Fifth Formula Installment: Adding Da Huang

Wow, this formula name just gets longer and longer!  For the final formula, Rhei Radix et Rhizoma (dà huáng) is added.  There is the line from the Shang Han Lun

 If the face is hot as if the person were drunk, this is stomach heat surging upward to smoke the face.  In this case, add Rhei Radix et Rhizoma (dà huáng) to disinhibit.

In this case, not only are there cold fluids in the lungs, there is also a Yang Ming large intestine fullness which causes the Yang to surge upward to the face.  This kind of facial color, a deep penetrating rubor, is a good indicator for the use of Rhei Radix et Rhizoma (dà huáng).  When this is seen in the clinic it is good to check for other Rhei Radix et Rhizoma (dà huáng) signs such as a full, distended belly.  Below, this kind of red face is contrasted with the “feather light” redness of the first formula in which Gui Zhi and Fu Ling are used for flushing up.

5. Poria, Licorice, Schisandra, Ginger, and Asarum Plus Pinellia, Armeniacae and Rhubarb Decoction (líng gān wǔ wèi jiāng xīn ban xia xing ren da huang tāng)  Continue reading

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Classic Formula Course

The Divine Peasant, Shen Nong

A commercial break in our discussion of the 5 wonderful formulas to let people know about a course on the organization of the Shang Han Lun taught through understanding amazingly useful formulas.  This course is being taught by me, Sharon Weizenbaum, in 8 cities in North America.  Click here for more information.  Below is a description of the course followed by a list of cities and contacts for Registration:

Course Description

There is a saying that there is a difference between a good herbal treatment and a correct herbal treatment.   We all can work at a level in which our patients do well enough on the herbs we give them.  However, when we have had the experience of stumbling upon a truly accurate herbal formula and seeing our patient’s complex issues resolve almost magically, we get a glimpse into the true power of Chinese herbal medicine.  Coming upon a correct formula with intention rather than by accident can be a daily occurrence in your clinic.

This is where Classic formulas come in. Continue reading

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Case Study using líng gān wǔ wèi jiāng xīn ban xia xing ren tāng

Before going onto the final formula in this series, I want to share a case from my own practice that illustrates the wonderful effectiveness of this formula:

I saw this patient for the second visit this week, the first visit having been last week.  This patient, age 51, was diagnosed with asthma 6 years previously after having had many episodes of bronchitis since childhood.  Her parents had been heavy smokers.  She is a singer and singing was her passion and emotional therapy, yet she had been unable to sing at all without coughing intensely since she developed the “asthma.”  This condition came on after a bad flu.  She felt that her chest was filled with mucous that was clear like egg white and loose.  It was worse with damp days and better when it snowed.  When she developed coughing fits she would sometimes gag to the point of vomiting.  She uses a flovent inhaler, allegra and flonase every day and albueterol as needed.  Even with these she was unable to sing or exercise. Continue reading

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Fourth Installment: Adding Xing Ren

The cases and discussions in this series of posts are all taken from the previously mentioned text, 金贵方百家医案评议, An Appraisal through Cases and Discussion of Jin Gui Formulas from Various Schools of Thought.  This is a text that goes through all of the formulas in the Jin Gui Yao Lue and gives case studies from a variety of well known classic formula physicians.  They also offer a discussion after most of the case studies and formula sections.  These discussions are written by the editors of this text, Doctors He Ren 何任, Zhang Zhi-Min 张志民 and Lian Jian-Diao连建伄.

The fourth formula in this family of formulas adds Armeniacae Semen (xìng rén) to the previous formula.  In addition, the warming and transforming herbs are increased.  As we can see from the case studies here, all of these formulas can be used for cough and asthma. However, this formula is, in my mind, most suited for a presentation in which the lung is most effected by the cold fluids.  This is evidenced by the presence of swelling (as mention in the Jing Gui Yao Lue) and the relative diminishment of vomiting.  The stomach may still be involved but the lung is the main location of the pathology. Continue reading

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Third Installment: Thirst due to cold?

