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Formulas & Strategies > Ch3: Formulas that are Cold and Purging > Flashcards

Ch3: Formulas that are Cold and Purging Flashcards

1
Q

What are the ingredients of Da Cheng Qi Tang?

A
  1. Da Huang (Rhubarb root)
  2. Mang Xiao (Mirabilite)
  3. Zhi Shi (Unripe bitter orange)
  4. Hou Po (Magnolia bark)
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2
Q

What are the functions of Da Cheng Qi Tang?

A
  • Strongly purge the bowels
  • Clear internal stagnated heat
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3
Q

What are the indications for DCQT?

A
  1. Yangming Fu Excess syndrome
  2. Heat retention with watery discharge
  3. Heat syncope, convulsive disease, mania due to internal excess heat
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4
Q

Key symptoms for choosing Da Cheng Qi Tang?

A
  • Fever (or afternoon fever)
  • Constipation
  • Thirst
  • Red tongue
  • Yellow thick dry coating
  • Rapid, strong pulse
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5
Q

Pathogenesis of heat and fire in the intestines causes which manifestations?

A
  • Abdominal pain
  • Constipation
  • Distention and fullness
  • Fever
  • Pain aggravated by pressure
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6
Q

Pathogenesis of heat consuming body fluids leading to lack of nourishment of tendons and eyes causes which symptoms?

A
  • Blurred vision
  • Convulsions
  • Dry mouth and tongue
  • Yellow, thick, dry coating
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7
Q

Mind being disturbed by heat causes which symptoms?

A
  • Delirium
  • Irritability
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8
Q

Cold limbs are caused by what pathogenesis?

A

Accumulation of heat which hinders yang qi reaching the limbs.

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9
Q

Excess pathogenic factors in the interior manifests in what way in the pulse?

A

Deep rolling and rapid pulse

or

Deep excess and forceful pulse

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10
Q

Yangming Fu Exces Syndrome:

Describe Pi vs Man symptoms. Which is objective vs subjective?

A

Pi - subjective feeling of fullness in the chest or abdomen

Man - objective distention and fullness that is resistant to palpation

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11
Q

Yangming Fu Excess Syndrome:

What does Zao refer to in the symptom cluster?

A

Dryness that refers to dry stool, dry mouth, dry tongue, dry coating

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12
Q

Yangming Fu Excess Syndrome:

What does Shi refer to in the symptom cluster?

A

Excess:

  • Constipation and abdominal pain worse with pressure
  • Forceful pulse
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13
Q

What is the unique and counterinutuitive manifestation for heat retention with watery discharge? How does Da Cheng Qi Tang help?

A

Liquid stool or watery discharge!

This is very smelly. This “diarrhea” is a false sign as the real culprit is a stuck, hard, dry stool blocking the passage.

DCQT is used to purge the dry stool so the “diarrhea” can be stopped.

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14
Q

What are the manifestations and pathogenesis unique to heat syncope?

A

Excess heat inside hinders yang qi reaching the limbs which leaves them feeling cold. This is true heat with false cold.

Still have the other signs of internal excess heat such as abdominal pain worse with pressure, constipation, dry mouth, thirst, slippery excess pulse.

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15
Q

Why is Da Cheng Qi Tang considered to “treat cold with cold”?

A

Da Cheng Qi Tang clears true heat with purging which allows the qi movement to normalize and limbs to warm with the arrival of Yang Qi.

Treats cold limbs with cold purgation.

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16
Q

Actions of Da Huang?

A

King herb

  • Bitter and cold to sedate heat
  • Purge bowels
  • Remove stagnation
17
Q

Actions of Mang Xiao?

A

Deputy herb

  • Salty to soften hardness
  • Cold to clear heat
  • Moisten the bowel and remove constipation
18
Q

Actions of Hou Po and Zhi Shi?

A

Assistants

  • Promote qi circulation
  • Promote bowel movement
  • Relieve distention and fullness
19
Q

What are the characteristics of the combination of herbs for DCQT?

A

Purging and regulating qi combination.

