Shang han lun formulas Flashcards
Symptoms:
Fever
- From Wei (Defensive) Qi fighting with the Evil Qi
Easily Perspires
- From the inability of the body to keep the pores closed due of Lung Qi Deficiency
- Also the bodys attempt to relieve the fever and heat
Headache
- Cold type of headache with muscle tension around the neck.
Chills
Aversion to Wind
Tongue: The tongue body appears deficient (perhaps pale), and the coating is normal: thin, white.
Pulse: Moderate Floating (superficial) pulse. The pulse is moderate (as opposed to strong) as this is a deficiency condition - the patient perspires easily. Consequently the pulse is not as rapid (as in an excess condition).
Shen (Spirit): The patient may appear tired and weak.
Tai Yang DEFIENCY - Small Intestine and Bladder
Formula: Gui Zhi Tang (Cinnamon Twig Decoction)
Function: Releases the pathogenic influences from the muscle layer and harmonizes the nutritive (Ying) and defensive (Wei) Qi.
Contents:
Gui Zhi - cinnamon twig - w.a.r.e. - chief
Bai Shao - white peony - tonify blood - deputy
+ both herbs enhance the ability of the wei qi to expel pathogen while nuturing the ying qi
Sheng Jiang - ginger - w.a.r.e. - assist.
Da Zao - red date - tonify qi - assit.
+ both herbs benefit the middle, regulates nutritive and protective qi
Gan Cao - licorice - tonify qi - envoy
+ harmonizes the herbs
Symptoms:
Fever and Chills with aversion to Cold
No Perspiration
- As this is an excess condition, the pores are closed and the skin is dry and tight
Headache
- In the Tai Yang Channel area (occipital region)
Lumbago
Arthralgia
General aching
Tongue: Normal body with thin white coating
Pulse: Floating and tight pulse.
Tai Yang EXCESS - Small Intestine Bladder
Formula: Ma Huang Tang (Ephedra Decoction)
Function: Releases the Exterior Cold and arrests wheezing. Opens the Lung Qi and induces sweating.
Contents:
Ma Huang - ephedra - w.a.r.e. - chief
+ strong diaphoretic, disseminates lung qi, treats wheezing
Gui Zhi - cinnamon bark - w.a.r.e. - deputy
+ diaphoretic that releases the muscle layer, warms and facilitates flow in the channels
Xing Ren - apricot kernel - assitang
+ directs lung qi down, stops wheezing and expel pathogen
Gan Cao - licorice - envoy
+ harmonizes the other herbs and moderates ephedra
Symptoms (The Four Big’s):
Big fever
- This indicates Interior Excess Heat
- This may be accompanied by mental restlessness or irritability if the Heat affects the mind
Big sweat
- Interior Excess Heat is evaporating fluids or forcing fluids out
Big thirst
- From consumption of body fluids and excess heat.
- A preference for cold drinks
Big pulse.
- Strong pathogenic and anti-pathogenic factors
Red Face
No aversion to cold
Tongue: Red Body with Thick Yellow Coat (or dry coating).
Pulse: Excess Pulse
Yang Ming Channel
Formula: Bai Hu Tang (White Tiger Decoction)
Function: Clears Qi Stage and Yang Ming Channel Heat; Drains Stomach Fire, generates body fluids and alleviates thirst.
Contents:
Shi Gao - gypsum - clear heat - chief
+ clear heat from interior, vent pathogenic heat to exterior, release heat constraint from muscle layer/skin, and enrich the yin to support the generation of body fluids
Zhi Mu - anemarrhenae rhizome - clear heat - deputy
+ assists shi gao in clearing heat, moisten dryness, enrich yin
Jing Mi - non glutenous rice - assistant/envoy
Zhi Gan Cao - prepared licorice - assistant/envoy
+ both benefit the stomach and protect the fluids. Prevent cold properties of the other ingredients from injuring the middle jiao.
Symptoms:
The Four Big’s (As Above)
Constant Fever, but more pronounced in the afternoon.
