Harmonizing, Dryness and Dampness Formulas

HBR class 9

Formulas that Harmonize

*Minor Bupleurum Decoction (xiao chai hu tang)

C: D:

Chai Hu Huang Qin

A: Ban Xia, Sheng Jiang, Ren Shen, Zhi Gan Cao, Da Zao Pattern: Lesser Yang Disorder Indications: Alternating fever and chills, dry throat, bitter or sour taste in the mouth, dizziness, irritability, sensation of fullness in the chest and hypochondria (often experienced as difficulty in taking deep breaths), heartburn, nausea and vomiting, reduced appetite, a thin, white tongue coating, and a wiry pulse.

CAUTIONS AND CONTRAINDICATIONS: has an ascending action which can injure the qi and cause headache, dizziness, and bleeding of the gums if taken long-term. Contraindicated in patients with excess above and deficiency below, Liver Fire, or bleeding of the gums. Caution in cases of ascendant Liver yang, hypertension, or vomiting of blood due to yin deficiency. Patients with relatively weak normal qi may experience fever and chills while taking this formula because the pathogenic influence is vented from the lesser yang stage via the greater yang.

Major Bupleurum Decoction (da chai hu tang) C: Chai Hu

Huang Qin, Da Huang, Zhi Shi, Sheng Jiang, Da Zao, Bai Shao Yao, Ban Xia, Zhi Gan Cao Pattern: Concurrent lesser yang and yang brightnessstage disorder.

Indications: Alternating fever and chills, fullness in the chest and hypochondria (with or without pain), a bitter taste in the mouth, nausea, continuous vomiting, hard focal distention or fullness and pain in the epigastrium, burning diarrhea or no bowel movements, despondency, slight irritability, a yellow tongue coating, and a wiry, forceful pulse.

*Frigid Extremities Powder (si ni san)

C: D: A: E: Chai Hu Zhi Shi Bai Shao Zhi Gan Cao

Pattern: Rebellious Liver qi disturbing the Stomach (or yang-type collapse) Indications: Cold fingers and toes (although the body is warm) sometimes with a sensation of irritability and fullness in the chest and epigastrium, a red tongue with a yellow coating, and a wiry pulse. There may also be abdominal pain and/or severe diarrhea.

MODIFICATION / ASSOCIATED FORMULA

Bupleurum Powder to Spread the Liver (chai hu shu gan san)

Chai Hu, Bai Shao, Xiang fu, Chuan xiong, Zhi Ke, Chen pi, Zhi Gan Cao
Spreads the Liver qi, harmonizes the blood, and alleviates pain. For constraint and clumping of the Liver qi with hypochondriac pain and alternating fever and chills. Also for premenstrual syndrome or dysmenorrhea.

*Rambling Powder (xiao yao san)

C: D: A: E: Chai Hu Dang Gui, Bai Shao Bai Zhu, Fu Ling, Zhi Gan Cao Wei Jiang, Bo He

Pattern: Liver Constraint with Blood Deficiency Indications: Hypochondriac pain, headache, vertigo, a bitter taste in the mouth, dry mouth and throat, fatigue, reduced appetite, pale-red tongue, and a wiry, deficient pulse. There may also be alternating fever and chills, and irregular menstruation or distended breasts.

MODIFICATION / ASSOCIATED FORMULA Augmented Rambling Powder (jia wei xiao yao san) Chai Hu, Dang Gui, Shao Yao, Bai Zhu, Fu Ling, Mu Dan Pi, Zhi Zi, Zhi Gan Cao

Spreads the Liver qi, strengthens the Spleen, nourishes the blood and clears heat.
For Liver constraint with Spleen deficiency that transforms into heat characterized by irritability, a short temper with possible tidal fever and sweating, red eyes, dry mouth, palpitations, lower abdominal pressure, difficult painful urination, and increased menstrual flow or uterine bleeding.

MODIFICATION / ASSOCIATED FORMULA Black Rambling Powder (hei xiao yao san) Chai Hu, Dang Gui, Bai Shao, Fu Ling, Sheng Di Huang, Gan Cao Spreads the Liver qi, strengthens the Spleen, nourishes the blood and regulates menstruation. For the same presentation as the principal formula, but with more severe blood deficiency characterized by premenstrual cramps or excessive menstrual bleeding, and a wiry deficient or wiry rapid pulse.