Regulate qi to assist purging, purge to assist in regulating qi.

20
Q

What are the precautions for DCQT?

A
  • Colon cancer
  • Deficiency syndrome
  • Exterior syndrome
  • Pregnancy
21
Q

What is DCQT applicable to?

A
  • Acute abdominal pain with high fever
  • Appendicitis
  • Intestinal obstructions
22
Q

What are the cooking methods for DCQT?

A
  1. Cook Zhi Shi and Hou Po first
  2. Cook Da Huang later - long cooking reduces the purging function
  3. Do NOT cook Mang Xiao, dissolve into decoction
23
Q

What is the modification of DCQT to gently purge bowel and relieve bloating?

A

Xiao Cheng Qi Tang

Remove Mang Xiao from DCQT

This means the Zao dryness symptoms are less because we do not have the moistening of Mang Xiao.

24
Q

What is the modification of DCQT to slowly purge the bowel and clear heat? Which symptoms are less?

A

Tiao Wei Cheng Qi Tang

Remove Zhi Shi and Hou Po. This means the fullness and distention are less so we do not need these herbs.

Add Gan Cao

25
Q

What are the ingredients of Da Huang Mu Dan Tang? (Know all 5)

A
  1. Da Huang (Rhubarb rhizome) 12g
  2. Mu Dan Pi (Moutan bark) 3g
  3. Mang Xiao (Mirabilite) 9g
  4. Tao Ren (Peach kernel) 9g
  5. Dong Gua Ren (Wax Gourd seed) 30g
26
Q

What are the functions of Da Huang Mu Dan Tang?

A
  • Sedate heat and remove stagnation
  • Disperse and relieve swelling
27
Q

What are the indications for DHMDT?

A

Initial stage of intestinal abscess (appendicitis)

28
Q

What is the pathogenesis for the symptoms of right lower abdominal pain aggravated by pressure on the abdomen and a hard lump?

A

Intestinal damp heat and stagnation of blood

29
Q

What is the pathogenesis for fever and chills in this case?

A

Disharmony of ying and wei due to accumulated heat in the blood, leading to poor circulation of qi and blood.

30
Q

What is the pathogenesis for rolling and rapid pulse?

A

Excessive heat and dampness in the interior

31
Q

What are the actions of Da Huang and Mu Dan Pi?

A

King herbs

  • Da Huang to clear heat, sedate fire, activate blood
  • Mu Dan Pi to clear heat, cool blood, activate blood
  • These two work together to clear heat and remove stasis, works well for stagnated heat and blood stasis.
32
Q

What are the actions of Mang Xiao?

A

Deputy

  • Sedate heat
  • Remove stagnation
  • Soften hardness
  • Disperse and relieve swelling
33
Q

What are the actions of Tao Ren and Dong Gua Ren?

A

Assistants

  • Help to relieve stagnated heat
  • Eliminate dampness
  • Activate blood
  • Reduce swelling
34
Q

What are the characteristics of the combination for Da Huang Mu Dan Tang?

A

Combination of purging the bowel, clearing heat, removing stasis in one formula to achieve the function of dispelling stagnation and stopping pain.

35
Q

What are the key symptoms for Da Huang Mu Dan Tang? Application?

A
  • Abdominal pain on right lower side
  • Constipation
  • Fever
  • Slippery, rapid pulse

Application: acute appendicitis

36
Q

What is the modification if clearing heat and relieving toxins is not strong enough?

A

Add:

  • Pu Gong Ying (Dandelion)
  • Jin Yin Hua (Honeysuckle flower)
  • Bai Jiang Cao (Dahurian Patrinia herb)
37
Q

What is the modification if there is severe abdominal pain?

A

Yuan Hua - Genkwa flower (Downward Draining Harsh Expellant)

Chuan Lian Zi - Toosendan fruit, Sichuan Chinaberry (Regulate Qi)

Qing Pi - Unripe Tangerine Peel (Regulate Qi)

Xiang Fu - Cyperus, Nut grass Rhizome (Regulate Qi)

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