act on the heart and liver channels

Clear heat and eliminate phlegm, clear heart heat, and arrest convulsion

Indicated for the treatment of loss of consciousness and delirious speech in febrile disease, windstrike with phlegmatic coma, epilepsy, infantile convulsion and night crying due to phlegmheat, and cough and panting due to phlegmheat. Normally, 3–9 g is decocted with water as an oral dose, or ground into powder for taking infused with 0.6–1 g each time

Its use is cautious in patients without damp-heat and phlegm-fire syndrome, and prohibited in patients with loose stool due to spleen deficiency-cold

Hogfennel Root (qian hu) (Radix Peucedani)

Initially recorded in Master Lei’s Discourse on Medicinal Processing (lei gong pao zhi lun). It is the dried root of Peucedanum praeruptorum Dunn of the Umbelliferae family. It is collected when stem and leaf are withered during winter to next spring; after fibrous root is removed, it is washed clean, and dried under the sun or at lower temperature

Bitter, acrid, slightly cold; act on the lung channel

Direct qi downward and dissolve phlegm, scatter wind, and clear heat

Indicated for the treatment of cough and panting, and expectoration of yellow thick phlegm due to phlegm-heat obstructing the lung and lung failing to diffuse and govern descent, accompanied by fullness and oppression in the chest and diaphragm, vomiting and less eating, or cough with excessive phlegm, headache due to windheat. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder

Its use is cautious in patients with cough due to yin deficiency or cold fluidretention

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TABLE 13.4 Properties, Actions, and Application of Common Herbs That Clear and Dissolve Hot Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Platycodon Root (jie geng) (Radix Platycodonis)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried root of Platycodon grandiflorum (Jacq.) A. DC. of the Campanulaceae family. It is collected in spring and autumn, and then washed clean; after fibrous root is removed, it is dried

Bitter, acrid, neutral; act on the lung channel

Diffuse the lung and relieve sore throat, dispel phlegm, and expel pus

Indicated for the treatment of cough with excessive phlegm due to external contraction, chest oppression and discomfort, swelling and pain of the throat and loss of voice due to exogenous pathogen invading the lung, lung abscess with cough, chest fullness and pain and spitting of pus, dysentery with abdominal pain, dribbling urinary block and constipation. Normally, 3–10 g is decocted with water as an oral dose, or made into pills or powder

It is not suitable for patients with chronic cough due to yin deficiency, qi counterflow and expectoration of blood, and its use is cautious in patients with gastric and duodenal ulcers

Boat-Fruited Stercurlia Seed (pang da hai) (Semen Sterculiae Lychnophorae)

Initially recorded in Supplement to “The Grand Compendium of Materia Medica” (ben cao gang mu shi yi). It is the dried matured seed of Sterculia lychnophora Hance of the Sterculiaceae family. It is collected when fruit is matured and split during April to June, and then dried under the sun

Sweet, cold; act on the lung and large intestine channels

Clear heat and moisten the lung, relieve sore-throat and ease-up the voice, and moisten the intestines to promote defecation

Indicated for the treatment of hoarseness, dry cough without phlegm, swelling and dry pain of the throat and cough due to lung heat, and toothache, constipation, headache, and red eyes due to dryness-heat. Normally, 2–3 pieces are infused with boiling water or decocted with water as an oral dose. The large dose can be at 10 pieces. If it is made into powder, the dose should be halved

Its use is cautious in patients with diarrhea due to deficiency-cold of the spleen and stomach

(Continued )

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TABLE 13.4 Properties, Actions, and Application of Common Herbs That Clear and Dissolve Hot Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Grosvenor’s Momordica Fruit (luo han guo) (Fructus Momordicae)

Initially recorded in Records of Medicinal Harvest in Lingnan (ling nan cai yao lu). It is the dried fruit of Siraitia grosvenorii (Swingle.) C. Jeffrey ex A. M. Lu et Z. Y. Zhang of the Cucurbitaceae family. It is collected when its color turns dark green from tender green in autumn, aired for several days and then dried in lower temperature

Sweet, cool; act on the lung and large intestine channels

Clear heat and moisten the lung, relieve sore-throat and ease-up the voice, and moisten the intestines to promote defecation