Important Formula for Painful Diarrhea (tong xie yao fang)

C: Bai Zhu Bai Shao Yao, Chen Pi, Fang Feng Pattern: Painful diarrhea due to Spleen deficiency with an overcontrolling Liver. Indications: Recurrent problems of borborygmus, abdominal pain, diarrhea with pain (which starts with the urge to defecate and subsides after completion), a thin, white tongue coating, and a wiry, moderate or wiry, thin pulse.

*Pinellia Decoction to Drain the Epigastrium (ban xia xie xin tang)

C:

ban xia

D:
A: E:

gan jiang, huang qin, huang lian

ren shen, da zao zhi gan cao

Pattern: Heat-Cold Complex in the Middle Burner Indications: Epigastric focal distention, epigastric fullness and tightness with very slight or no pain, dry heaves or frank vomiting, borborygmus with diarrhea, reduced appetite, a thin, yellow, and greasy tongue coating, and a wiry, rapid pulse.

Formulas that Treat Dryness

Apricot Kernel and Perilla Leaf Powder (xing su san)

C: Xing Ren, Zi Su Ye Qian Hu, Jie Geng, Zhi Ke, Chen Pi, Fu Ling, Ban Xia, Sheng Jiang, Da Zao, Gan Cao Pattern: Externally-contracted cool-dryness interfering with the disseminating and descending functions of the Lungs. Indications: Slight headache, chills without sweating, cough with watery sputum, stuffy nose, dry throat, a dry, white tongue coating, and a wiry pulse.

Mulberry Leaf and Apricot Kernel Decoction (sang xing tang)

C: Sang Ye, Xing Ren

Zhi Zi, Dan Dou Chi, Zhe Bei Mu, Sha Shen, Bei Sha Shen, Li Pi Pattern: Warm-dryness injuring the Lung qi at a relatively superficial (exterior) level. Indications: Moderate fever, headache, thirst, a dry, hacking cough or cough with scanty, thick, and sticky sputum, a red tongue with a thin, dry, and white coating, and a floating, rapid pulse (especially on the right).

Eliminate Dryness and Rescue the Lungs Decoction (qing zao jiu fei tang)

C: Sang Ye, Shi Gao

Mai Men Dong, E Jiao, Hei Zhi Ma, Xing Ren, Pi Pa Ye, Ren Shen, Gan Cao Pattern: Warm-dryness attacking the Lungs. Indications: Headache, fever, hacking cough, wheezing, a dry and parched throat, dry nasal passages, a sensation of fullness in the chest, hypochondriac pain, irritability, thirst, a dry tongue without coating, and a deficient, big, and rapid pulse.

Lily Bulb Decoction to Preserve the Metal (bai he gu jin tang)

C: Bai He, Sheng Di Huang, Shu Di Huang Mai Men Dong, Xuan Shen, Chuan Bei Mu, Jie Geng, Dang Gui, Bai Shao, Gan Cao

Pattern: Internal dryness of the Lungs due to Lung and Kidney yin deficiency.
Indications: Coughing with blood-streaked sputum, wheezing, a dry and sore throat, hot palms and soles, night sweats, a red tongue with little coating, and a thin, rapid pulse.

Ophiopogonis Decoction (mai men dong tang)

C: Mai Men Dong
Ren Shen, Jing Mi, Da Zao, Gan Cao, Ban Xia Pattern: Lung atrophy (fei wei).

Indications: Coughing and spitting of saliva, wheezing, shortness of breath, a dry and uncomfortable sensation in the throat, a dry mouth, a dry, red tongue with little coating, and a deficient, rapid pulse.

Increase the Fluids Decoction (zeng ye tang)

C: Xuan Shen Mai Men Dong, Sheng Di Huang Pattern: This is dry Intestines due to injury to the fluids, usually from a warm-febrile disease. Indications: Constipation, thirst, a dry, red tongue, and a thin and slightly rapid, or a weak, forceless pulse.

