Chapter 5 祛寒剂 Formulas that warm the interior
1. 温中祛寒 Formulas that warm the middle and expel cold
1. 理中丸 Li Zhong Wan
(From Shang Han Lun, means regulate the middle pill)
Ingredients:
Chief--- Gan Jiang (rhizome Zingiberis officinalis) 9g
Deputy--- Ren Shen (radix ginseng) 9g
Assistant--- Bai Zhu (rhizome atractrylodis macrocephalae) 9g
Envoy--- Zhi Gan Cao (honey fried radix glycyrrhizae uralensis) 9g
Actions: warm the middle and expel cold, tonify Qi and spleen
Indications: Middle Jiao deficient cold syndrome due to Spleen Yang deficiency manifested as abdominal pain, warm and pressure make it better, vomiting or diarrhea, abdominal distention and poor appetite, cold no thirst, pale tongue with white coat, deep thin pulse. Or bleeding due to Yang deficiency, or cold Chest Bi with fullness due to Middle Jiao deficient cold.
2. 小建中汤Xiao Jian Zhong Tang
(From Shang Han Lun, means minor decoction for strengthening the middle)
Ingredients:
Chief---Yi Tang (maltose) 60g
Deputy---Gui Zhi (Ramulus cinnamomi cassiae) 9g
Deputy---Bai Shao Yao (radix paeoniae) 18g
Assistant & Envoy ---Sheng Jiang (rhizome zingiberis officinalis recins) 9g
Assistant & Envoy ---Da Zao (fructus zizyphi jujubae) 4 pieces
Assistant & Envoy ---Zhi Gan Cao (honey fried radix glycyrrhizae uralensis) 6g
Actions: warm and tonify middle Jiao, moderate spasmodic abdominal pain
Indications: deficient cold of the Middle Jiao manifested as intermittent spasmodic abdominal pain, warmth and massage make it better. Pale face. Pale tongue with white coating, wiry and moderate pulse.
Modern use: stomach and duodenum ulcer, neurosis, aplastic anemia, functional fever, chronic hepatitis.
This formula is composed by Gui Zhi Tang + Yi Tang with double dosage of Shao Yao.
3. 吴茱萸汤Wu Zhu Yu Tang
(From Shang Han Lun, means Wu Zhu Yu decoction)
Ingredients:
Chief--- Wu Zhu Yu (fructus evodiae rutaecarpae) 6g
Deputy--- Sheng Jiang (rhizome zingiberis officinalis recins) 18g
Assistant--- Ren Shen (radix ginseng) 9g
Envoy--- Da Zao (fructus zizyphi jujubae) 12 pieces
Actions: warm and tonify the middle, redirect rebel Qi, stop vomiting
Indications: 1. liver cold attack stomach or stomach deficiency cold manifested as vomiting, abdomonal pain, inability to keep food down, and sometimes hunger. 2. liver and stomach deficiency cold leading to vertex headache (Jueyin headache), dry vomiting, spitting of clear fluids. 3. cold Middle Jiao attacked manifested as diarrhea, cold hands and feet, headache and vomiting, which may be so bad that the patient wants to die. White slippery tongue coat, slow and thin or wiry and thin pulse.
2. 回阳救逆 Formulas that restore Yang and rescue collapse
1. 四逆汤 Si Ni Tang
From Shang Han Lu, means “improper flow of Qi to the four limbs (frigid extremities) decoction”.
Ingredients:
Fu Zi (radix lateralis aconite carmichaeli praeparata)…15g (decocte for 30-60 minutes before adding other herbs)
Gan Jiang (rhizome zingiberis officinalis)…9g
Zhi Gan Cao (honey freid radix glycyrrhizae uralensis)…6g
Actions: rescues devastated Heart Kidney Yang (shock), warms mid Jiao, stop diarrhea, warm cold hands & feet.
Indications: very cold extremities, aversion to cold, sleeping in fetal position to keep warm, always tired, vomiting, diarrhea with undigested food in stool, abdominal pain, no thirst, T- pale with white slippery coat, P- deep weak thin.
2. 参附汤Shen Fu Tang (Ginseng and Prepared Aconite Decoction)
Ingredients:
Ren Shen (Radix Ginseng)15g 人参
Zhi Fu Zi (Radix Aconiti Lateralis Praeparata)30g 附子 (Decoct it 30-60 munites longer)
Actions: Restore Yang, tonify Qi, rescure collapse.
Indications: Very cold extremities, excessive cold sweating, weak breath, very weak pulse.
3. 温经散寒 Formulas that warm channels and expel cold
1. 当归四逆汤 Dang Gui Si Ni Tang
Shang Han Lun
- Dang Gui for improper flow of Qi to the four limbs (frigid extremities) decoction
Ingredients:
Dang Gui (radix angelicae sinensis)…9g
Bai Shao Yao (Radix paeoniae)…9g
Gui Zhi (ramulus cinnamomi cassiae)…9g
Xi Xin (herba cum radice asari)…6g
Zhi Gan Cao (honey fried radix glycyrrhizae uralensis)…6g
Da Zao (fructus zizyphi jujubae)…5 pieces
Mu Tong (caulis mutong)…6g
Actions: warms meridians, expel Cold, nourish blood, unblocks blood vessels
Indications: Cold in the meridians with Blood deficiency manifested as chronic cold hands and feet. T- pale with white coat, P- deep weak thin.