Today we look at the third formula in this family of formulas.  This rendition is the same as the last with the addition of Pinelliae Rhizoma preparatum (zhì bàn xià).  This creates the formula Cinnamon Twig, Poria, Schisandra, and Licorice Decoction, remove cinnamon, add Ginger, Asari, and Pinellia (guì líng wǔ wèi gān cǎo qu gui jia jiang xin xia tāng)

Taking a quick look at Giovanni Maciocia’s book entitled Diagnosis in Chinese Medicine, he gives 15 possible patterns that can cause thirst and 3 that can cause dry mouth.  Without exception all of these patterns are related to heat, either excess or deficient.  We see here in the first case, that thirst can be caused from cold as well.  In fact, thirst was the main complaint for the patient below.  This case illustrates a point that is the core emphasis in the diagnostic training that is part of the Graduate Mentorship Program: that symptoms need to be explained by the diagnosis and that most symptoms, by themselves, will not reveal the truth about what is going on with a patient.  Dr. Cao Ying-Fu held himself back from jumping to conclusions about the thirst, unlike the doctors the patient had seen previously.  He saw the cold fluids and understood physiology enough to know that ice traps fluids and makes them unavailable for moistening.  Melting and steaming the frozen water allowed the moisture to once again become physiological.  In the Graduate Mentorship Program we call this Explaining the Symptom with What We Know for Sure.  One must have a good understanding of physiology in order to do this well.  Hence, we see thirst as simply the subjective sensation of wanting fluids in the mouth and then let the rest of the diagnosis explain why this is happening.   Continue reading

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Second Installment on Jin Gui Cough Formulas

Last post we looked at the formula Cinnamon Twig, Poria, Schisandra, and Licorice Decoction (guì líng wǔ wèi gān cǎo tāng).  I must say that for me, the names of these formulas are a bit dizzying.  It has helped me to see these formulas as a group of 5 and then to see that this first formula is the only one to include Cinnamomi Ramulus (guì zhī).  Then the next formulas Cinnamomi Ramulus (guì zhī) is removed and new herbs are added progressively:

  • first Asari Radix et Rhizoma (xì xīn) and Zingiberis Rhizoma (gān jiāng)
  • next Pinelliae Rhizoma preparatum (zhì bàn xià)
  • then Armeniacae Semen (xìng rén)
  • finally Rhei Radix et Rhizoma (dà huáng)

 So this next post is about the next formula with Cinnamomi Ramulus (guì zhī) removed and Asari Radix et Rhizoma (xì xīn) and Zingiberis Rhizoma (gān jiāng) added.  For a short little formula, it is packed with meaning.  There is tonification within dispersion and scattering with restraining.  The commentary by the editors discusses these herbal combinations. Continue reading

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5 Important Jīn Guì Yào Lüè Formulas for Cough Season

Chapter 12 of the  Jīn Guì Yào Lüè focuses on the diagnosis and treatment of Phlegm-Rheum and Cough disorders.  There are 20 formulas discussed in this chapter in 41 clauses.

In preparing for the up-coming next weekend of the Graduate Mentorship Program, I got interested in 5 of these formulas that all have similar names and hence ingredients.  The 3 herbs that are common to all of these 5 formulas are

  • Poria (fú líng),
  • Schisandrae Fructus (wǔ wèi zǐ) and
  • Glycyrrhizae Radix (gān cǎo)
4 of them also include 
  • Zingiberis Rhizoma (gān jiāng) and
  • Asari Radix et Rhizoma (xì xīn)

These 5 formulas are:

1. Cinnamon Twig, Poria, Schisandra, and Licorice Decoction (guì líng wǔ wèi gān cǎo tāng)

2. Poria, Licorice, Schisandra, Ginger, and Asarum Decoction (líng gān wǔ wèi jiāng xīn tāng)

3. Cinnamon Twig, Poria, Schisandra, and Licorice Decoction, remove cinnamon, add Ginger, Asari, and Pinellia (guì líng wǔ wèi gān cǎo qu gui jia jiang xin xia tāng)