Formulas that Expel Dampness

*Five-Ingredient Powder with Poria (wu ling san)

C: D: Ze Xie Fu Ling, Zhu Ling

A:
E:

Bai Zhu
Gui Zhi

Pattern: Taiyang-sage Water Buildup (Xu Shui) Indications: (1) Headache, fever, irritability, strong thirst but with vomiting immediately after drinking, urinary difficulty, and a floating pulse;

Indications, continued: (2) edema, generalized sensation of heaviness, diarrhea, urinary difficulty, and possible vomiting and diarrhea due to sudden turmoil disorder; (3) throbbing pulsations just below the umbilicus, vomiting frothy saliva, vertigo, shortness of breath, and coughing. COMMENTARY: The basic strategy is to restore to the qi its function of regulating fluid metabolism. This formula may therefore be used in treating other problems than those described above.

CAUTIONS AND CONTRAINDICATIONS: In patients with Spleen or Kidney qi deficiency, the dosage and duration of use of this formula must be carefully limited. Symptoms of overdose may include dizziness, vertigo, a bland taste, and reduced appetite. In cases with deficiency, this formula is often combined with others that tonify and nourish the Spleen and Stomach to prevent injury to the normal qi. In cases of urinary difficulty with yin deficiency, this formula should be modified to protect the yin from further injury.

*Polyporus Decoction (zhu ling tang)

C:
D: A:

Zhu Ling, Fu Ling

Ze Xie Hua Shi, E Jiao

Pattern: Injury from cold entering the yang brightness or the lesser yin stage where it transforms into heat.
Indications: Urinary difficulty accompanied by fever and thirst with a desire to drink. There may also be diarrhea, cough, nausea, irritability, or insomnia.

*Five-Peel Powder (wu pi san)

Sang Bai Pi, Sheng Jiang Pi, Fu Ling Pi, Chen Pi, Da Fu Pi Pattern: Skin edema (pi shui). Indications: Generalized edema with a sensation of heaviness, distention, and fullness in the epigastrium and abdomen, labored and heavy breathing, urinary difficulty, a white, greasy tongue coating, and a submerged and moderate pulse.

Add Spleen-tonifying herbs for SP deficiency.

*Calm the Stomach Powder (ping wei san)

C:
D: A:

Cang Zhu
Hou Po Chen Pi

E:

Zhi Gan Cao, Sheng Jiang, Da Zao

Pattern: Damp-Cold Stagnating in SP/ST Indications: Distention and fullness in the epigastrium and abdomen, loss of taste and appetite, heavy sensation in limbs, loose stool or diarrhea, easily-fatigued, increased desire to sleep, nausea & vomiting, belching, acid regurgitation, swollen tongue with thick white greasy coating, moderate or slippery pulse.

CAUTIONS AND CONTRAINDICATIONS: This formula contains warm, drying herbs which easily injure the yin and the blood, and should therefore only be used with significant modification for patients with yin deficiency or blood deficiency. It should also be used with caution during pregnancy.

*Agastache Powder to Rectify the Qi (huo xiang zheng qi san)

C: D: Huo Xiang Hou Po, Chen Pi, Zi Su Ye, Bai Zhi

A:
E:

Ban Xia, Da Fu Pi, Bai Zhu, Fu Ling, Jie Geng

Zhi Gan Cao, Sheng Jiang, Da Zao

Pattern: Externally-contracted wind-cold with concurrent internal injury due to stagnation. Indications: Fever and chills, headache, fullness and stifling oppression in the chest, pain in the epigastrium & abdomen, nausea & vomiting, borborygmus, diarrhea, loss of taste, white, greasy tongue coating, moderate, soggy pulse.

CAUTIONS AND CONTRAINDICATIONS: Because this formula contains warm and drying herbs, it should not be used without significant modification for conditions of wind-heat or fire due to deficiency.

*Eight-Herb Powder for Rectification (ba zheng san)

C: D: Mu Tong Hua Shi, Che Qian Zi, Qu Mai, Bian Xu

A:
E:

Zhi Zi, Da Huang

Deng Xin Cao, Gan Cao

Pattern: Hot or bloody painful urinary dysfunction caused by the clumping of damp-heat in the lower burner. Indications: Dark, turbid, scanty, difficult, and painful urination, a dry mouth and throat, a yellow, greasy tongue coating, and a slippery, rapid pulse. In severe cases, there may be urinary retention and lower abdominal distention and pain.

CAUTIONS AND CONTRAINDICATIONS: Long-term use of this formula may cause weakness, lightheadedness, palpitations, and a loss of appetite. It should not be used without significant modification in treating conditions of cold from deficiency, or during pregnancy.