Indicated for the treatment of dry cough due to lung heat or phlegm-fire, whooping cough, throat bì (pharyngitis), throatmoth (tonsillitis), or acute gastritis, or sore throat, loss of voice, constipation due to intestinal dryness or blood dryness or stomach heat, and wasting-thirst (xia¯ o kĕ). Normally, 9–15 g is decocted with water as an oral dose, or infused with boiling water, or stewed with meat

Its use is prohibited in patients with lung cold and cough due to external contraction and deficiency-cold of the spleen and stomach

Seaweed (hai zao) (Sargassum)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried alga of Sargassum pallidum (Turn.) C. Ag. or Sargassum fusiforme (Harv.) Setch. of the Sargassaceae family. It is collected in summer and autumn; after impurities are removed, it is washed clean and dried under the sun

Bitter, salty, cold; acts on the liver, stomach, and kidney channels

Disperse phlegm and soften hardness and dissipate masses, promote urination, and relieve edema

Indicated for the treatment of goiter, scrofula, swelling and distention, and pain of the testis, or hernia pain, accumulations and gatherings (abdominal masses; jī jù), edema due to phlegm-rheum, and weak foot with puffiness due to dampness. Normally, 10–15 g is decocted with water as an oral dose, or steeped in wine or made into pills or powder. Or an appropriate amount is ground into powder or pounded for applying the afflicted part

It is not suited to combine with Radix et Rhizoma Glycyrrhizae (gan cao) to use. And its use is prohibited in patients with deficiency-cold of the spleen and stomach and dampness stagnation

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TABLE 13.4 Properties, Actions, and Application of Common Herbs That Clear and Dissolve Hot Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Kelp (kun bu) (Thallus Laminariae) or (Thallus Eckloniae)

Initially recorded in Miscellaneous Records of Famous Physicians (ming yi bie lu). It is the dried thallus of Laminaria japonica Aresch. or Ecklonia kurome Okam. of the Laminariaceae family. It is collected in summer and autumn, and then dried under the sun

Salty, cold; acts on the liver, stomach, and kidney channels

Disperse phlegm and soften hardness and dissipate masses, promote urination, and relieve edema

Indicated for the treatment of goiter, scrofula, dysphagia, edema due to phlegmrheum, swelling and pain of the testis, concretions and conglomerations (lower abdominal masses; zhēng jia˘), abnormal vaginal discharge, and weak foot with puffiness due to dampness; also for the treatment of plum-stone qi (globus hystericus). Normally, 6–12 g is decocted with water as an oral dose, or made into pills or powder

Its use is cautious in patients with deficiency-cold of the spleen and stomach and dampness stagnation

Airpotato Yam (huang yao zi) (Rhizoma Dioscoreae Bulbiferae)

Initially recorded in Materia Medica of South Yunnan (dian nan ben cao). It is the dried tuber of Diosc orea bulbifera L. of the Dioscoreaceae family. It is collected in autumn and winter; after root leaf and fibrous root are removed, it is washed clean, cut into pieces, and dried under the sun

Bitter, cold, poisonous; act on the lung and liver channels

Dissolve phlegm and dissipate masses and disperse goiter, clear heat, and resolve toxins

Indicated for the treatment of goiter, swollen sores and ulcers, swelling and pain of the throat due to heat toxin, thanatophidia bite, spitting of blood, nosebleed, expectoration of blood, cough and panting, and whooping cough. Normally, 5–15 g is decocted with water as an oral dose, or ground into powder for oral taking with 1–2 g each time. Or an appropriate amount is used externally

Don’t take too much or for a long time. Its use is cautious in patients with weakness of the spleen and stomach and functional lesion of the liver and kidney

(Continued )

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TABLE 13.4 Properties, Actions, and Application of Common Herbs That Clear and Dissolve Hot Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Clam Shell (hai ge qiao) (Concha Meretricis seu Cyclinae)

Initially recorded in Shen Nong’s Classic of the Materia Medica (shen nong ben cao jing). It is the dried shell of Meretrix meretrix Linnaeus or Cyclina sinensis Gmelin of the Veneridae family. It is caught in summer and autumn; after meat is removed, it is washed clean and dried under the sun

Bitter, salty, cold; act on the lung, kidney, and stomach channels

Clear heat and dissolve phlegm, soften hardness and dissipate masses, relieve hyperacidity and promote urination, eliminate dampness, and close sore