4. Poria, Licorice, Schisandra, Ginger, and Asarum Plus Pinellia and Armeniacae Decoction (líng gān wǔ wèi jiāng xīn ban xia xing ren tāng)

5. Poria, Licorice, Schisandra, Ginger, and Asarum Plus Pinellia, Armeniacae and Rhubarb Decoction (líng gān wǔ wèi jiāng xīn ban xia xing ren da huang tāng)

These 5 formulas are incredibly useful in the clinic and once you know them, I am sure you will use them every week, if not every day.   They are sometimes considered a modification of Minor Bluegreen Dragon Decoction (xiǎo qīng lóng tāng) though none of them include Ephedrae Herba (má huáng).  Compared to Minor Bluegreen Dragon Decoction (xiǎo qīng lóng tāng), these formulas have less of a tendency to damage Yin and Yang.  I’ve decided to do a series of blog entries about these formulas, one entry for each formula.  This will be followed by a post that is a summary discussion about how to use them in the clinic.  The discussions and cases below illustrate the usefulness of these formulas and give us teachings about the nature and use of the individual ingredients. Continue reading

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Debra Betts and Working with Pregnant Women

Yesterday I was called to a birth to give acupuncture for pain relief.  When I got to the birthing center, my patient, a woman I have been seeing since before her pregnancy, was laboring in a dim room.  It took me a few minutes to adjust to the darkness after having been out in a bright day.  I watched her manage a couple of contractions and asked her where she felt the pain.  She was managing the contractions well but I could tell that the intensity needed to give birth had not yet arrived.  She told me that the pain was in her rectum.  I told her that it was likely that the needles would help with the pain but that they could also intensify the labor.  I placed needles only on her left side as her partner was on her right, blocking her leg and holding her hand.

I used a point near Large Intestine 4 where there was an induration, Spleen 6 and Bladder 60.  The next contraction was completely different than the previous ones.  It was much  more intense but the pressure had shifted to the perineum. Continue reading

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A Magical Experiential Formula from Dr. Qiu Xiao-Mei

An outstanding result with a simple experiential formula for healing tissue damage sustained during birthing.  (episiotomy, vaginal tears and cesarian section scars)

One of my main gynecology teachers was Dr. Qiu Xiao-Mei.  I studied with her in 1990 when I lived in Hang Zhou, PRC.  I have also translated her text entitled Qiu Xiao Mei’s Clinical Experience in Gynecology (裘笑梅妇科临床经验选). I’ve published material from this text in this blog but I primarily use the text as a teaching reference for students in the Graduate Mentorship Program.   In this text, Dr. Qiu shares some herbal formulas that she developed herself.  Her insight into herbs is astounding and sometimes magical.

A recent exchange with a student of mine inspired me to share information about one particular formula of hers.  Check out the results!

This is just one example of her creativity and effectiveness.  Her work is something to study and try to keep alive.

My student’s inquiry:

“I have never treated a case like this and would love some input.

A patient gave birth one month ago. She is having significant pain and bleeding
due to 4th degree tearing. She saw her OB/GYN yesterday who was unable to do an
internal exam because of the pain. The pain is sharp and feels ‘tight’. The
blood itself is light colored. initially there were clots but she has not seen
any lately. Continue reading

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Warm the Kidney Yang with Cupping?

White Pine Institute is hosting a unique teacher from Australia in May.  He is Bruce Bentley, a man who has devoted his life to traveling the world in the exploration and development of the ancient art of cupping.  He will teach his Three-day Master Class in Traditional East-West Cupping twice so that he can keep the groups small and intimate.  In his own words “You will be taught with meticulous care.”  There are still a few spots in each weekend.  (May 3-5 and May 10-12) You will learn skills that will last you a life time.

“We also introduce a traditional Moroccan method for infertility based on the ability of cups to withdraw coldness from the uterus.”

Continue reading

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