Abdominal distention
- The Yang Ming Fu (Organ) syndrome will also have abdominal bloating or in more severe cases, abdominal masses. This is due to the heat drying the fluids, causing Qi Stagnation in the organs
Constipation
- The main distinguishing symptom of the Organ (Fu) and Channel (Jing) syndrome
- Due to interior heat consuming fluids
Tongue: Thick, Dry, Yellow Coat.
Pulse: Excess Pulse
Yang Ming ORGAN
Formula: Da Cheng Qi Tang (Major Order the Qi Decoction)
Function: Vigorously purges the Heat Accumulation (induces defecation).
Contents:
Da Huang - rhubarb - purgative - chief
+ dissipates clumps and purges heat from the stomach and out the intestines
Mang Xiao - Natrii Sulfas - purgative - deputy
+ softens stools
++ both herbs moisten dryness and drain downward
Hou Po - magnolia bark - invig. qi - assistant
Zhi Shi - Fructus Aurantii Immaturus - invig. qi - assistant
++ assist in the expulsion of stool by moving qi
Symptoms:
Alternating chills and fever
- It was believed that fevers corresponded to the body’s Zheng (Upright or Good) Qi fighting and winning against the pathogenic Evil Qi, and that Chills indicated that the body’s Zheng Qi was losing the fight against the pathogenic Evil Qi.
Bitter taste in mouth
- Indicates an excess Gall Bladder condition, heat disrupting the flow of bile.
Blurred vision
- The Liver, which opens to the eyes, is affected.
Nausea, vomiting, bloating, poor appetite, and stomach ache.
- An excess Liver condition can easily affect (attack) the Spleen and Stomach, which govern the digestive system.
Pain in the costal (hypochondriac) region
- The costal region is the region of the Liver so as the Meridian flow is disturbed, so is this area.
Irritability, Heart Vexation, and irregular heart beat.
- This corresponds to the Pericardium channel being affected. The Pericardium is closely related to the Heart which controls the Shen (Mind).
- As the Heat disturbs the Pericardium, the Heart and thus the Mind is also affected producing irritability (or even insomnia).
Tongue: Sides of the tongue are more red, mixed yellow and white coating (again reflecting the halfway characteristic of the Shao Yang syndrome).
Pulse: Wiry pulse.
Shao Yang syndrome
Formula: Xiao Chai Hu Tang (Minor Bupleurum Decoction)
Function: Harmonizes and releases Shao Yang (lesser yang) channel disorders.
Contents:
Chai Hu - bupleurum - c.a.r.e. - chief
+ venting pathogen in lesser yang warp disorder
Huang Qin - scutellaria - clear heat - deputy
+ drains heat from LV and GB, vents pathogens
++ both herbs together clear heat without causing it to sink deeper into the body.
Ban Xia - pinellia - assistant
Sheng Jiang - ginger - assistant
+ harmonizes the middle burner, direct qi downward
Ren Shen - ginseng - tonify qi - assistant
Da Zao - red date - tonify qi - assistant
Zhi Gan Cao - prep. licorice - tonify qi - assistant
+ moderate the acrid properties of other herbs, support the qi to prevent pathogen from sinking deeper into the body
Symptoms:
Abdominal Fullness
- From the Spleen not being able to transform and transport.
Abdominal Pain
- As this is a deficient pain, it will be alleviated by warmth and pressure.
Diarrhea, nausea, vomiting.
- Dampness affects nausea and diarrhea.
- Also due to the Dampness, the Stomach Qi may be obstructed from descending and may rebel producing vomiting.
No Thirst
- No interior Heat
Tongue: Pale with a white sticky coat.
Pulse: Slow and weak pulse.
Shen/Spirit: Low energy, fatigued.
Formula: Li Zhong Wan (Regulate the Middle Pill)
Function: Warms the Middle Jiao and strengthens the Spleen and Stomach.
Contents:
Gan Jiang - ginger - w.a.r.e. - cheif
+ warms the spleen and stomach yang, eliminates interior cold
Ren Shen - ginseng - tonify qi - deputy
+ strongly tonifies source qi
Bai Zhu - atractylodis - tonify qi - assit.