Indicated for the treatment of cough and panting with bloodstained phlegm due to lung heat or phlegm-fire, chest and hypochondriac pain, scrofula and goiter, stomachache and acid regurgitation, edema, difficulty in micturition, eczema, and scald. Normally, 6–15 g is added first and decocted with water as an oral dose. The powder of Clam shell should be wrapped for decoction. Or an appropriate amount is ground into fine powder (or mixed with oil) for applying the affected area

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Pumice Stone (hai fu shi) (Pumex)

Initially recorded in Supplement to “The Materia Medica” (ben cao shi yi). It is the dried skeleton of Costazia aculeala Canu et Bassler or C. costazi Audouim of the Poricellariidae family, or polyporous stone formed from volcano magma. It is collected in whole year and washed clean, then dried under the sun

Salty, cold; act on the lung and kidney channels

Clear lung heat and dissolve phlegm, soften hardness and dissipate masses, promote urination, and relieve strangury

Indicated for the treatment of cough and panting with sticky phlegm or blood-stained phlegm due to phlegmheat obstructing the lung, palpable mass due to lingering phlegm, scrofula and goiter, difficulty in micturition, blood strangury, stony strangury, swollen sores and nebula. Normally, 10–15 g is broken into pieces and decocted first with water as an oral dose

Its use is prohibited in patients with cough due to deficiency-cold

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TABLE 13.4 Properties, Actions, and Application of Common Herbs That Clear and Dissolve Hot Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Arc Shell (wa leng zi) (Concha Arcae)

Initially recorded in Essentials of Materia Medica (ben cao bei yao). It is the dried shell of Arca subcrenata Lischke, Arca granosa Linnaeus or Arca inflata Reeve of the Arcidae family. It is caught during autumn, winter to next spring, and then washed clean, slightly decocted with boiling water; after meat is removed, it is dried

Salty, neutral; act on the lung, stomach, and liver channels

Disperse phlegm and dissolve stasis, soften hardness and dissipate masses, relieve hyperacidity, and relieve pain

Indicated for the treatment of sticky phlegm with difficulty in expectoration due to obstinate phlegm coagulation, goiter, scrofula, concretions and conglomerations (lower abdominal masses; zhēng jia˘) and pĭ syndrome due to qi stagnation and blood stasis or phlegm accumulation, stomach ache with acid regurgitation, chilblain, scald and burn. Normally, 9–15 g is broken into pieces and decocted first with water as an oral dose, or ground into powder for oral taking with 1–3 g each time Or an appropriate amount is used externally

It is not suitable for patients without static blood and phlegm accumulation

Chlorite Schist (qing meng shi) (Lapis Chloriti)

Initially recorded in Materia Medica of the Jiayou Era (jia you ben cao). It is the black mica schist or carbonate schist of chlorite mica of the metamorphite group. It is collected in whole year. The mixed stone and sediment are removed

Sweet, salty, neutral; act on the lung, heart, and liver channels

Disperse phlegm and lower qi, calm the liver, and suppress fright

Indicated for the treatment of panting and cough with qi counterflow due to obstinate phlegm coagulation, epilepsy, mania, vexation and agitation, chest oppression, and convulsion due to hot phlegm obstruction. Normally, 3–6 g is made into pills or powder as an oral dose, or 10–15 g is broken into pieces and wrapped and decocted first with water as an oral dose

It is not suitable for patients without excess phlegm-heat accumulation, and its use is prohibited in pregnant women and patients with weakness of the spleen and stomach

(Continued )

276 PART | I Chinese Materia Medica

TABLE 13.4 Properties, Actions, and Application of Common Herbs That Clear and Dissolve Hot Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Mica Schist (jin meng shi) (Micaelapis Aureus)

Initially recorded in Records of Chinese Medicinals (zhong yao zhi). It is the vermiculite schist or hydrobiotite schist of the metamorphite group. It is collected in whole year. The mixed stone and sediment are removed

Sweet, salty, neutral; act on the lung, heart, and liver channels

Disperse phlegm and lower qi, calm the liver, and suppress fright

Indicated for the treatment of panting and cough with qi counterflow due to obstinate phlegm coagulation, epilepsy, mania, vexation and agitation, chest oppression, and convulsion. Normally, 3–6 g is made into pills or powder as an oral dose, or 10–15 g is broken into pieces and wrapped and decocted first with water as an oral dose

