Ch4: Formulas that Regulate Liver and Spleen

Question 1

What are the ingredients of Si Ni San?

Answer 1

1. Chai Hu (bupleurum) 6g
2. Bai Shao (white peony) 6g
3. Zhi Shi (unripe bitter orange) 6g
4. Gan Cao (licorice) 6g

Question 2

What are the functions for Si Ni San?

Answer 2

• Dispel pathogenic factors and remove stagnation
• Regulate qi in spleen and liver

Question 3

Indications for Si NI San?

Answer 3

• Cold limbs from wei qi stagnation, depressed liver in which flow of yang qi is impaired
• Epigastric and hypochondriac pain or diarrhea due to disharmony between liver and spleen

Question 4

What causes feverishness (just the sensation of feeling warm but not high fever) and cold limbs?

Answer 4

• Exterior evil factors go inside
• Qi stagnation such that yang qi cannot reach hands and feet. Body is ok but cold limbs. (This is just from stagnation, not from deficiency)

Question 5

Pathogenesis of epigastric and hypochondriac pain? Wiry pulse?

Answer 5

Qi stagnation in the liver

Qi stagnation generally

Question 6

Pathogenesis of diarrhea, dysentery and tenesmus?

Answer 6

Prolonged stagnation of qi in the liver transforms into fire which impairs the spleen function of T & T

Question 7

Actions of Chai Hu?

Answer 7

King herb

• Soothe the liver and resolve the stagnation
• Vent pathogens through the exterior

Question 8

Actions of Bai Shao?

Answer 8

Deputy

• Nourish blood
• Replenish yin
• Pacify liver and stop pain

Question 9

Zhi Shi (unripe bitter orange) actions?

Answer 9

• Promote qi circulation (regulate qi category)
• Regulate spleen and stomach

Question 10

Gan Cao action?

Answer 10

Messenger

• Harmonize
• Tonify spleen

Question 11

Describe the combination characteristics for Chai Hu and Bai Shao

Answer 11

Chai Hu dispels, Bai Shao astringes. Together they can soothe yang qi and harmonize yin qi. They can dispel without damaging yin.

This is also a common combination to regulate the liver.

(ZZJ used Si Ni San to treat Yang deficient Shaoyin syndrome)

Question 12

How do Chai Hu (bupleurum, thorowax) and Zhi Shi (unripe bitter orange) work together?

Answer 12

Both break up stagnant qi. Chai Hu ascends (raises Yang Qi) while Zhi Shi descends. Together they can regulate qi movement.

Question 13

Zhi Shi and Bai Shao combination characteristics?

Answer 13

Zhi Shi regulates qi while Bai Shao nourishes blood. Common combination for regulate qi and blood.

Question 14

What are the key symptoms for Si Ni San?

Answer 14

• Cold extremeties
• Abdominal pain
• Wiry pulse

Question 15

Western disorders that Si Ni San may treat?

Answer 15

• Cholecystitis
• Gastritis
• Gastric ulcer
• Hepatitis (no jaundice)
• Intercostal neuralgia

Applicable to Liver/Gallbladder disorders, Stomach and intestinal disorders

Question 16

What are the precautions for Si Ni San?

Answer 16

Not suitable for cold extremeties due to yang deficiency

Question 17

Why do we use Bai Shao to nourish blood in the Si Ni San formula?

Answer 17

To resolve liver qi stagnation we also need to consider the optimal form of the liver. Qi stagnation can easily cause heat and damage yin-blood. Liver is yin in form and yang in function. The function of soothing qi flow belongs to yang. This yang function depends on the liver having a certain level of moisture to nourish the yin and blood.

Question 18

What are the ingredients for Xiao Yao San?

Answer 18

• Chai Hu (bupleurum) 30g
• Dang Gui (angelica) 30g
• Bai Shao (white peony) 30g
• Bo He (mint) 9g
• Bai Zhu (white atractylode) 30g
• Sheng Jiang (ginger) 6g
• Fu Ling (poria) 30g
• Gan Cao 15g

Question 19

Function of Xiao Yao San?

Answer 19

• Promote qi circulation in the liver and remove stagnation
• Strengthen the function of the spleen and harmonize the ying system

Question 20

Indications for Xiao Yao San?

Answer 20

• Disharmony between liver and spleen
• Blood deficiency and stagnation of liver qi

Question 21

What are the three main pathogenic factors (patterns) involved in Xiao Yao San condition? What is the main problem?

Answer 21

1) Liver constraint causing 2) blood deficiency and 3) spleen deficiency

Spleen deficiency also contributing to blood deficiency

Liver qi constraint is the main problem.

Question 22

Actions of Chai Hu?

Answer 22

King herb

• Soothe the liver
• Relieve stagnation

Question 23

Bai Shao and Dang Gui actions?

Answer 23

Deputies

• Nourish blood
• Strengthen liver by removing stagnation of qi

Question 24

Actions of Bai Zhu, Fu Ling, Sheng Jiang?

Answer 24

Assistants

• Tonify spleen and stomach

Question 25

Bo He action?

Answer 25

Assistant

• Regulate and promote qi circulation in liver to remove stagnation

Question 26

Characterstics of combination of herbs in Xiao Yao San?

Answer 26

Combination of soothing and nourishing, treats both qi and blood, liver and spleen at the same time.

Question 27

What are the key symptoms for Xiao Yao San?

Answer 27

• Distending hypochondriac pain
• Lassitude
• Poor appetite
• Mood swings
• Irregular period
• Wiry and weak pulse

Question 28

Western diseases applicable to Xiao Yao San?

Answer 28

• Anemia
• Chronic hepatitis
• Functional uterine bleeding
• Neurosis
• PMS