Artemisia Yinchenhao Decoction (yin chen hao tang)

C: Yin Chen Hao

Shan Zhi Zi, Da Huang

Pattern: Yang-type jaundice or damp-heat jaundice due to dampness and static heat accumulating in the interior. Indications: Whole-body jaundice with color that resembles a fresh tangerine, slight abdominal distention, urinary difficulty, thirst (with the ability to take only sips), a yellow, greasy tongue coating, and a slippery, rapid pulse.

*True Warrior Decoction (zhen wu tang)

C: D: A: Fu Zi Bai Zhu, Fu Ling Sheng Jiang, Bai Shao

Pattern: Retention of Pathogenic Fluids with Kidney Yang (or Spleen and Kidney Yang) Deficiency Indications: Abdominal pain which is aggravated by cold, urinary difficulty, and deep aching and heaviness in the extremities.

Indications, continued: There may also be generalized edema, loose stools, dizziness, a heavy sensation in the head, palpitations, coughing, vomiting, a pale or dark swollen tongue with tooth marks, a white, slippery tongue coating, and a submerged, thin, and forceless pulse. Also for externally-contracted disorders with sweating that does not reduce the fever, palpitations in the epigastrium, dizziness, shivering and trembling with an unsteady appearance, a white, slippery tongue coating, and a submerged, thin, and forceless pulse.

Dioscorea Hypoglauca Decoction to Separate the Clear (bei xie fen qing yin)

C:

Bei Xie

Yi Zhi Ren, Wu Yao, Fu Ling, Shi Chang Pu, Gan Cao Pattern: Cloudy painful urinary dysfunction (gao lin) d/t cold from deficiency in the lower burner. Indications: Frequent urination with cloudy, dense, milky (resembling rice water), or greasy urine. Note: There is a similarly-named formula for DampHeat

*Angelica Pubescens and Sangjisheng C:Decoction Du Huo (du huo ji sheng tang)

D:

Xi Xin, Fang Feng, Qin Jiao

A: Sang Ji Sheng, Du Zhong, Niu Xi, Rou Gui, Dang Gui, Chuan Xiong, Sheng Di Huang, Bai Shao, Ren Shen, Fu Ling
E: Zhi Gan Cao

Pattern: Painful obstruction with Liver-Kidney Deficiency Indications: Heavy and painful sensations at fixed locations in the lower back and lower extremities accompanied by weakness and stiffness, an aversion to cold and attraction to warmth, palpitations, shortness of breath, a pale tongue with a white coating, and a thin, weak, slow pulse.

Notopterygium Decoction to Overcome Dampness (qiang huo sheng shi tang)

C:

Qiang Huo, Du Huo

Fang Feng, Gao Ben, Chuan Xiong, Man Jing Zi, Zhi Gan Cao Pattern: Wind-dampness in the superficial aspects of the body, the exterior and muscle levels Indications: Heavy and painful head, a generalized sensation of heaviness, back pain or generalized pain, difficulty in rotating or bending the trunk, mild fever, chills, a white tongue coating, and a floating pulse.

Remove Painful Obstruction Decoction from Medical Revelations (juan bi tang)

C:

Qiang Huo, Du Huo

Qin Jiao, Sang Zhi, Hai Feng Teng, Dang Gui, Chuan Xiong, Ru Xiang, Mu Xiang, Rou Gui, Gan Cao
Pattern: Joint pain due to local obstruction of qi from the effects of wind, dampness, and cold. Indications: Joint pain that increases with cold and diminishes with warmth, possibly accompanied by a sensation of heaviness and numbness in the limbs, a thick, white tongue coating, and a slow, possibly slippery pulse.

Cinnamon Twig, Peony, and Anemarrhena Decoction (gui zhi shao yao zhi mu tang)

C:

Gui Zhi, Ma Huang

Fu Zi, Zhi Mu, Bai Shao, Bai Zhu, Fang Feng, Sheng Jiang, Gan Cao Pattern: Recurrent wind-cold-damp painful obstruction in which localized constraint generates heat. Indications: Swollen and painful joints (especially of the lower extremities), joints that are warm to the touch and worsen at night, reduced range of motion in the affected joints, chills, no sweating, weight loss, headache, dizziness, a white, greasy tongue coating, and a wiry, slippery pulse.