+ aids deputy herb in tonifying middle jiao and dries dampness
Zhi Gan Cao - licorice prep. - tonify qi - envoy
+ harmonizes and augments the qi
Symptoms:
Aversion to Cold, Cold Limbs.
- The Shao Yin feeling of cold is colder than that of the Tai Yin syndrome.
- The patient may lie curled up or prefer many blankets.
- There is little thirst and the patient may prefer warm drinks.
Tendency to sleep and Listlessness.
- From Yang Deficiency.
Diarrhea with undigested food
- Cold affecting the Spleen and Kidney
Clear Urine with Increased Volume
- Yang deficiency leading to excess Yin
No Fever
Tongue: Pale (Very Deficient) with a thin white coat.
Pulse: Deep, minute (very weak) pulse.
Formula: Si Ni Tang (Frigid Extremities Decoction)
Function: Rescues devastated Yang, warms the Middle Jiao, and stops the diarrhea.
Contents:
Fu Zi - aconite - warm interior - cheif
+ warming and stimulating the fire at the gate of vitality to disseminate through the body and reach the extremities
Gan Jiang - ginger - warm interior - deputy
+ warms the middle jiao and eliminates cold
Zhi Gan Cao - prep. licorice - tonify qi
+ augments the qi, strengthens the spleen, reduces toxicity of fu zi/aconite and gan jiang/ginger
Symptoms:
Insomnia, irritability.
- From Fire Flaring up from Deficiency. The Yin is Deficient so the Yang can not be subdued at night.
Dry mouth and throat.
- Yin Deficiency implies deficiency of body fluids producing dry mouth and throat (or even skin and eyes).
Scanty dark yellow urination.
- From consumption of Yin from Heat
No Desire to Drink Fluids
Tongue: Dark Red body, Red Tip with little or no coating.
Pulse: Thin and rapid pulse.
Formula: Huang Lian E Jiao Tang (Coptis and Ass-Hide Gelatine Decoction)
Function: Nourishes the Yin, causes the Deficient Fire to descend, eliminates irritability and calms the Shen (Spirit).
Contents:
Huang Lian - coptis - clear heat - chief
E Jiao - ass hide gelatin - tonify yin - chief
++ both herbs clear heat while nourishing yin and blood
Huang Qin - scutalaria - clear heat - deputy
+ drains heat from the upper jiao to assit huang lian
(bai) Shao Yao - peony - tonify blood - deputy
+ assist e jiao/ass hide
Ji Zi Huang (egg yolk) - tonify yin - assit/envoy
+ tonify yin and blood, resolve heat toxicity, assists the heat draining herbs in eliminating the pathogen and protect against the drying properties of the other herbs
Symptoms
- Abdominal pain aggravated by cold
- Urinary difficulty
- Deep aching heaviness in the extremities
May also have:
- Generalized edema
- Loose stools
- Dizziness
- Heavy sensation in the head
- Feeling weak and unstable
- Palpitations
- Coughing
- Vomiting
Tongue: Pale or dark, swollen with tooth marks, with a white, slippery coat
Pulse: submerged, thin and forceless
Formula: Zhen Wu Tang - True Warrior Decoction
This is for externally contracted disorders not relieved by sweating due to KD and SP yang defiency. It can also be due to externally contracted wind cold at the tai yang warp. When sweating doesn’t alleviate the fever, the fluids can cause the body to wither and deplete the yang qi.