It is not suitable for patients without excess phlegm-heat accumulation, and its use is prohibited in pregnant women and patients with weakness of the spleen and stomach

Pig Gall Powder (zhu dan fen) (Pulvis Fellis Suis)

Initially recorded in Chinese Pharmacopoeia (zhong hua ren min gong he guo yao dian). It is the dried product of bile of Sus scrofadomestica Brisson. of the Suidae family. The pig bile is collected, filtered, dried, and then crushed to powder

Bitter, cold; act on the liver, gallbladder, lung, and large intestine channels

Clear heat and moisten dryness, relieve cough and calm panting, and resolve toxins

Indicated for the treatment of whooping cough, wheezing and panting, thirst in febrile disease, constipation, red eye with nebula, jaundice, throat bì (pharyngitis), diarrhea, dysentery, swollen carbuncles and sores. Normally, 0.3–0.6 g is taken infused or made into pills as an oral dose. Or an appropriate amount is mixed with water for applying the affected area

Taking orally is cautious in patients with deficiency-cold of the spleen and stomach

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2. Attached herbs (Table 13.5) TABLE 13.5 Introduction to Attached Herbs That Clear and Dissolve Hot-Phlegm Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Sinkiang Fritillary Bulb (yi bei mu) (Bulbus Fritillariae Pallidiflorae)

It is dried squamous bulb of Fritillaria walujewii Regel or Fritillaria pallidiflora Schrenk of the Liliaceae family. It is collected during May to July; after sediment is removed, it is dried under the sun, and then the fibrous root and outer bark are removed

Bitter, sweet, slightly cold; act on the lung and heart channels

Clear heat and moisten the lung, dissolve phlegm and relieve cough

Indicated for the treatment of dry cough with scanty phlegm due to lung heat, and over-strained cough with blood-flecked phlegm due to yin deficiency. Normally, 3–9 g is decocted with water as an oral dose

It antagonizes Aconite strains

Hupeh Fritillary Bulb (hu bei bei mu) (Bulbus Fritillariae Hupehensis)

It is dried squamous bulb of Fritillaria hupehensis Hsiao et K. C. Hsia of the Liliaceae family. It is collected when plant is withered in early summer, then soaked in clear water or limewater, and dried

Slightly bitter, cool; act on the lung and heart channels

Clear heat and dissolve phlegm, relieve cough, and dissipate masses

Indicated for the treatment of cough due to phlegm-heat, scrofula, phlegm nodule, swollen sores and carbuncles. Normally, 3–9 g is ground into powder for taking infused

It antagonizes Aconite strains

Trichosanthes Peel (gua lou pi) (Pericarpium Trichosanthis)

It is the dried matured pericarp of Trichosanthes kirilowii Maxim. or Trichosanthes rosthornii Harms of the Cucurbitaceae family. The matured fruit is collected in autumn, then split; after pulp of fruit and seed are removed, it is dried in the shade

Sweet, cold; act Clear heat and on the lung and dissolve phlegm, stomach channels and promote qi movement to loosen the chest

Indicated for the treatment of cough due to phlegm-heat, with chest oppression and hypochondriac pain. Normally, 6–10 g is decocted with water as an oral dose

It antagonizes Aconite strains, and is not suitable for patients with spleen deficiency and damp-phlegm

Dry-Fried Trichosanthes Seed (chao gua lou zi) (Tostum Semen Trichosanthis)

It is the processed product of matured seed of Trichosanthes kirilowii Maxim. or Trichosanthes rosthornii Harms of the Cucurbitaceae family. The clean seed is fried to slightly swell according to the simple stir-frying method, and then pounded to pieces for use

Sweet, cold; act on the lung, stomach, and large intestine channels

Moisten the lung and dissolve phlegm, and lubricate the intestines to promote defecation

Indicated for the treatment of dry cough with sticky phlegm, and constipation due to intestinal dryness. Normally, 9–15 g is decocted with water as an oral dose

It antagonizes Aconite strains, and its use is prohibited in patients with sloppy diarrhea