1. 理中丸 Li Zhong Wan
(From Shang Han Lun, means regulate the middle pill)
Ingredients:
Chief--- Gan Jiang (rhizome Zingiberis officinalis) 9g
Deputy--- Ren Shen (radix ginseng) 9g
Assistant--- Bai Zhu (rhizome atractrylodis macrocephalae) 9g
Envoy--- Zhi Gan Cao (honey fried radix glycyrrhizae uralensis) 9g
Actions: warm the middle and expel cold, tonify Qi and spleen
Indications: Middle Jiao deficient cold syndrome due to Spleen Yang deficiency manifested as abdominal pain, warm and pressure make it better, vomiting or diarrhea, abdominal distention and poor appetite, cold no thirst, pale tongue with white coat, deep thin pulse. Or bleeding due to Yang deficiency, or cold Chest Bi with fullness due to Middle Jiao deficient cold.
2. 小建中汤Xiao Jian Zhong Tang
(From Shang Han Lun, means minor decoction for strengthening the middle)
Ingredients:
Chief---Yi Tang (maltose) 60g
Deputy---Gui Zhi (Ramulus cinnamomi cassiae) 9g
Deputy---Bai Shao Yao (radix paeoniae) 18g
Assistant & Envoy ---Sheng Jiang (rhizome zingiberis officinalis recins) 9g
Assistant & Envoy ---Da Zao (fructus zizyphi jujubae) 4 pieces
Assistant & Envoy ---Zhi Gan Cao (honey fried radix glycyrrhizae uralensis) 6g
Actions: warm and tonify middle Jiao, moderate spasmodic abdominal pain
Indications: deficient cold of the Middle Jiao manifested as intermittent spasmodic abdominal pain, warmth and massage make it better. Pale face. Pale tongue with white coating, wiry and moderate pulse.
Modern use: stomach and duodenum ulcer, neurosis, aplastic anemia, functional fever, chronic hepatitis.
This formula is composed by Gui Zhi Tang + Yi Tang with double dosage of Shao Yao.
3. 吴茱萸汤Wu Zhu Yu Tang
(From Shang Han Lun, means Wu Zhu Yu decoction)
Ingredients:
Chief--- Wu Zhu Yu (fructus evodiae rutaecarpae) 6g
Deputy--- Sheng Jiang (rhizome zingiberis officinalis recins) 18g
Assistant--- Ren Shen (radix ginseng) 9g
Envoy--- Da Zao (fructus zizyphi jujubae) 12 pieces
Actions: warm and tonify the middle, redirect rebel Qi, stop vomiting
Indications: 1. liver cold attack stomach or stomach deficiency cold manifested as vomiting, abdomonal pain, inability to keep food down, and sometimes hunger. 2. liver and stomach deficiency cold leading to vertex headache (Jueyin headache), dry vomiting, spitting of clear fluids. 3. cold Middle Jiao attacked manifested as diarrhea, cold hands and feet, headache and vomiting, which may be so bad that the patient wants to die. White slippery tongue coat, slow and thin or wiry and thin pulse.
2. 回阳救逆 Formulas that restore Yang and rescue collapse
1. 四逆汤 Si Ni Tang
From Shang Han Lu, means “improper flow of Qi to the four limbs (frigid extremities) decoction”.
Ingredients:
Fu Zi (radix lateralis aconite carmichaeli praeparata)…15g (decocte for 30-60 minutes before adding other herbs)
Gan Jiang (rhizome zingiberis officinalis)…9g
Zhi Gan Cao (honey freid radix glycyrrhizae uralensis)…6g
Actions: rescues devastated Heart Kidney Yang (shock), warms mid Jiao, stop diarrhea, warm cold hands & feet.
Indications: very cold extremities, aversion to cold, sleeping in fetal position to keep warm, always tired, vomiting, diarrhea with undigested food in stool, abdominal pain, no thirst, T- pale with white slippery coat, P- deep weak thin.
2. 参附汤Shen Fu Tang (Ginseng and Prepared Aconite Decoction)
Ingredients:
Ren Shen (Radix Ginseng)15g 人参
Zhi Fu Zi (Radix Aconiti Lateralis Praeparata)30g 附子 (Decoct it 30-60 munites longer)
Actions: Restore Yang, tonify Qi, rescure collapse.
Indications: Very cold extremities, excessive cold sweating, weak breath, very weak pulse.
3. 温经散寒 Formulas that warm channels and expel cold
1. 当归四逆汤 Dang Gui Si Ni Tang
Shang Han Lun
- Dang Gui for improper flow of Qi to the four limbs (frigid extremities) decoction
Ingredients:
Dang Gui (radix angelicae sinensis)…9g
Bai Shao Yao (Radix paeoniae)…9g
Gui Zhi (ramulus cinnamomi cassiae)…9g
Xi Xin (herba cum radice asari)…6g
Zhi Gan Cao (honey fried radix glycyrrhizae uralensis)…6g
Da Zao (fructus zizyphi jujubae)…5 pieces
Mu Tong (caulis mutong)…6g
Actions: warms meridians, expel Cold, nourish blood, unblocks blood vessels
Indications: Cold in the meridians with Blood deficiency manifested as chronic cold hands and feet. T- pale with white coat, P- deep weak thin.