Bao fu zi - baked aconite - warm the interior - chief
+ Warms fire at the gate of vitality, restores KD yang, enables KD to transform water
Bai zhu - atractylodis - tonify qi - deputy
Fu ling - poria - drain damp - deputy
++ both of these tonify the spleen and promote urination
Sheng jiang - fresh ginger - w.a.r.e. - assist
+ warms and dispels pathogenic water
+++ Bai zhu, Fu ling, and Sheng jiang reinforce the earth’s control over water
(Bai) Shao yao - peony - tonify blood - assist
+ preserves the yin and alleviates pain. Prevents the hot dry herbs from injuring the yin
Symptoms:
- Aversion to cold
- Irritability
- Fever
- Urine retention*
- Slight thirst
- ## Vomiting after drinking*
- Edema
- Feelings of heaviness
- ## Diarrhea
- Throbbing sensation below the umbilicus
- Frothy saliva
- Vertigo
- Shortness of breath with cough
Pulse: rapid, floating
Tongue: white coating
Formula: Wu Ling San - Five-Ingredient Powder with Poria
1st group of sx relates to the Tai Yang with Water Overflowing pattern. When the externally contracted pathogen invades the bladder.
2nd and 3rd grouping are other sets of symptoms that this formula is relevant to but not associated with the Shang Han Lun. #2 is due to spleen xu of earth failing to transform water. #3 retention of thin mucous in the lower jiao that prevents the clear yang from ascending.
Ze xie - alismatis rhizome - drain damp - chief
+ leaches out damp, eleminates heat constraint caused by water/mucous build up
Fu ling - poria - drain damp - deputy
Zhu ling - polyporus - drain damp - deputy
++ leaching out dampness, promote urination, unblock urinary pathways and drain heat from bladder
Bai zhu - atractylodis - tonify qi - assit
+ stregnthens spleen qi to aid in transformation and transportation of fluids
Gui zhi - cinnamon twig - release the exterior - assist and envoy
+ warm the fire at gate of vitality, assist bladder in transforming and discharging urine, helps spleen qi to raise the clear, facilitate the movement and steaming of fluids by KD yang, also dispels pathogenic factor from exterior
Which formula vigorously purges heat accumulation and is for constipation with abdominal pain that is worse with pressure?
A. Da Cheng Qi Tang - Major Order The Qi Decoction
B. Xiao Cheng Qi Tang - Minor Order The Qi Decoction
C. Tiao Wei Cheng Qi Tang - Regulate The Stomach and Order the Qi Decoction
D. Zheng Ye Cheng Qi Tang - Increase Fluids And Order The Qi Decoction
A. Da Cheng Qi Tang - Major Order The Qi Decoction
T: dry, yellow or dry, black coat with prickles
P: submerged, excess
Which formula moderately purges heat accumulation and is for constipation with abdominal pain that is NOT worse with pressure?
A. Da Cheng Qi Tang - Major Order The Qi Decoction
B. Xiao Cheng Qi Tang - Minor Order The Qi Decoction
C. Tiao Wei Cheng Qi Tang - Regulate The Stomach and Order the Qi Decoction
D. Zheng Ye Cheng Qi Tang - Increase Fluids And Order The Qi Decoction
B. Xiao Cheng Qi Tang - Minor Order The Qi Decoction
T: dirty and dry yellow coat
P: slippery and rapid
Which formula mildly purges clumped heat and is for constipation with no abdominal pain
A. Da Cheng Qi Tang - Major Order The Qi Decoction
B. Xiao Cheng Qi Tang - Minor Order The Qi Decoction
C. Tiao Wei Cheng Qi Tang - Regulate The Stomach and Order the Qi Decoction
D. Zheng Ye Cheng Qi Tang - Increase Fluids And Order The Qi Decoction
C. Tiao Wei Cheng Qi Tang - Regulate The Stomach and Order the Qi Decoction
P: slippery, rapid
Which formula enriches yin, generates fluids, drains heat and unblocks the bowels? It is used for yangming disorder with heat burning up the fluids where purging formulas cannot expel the dry stools.
A. Da Cheng Qi Tang - Major Order The Qi Decoction
B. Xiao Cheng Qi Tang - Minor Order The Qi Decoction
C. Tiao Wei Cheng Qi Tang - Regulate The Stomach and Order the Qi Decoction
D. Zheng Ye Cheng Qi Tang - Increase Fluids And Order The Qi Decoction
D. Zheng Ye Cheng Qi Tang - Increase Fluids And Order The Qi Decoction
T: dry with thin yellow coat
P: rapid, thin