Common Hogfennel Root (zi hua qian hu) (Radix Angelicae Decursivae)

It is the dried root of Peucedanum decursivum (Miq.) Maxim. of the Umbelliferae family. It is collected when aerial part is withered in autumn and winter; after fibrous root is removed, it is dried under the sun

Bitter, acrid, slightly cold; act on the lung channel

Direct qi downward and dissolve phlegm, scatter wind and clear heat

Indicated for the treatment of dyspneal fullness due to phlegm-heat, expectoration of yellow thick phlegm, cough with excessive phlegm due to wind-heat, or fullness and oppression in the chest and diaphragm. Normally, 3–9 g is decocted with water or made into pills or powder as an oral dose

Its use is cautious in patients with cough due to yin deficiency or cold fluid retention

(Continued )

278 PART | I Chinese Materia Medica

TABLE 13.5 Introduction to Attached Herbs That Clear and Dissolve Hot-Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Dragon’s Tongue Leaf (long li ye) (Folium Sauropi)

It is the dried leaf of Sauropus spatulifolius Beille of the Euphorbiaceae family. It is collected in summer and autumn, and then dried under the sun

Sweet, bland, neutral; act on the lung and stomach channels

Clear heat, moisten the lung and relieve cough, dissolve phlegm, and promote defecation

Indicated for the treatment No special of cough due to lung contraindications dryness, or panting due to lung heat, sore throat with loss of voice, dry mouth, and constipation. Normally, 9–15 g is decocted with water as an oral dose

Japanese Milkwort Herb (gua zi jin) (Herba Polygalae Japonicae)

It is the dried entire plant of Polygala japonica Houtt. of the Polygalaceae family. It is collected when blooming in late spring; after sediment is removed, it is dried under the sun

Acrid, bitter, neutral; act on the lung channel

Dispel phlegm and relieve cough, invigorate blood and relieve swelling, resolve toxins and relieve pain

Indicated for the treatment of cough with excessive phlegm, swelling and pain of the throat, injury from falling down, swollen boils and furuncles and sores, snake or insect bite. Normally, 15–30 g is decocted with water as an oral dose. Or an appropriate amount is used externally

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Bliz’s Conyza Herb (jin long dan cao) (Herba Conyzae Blizii)

It is the dried aerial part of Conyza blinii Lévl. of the Compositae family. It is collected in summer and autumn; after impurities are removed, it is dried under the sun

Bitter, cold; act on the lung and liver channels

Clear heat and dissolve phlegm, relieve cough and calm panting, resolve toxins and drain dampness, cool the blood, and stanch bleeding

Indicated for the treatment of cough due to lung heat, excessive phlegm, panting, sore throat, oral ulcer, jaundice with damp-heat pathogen, nosebleed, bloody stool, flooding and spotting (uterine bleeding), and bleeding from external injury. Normally, 6–9 g is decocted with water as an oral dose

Its use is cautious in patients with deficiency-cold of the spleen and stomach

Manchurian Lilac Bark (bao ma zi pi) (Cortex Syingae Amurensis)

It is the dried trunk bark or branch bark of Syringa reticulate (B1.) Hara var. mandshurica (Maxim.) of the Oleaceae family. It is collected in spring and autumn, and then dried

Bitter, slightly cold; act on the lung channel

Clear lung heat and dispel phlegm, relieve cough and calm panting

Indicated for the treatment of cough and panting with excessive phlegm. Normally, 30–45 g is decocted with water as an oral dose, or made into pills or powder

No special contraindications

Waternut Corm (bi qi) (Cormus Eleocharitis)

It is the corm of Eleocharis dulcis (Burm. f.) Trin. ex Henschel of the Cyperaceae family. It is collected in winter; after earth is washed clean, the fresh or airdried one is for use

Sweet, cold; act Clear heat and on the lung and promote fluid stomach channels production, dissolve phlegm, and disperse accumulation

Indicated for the treatment of thirst in warm disease, swelling and pain of the throat, cough due to phlegm-heat, red eyes, wasting-thirst (xia¯o kĕ), dysentery, jaundice, heat strangury, and food accumulation syndrome. Normally, 60–120 g is decocted with water or pounded to extract the juice as an oral dose

Its use is cautious in patients with deficiency-cold or blood deficiency

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TABLE 13.5 Introduction to Attached Herbs That Clear and Dissolve Hot-Phlegm (cont.) Name of Medicinal

Source and Collection

Property, Channel Entry

Efficacy and Action

Clinical Application and Usage

Caution for Use

Pear (li) (Fructus Pyri)

It is the fruit of Pyrus bretschneideri Rehd., Pyrus pyrifolia (Burm. f.) Nakai or Pyrus Ussuriensis Maxim. of the Rosaceae family. It is collected during August to September

Sweet, slightly sour, cool; act on the lung, stomach, and heart channels

Clear lung heat and dissolve phlegm, and promote fluid production to quench thirst

Indicated for the treatment of cough due to lung dryness, vexation and agitation in febrile disease, dry mouth due to scanty fluid, wastingthirst (xia¯o kĕ), red eyes, sores and ulcers, scald and burn. Normally, 15–30 g is decocted with water as an oral dose, or pounded to extract the juice for use; or be eaten raw; or an appropriate amount is used externally

Its use is cautious in pregnant women or patients with loose stool due to spleen deficiency or cough due to lung cold

Melon Seed (tian gua zi) (Semen Melo)

It is the dried matured seed of Cucumis melo L. of the Cucurbitaceae family. It is collected when fruit is matured in summer and autumn, and then washed clean, and dried under the sun

Sweet, cold; act on the lung, stomach, and large intestine channels

Clear lung heat and moisten the intestines, dissolve stasis, and expel pus

Indicated for the treatment of cough due to lung heat, thirst, constipation, lung abscess, intestinal abscess, injury from falling down, and fracture and injury of sinew and bone. Normally, 9–30 g is decocted with water or 3–6 g is ground into powder as an oral dose

Its use is prohibited in patients with deficiency-cold of the spleen and stomach and diarrhea

3. Herb differentiation (Table 13.6) TABLE 13.6 Differentiation Between Similar Efficacy Herbs That Clear and Dissolve Hot-Phlegm Name of Medicinal

Similarity

Differences

Tendrilled Fritillaria Bulb (chuan bei mu) (Bulbus Fritillariae Cirrhosae)

Both are collectively called “fritillaria” in medicinal books of previous dynasties before The Grand Compendium of Materia Medica (ben cao gang mu). Both are bitter and cold, act on the lung and heart channels, can clear heat and dissolve phlegm, dissipate masses and relieve swelling, and treat cough due to lung heat, scrofula, lung abscess and mammary abscess

It has sweet-based flavor, and is partial to moistening in nature, good at moistening the lung and relieving cough, and is quite suitable for the treatment of dry cough due to lung heat, over-strained cough due to lung yin deficiency, or chronic cough in the lung consumption (tuberculosis)

Thunberg Fritillary Bulb (zhe bei mu) (Bulbus Fritillariae Thunbergii)

It has bitter-based flavor, and is partial to discharging in nature, good at clearing lung heat and dissolving phlegm, and is suitable for the treatment of cough with yellow phlegm due to wind-heat invading the lung or phlegmheat stagnating in the lung. And its effects of clearing heat and dissipating masses are stronger than that of Bulbus Fritillariae Cirrhosae (chuan bei mu) (Continued )

280 PART | I Chinese Materia Medica

TABLE 13.6 Differentiation Between Similar Efficacy Herbs That Clear and Dissolve Hot-Phlegm (cont.) Name of Medicinal

Similarity

Differences

Snakegourd Fruit (gua lou) (Fructus Trichosanthis)

All three medicinals are the different medicament portions of Trichosanthes kirilowii Maxim. or Trichosanthes rosthornii Harms of the Cucurbitaceae family, can clear heat and dissolve phlegm, and treat cough due to phlegmheat. Fructus Trichosanthis (gua lou) and Semen Trichosanthis (gua lou zi) both can moisten dryness and promote defecation. Fructus Trichosanthis (gua lou) and Pericarpium Trichosanthis (gua lou pi) both can loosen the chest and rectify qi

It includes peel, seed, and pulp, and has the effects of both Pericarpium Trichosanthis (gua lou pi) and Semen Trichosanthis (gua lou zi), not only can clear heat and dissolve phlegm, promote qi movement and loosen the chest, also moisten the intestines to promote defecation, dissipate masses and relieve swelling, and suitable for the treatment of cough and panting due to phlegm-heat obstructing the lung, yellow phlegm with difficulty in expectoration, pĭ, and fullness in the chest, dry stool, and excess heat syndrome of the stomach and intestines

Trichosanthes Seed (gua lou zi) (Semen Trichosanthis)

Trichosanthes Peel (gua lou pi) (Pericarpium Trichosanthis)

Bamboo Shavings (zhu ru) (Caulis Bambusae in Taenia)

Bamboo Sap (zhu li) (Succus Bambusae)

It is the outer coating of Mongolian Snakegourd fruit, and good at clearing heat and dissolving phlegm, promoting qi movement and loosen the chest, and suitable for the treatment of cough due to phlegm-heat, accompanied by chest oppression All three medicinals come from bamboo, are cold in nature, can clear heat and dissolve phlegm, and treat cough and panting due to phlegm-heat. Bamboo Sap (zhu li) and Tabasheer (tian zhu huang) both have the effect of arresting convulsion and can treat convulsion due to phlegm-heat, epilepsy, and wind-strike with coma and wheezy phlegm in the throat

Tabasheer (tian zhu huang) (Concretio Silicea Bambusae)

Hogfennel Root (qian hu) (Radix Peucedani)

Cynanchum Root and Rhizome (bai qian) (Rhizoma et Radix Cynanchi Stauntonii)

It is the kernel of Mongolian Snakegourd fruit, and partial to moistening dryness and dissolving phlegm, and moistening the intestines to promote defecation, and suitable for the treatment of dry cough with sticky phlegm, accompanied by constipation due to intestinal dryness

It has fewer efficacies than the other two, is good at clearing heart heat and relieving vexation, and can be usually used for the treatment of cough and panting due to phlegm-heat and vexation and insomnia due to phlegm-heat disturbing the heart. It also can clear stomach heat and arrest vomiting, cool the blood and stanch bleeding, and treat vomiting due to stomach heat and bleeding due to blood heat It is cold and lubricating in nature, has a strong effect of clearing heat and clearing up phlegm, and is often used for the treatment of adult convulsive epilepsy and windstrike, obstinate phlegm coagulation with difficulty in expectoration due to lung heat It is sweet in flavor and moderate in nature, the effects of clearing and dissolving hot phlegm are similar to that of Succus Bambusae (zhu li) but no disadvantage of lubricating. It has strong effects of clearing heart heat and arresting convulsion, and is often used for the treatment of infantile convulsion, coma in febrile disease, windstrike with phlegm confounding, depressive psychosis and mania

Both are acrid and bitter in flavor, can direct qi downward and dissolve phlegm, and treat cough and panting with fullness and discomfort in the chest, and excessive sticky phlegm due to phlegmdrool obstructing the lung and lung failing to diffuse and govern descent. Both often combine with each other to reinforce their effects

It is slightly cold in nature, combines the effects of scattering wind and dissipating heat, and is often used for the treatment of externally-contracted wind-heat syndrome with fever, headache and cough, or cough and panting due to phlegm-heat It is slightly warm in nature, has a stronger effect of dispelling phlegm than that of Radix Peucedani (qian hu), and is often used for the treatment of cough and panting with excessive phlegm due to cold-phlegm or dampphlegm obstructing the lung and lung qi failing to govern descent

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SECTION 3  HERBS THAT RELIEVE COUGH AND CALM PANTING Outline Medicinals in this section mainly act on the lung channel, are acrid or bitter or sweet in flavor, and warm or cold in nature. Because the differences of property and flavor as well as different medicinal nature, such as moistening and dryness, mechanisms of relieving cough and calming panting are various, which may be involved in diffusing the lung, clearing lung heat, moistening the lung, directing lung qi downward, astringing the lung, and dissolving phlegm. Some medicinals are partial to relieving cough, some are partial to calming panting, and some have both at the same time. Medicinals in this section are indicated for the treatment of cough and panting. But the syndromes of cough and panting have the complex pathogenic conditions, such as the differences of external contraction and internal damage, cold and heat, deficiency and excess. In clinical application, doctors should combine different herbs that relieve cough and calm panting with corresponding medicinals based on “identification of etiology accordin