Treatment of deficiency with tonifying prescriptions and acupucture

Tonic formulas are composed of mainly tonic herbs and have the actions to tonify the Qi, blood, Yin, and Yang of the body for treatment of various deficiency syndromes. There are various types of deficiency syndromes. However, they can be classified into four major categories: Qi, blood, Yin, and Yang deficiency syndromes. Therefore, tonic formulas can be classified into Qi, blood, Yin, and Yang Tonic formulas. These formulas can be targeted to tonify deficiencies of various organs. Since Qi and blood belong to Yang and Yin respectively, they are mutually dependent. Therefore when Qi is deficient, both Qi and blood should be tonified, and when blood is deficient, both blood and Qi need to be tonified. This principle also applies when tonifying Yin or Yang. Since the Qi, blood, Yin, and Yang deficiencies can occur in different organs of the body, one can also apply the five- element theory for treatment. For example, in a liver deficiency syndrome, one could tonify the kidney because kidney is the mother organ of the liver. This method of tonification would be an indirect method of tonification. Also, another theory of tonification is to tonify the spleen and the kidney to try to improve the condition of other organs. This theory has its basis on the understanding that spleen is responsible for postnatal nourishment and kidney essence is the foundation of the body and that malfunctioning of these two organs may lead to deficiency of other parts of the body. Tonic formulas are often combined with spleen-strengthening, stomach-harmonizing, and Qi-regulating herbs to achieve the maximum effect of the formulas.

Qi tonic formulas are often used to treat spleen and lung Qi deficiencies. Qi tonic herbs such as Radix Ginseng (Ren Shen) and Radix Astragali (Huang Qi) are of primary importance in these formulas while some Qi-regulating, diuretic, blood-tonic, and Yin-nourishing herbs are included to enhance the overall effect of tonification. The common clinical manifestations of a Qi syndrome include lassitude, general weakness, weak extremities, shortness of breath, low voice, pale face, loose stool, diarrhea, lack of appetite, spontaneous sweating, even prolapse of the uterus or rectum, pale tongue, and weak pulse.

COMPOSITION

1. Radix Ginseng (Ren Shen) 10g

2. Rz. Atractylodis Macrocephalae (Bai Zhu) 9g

3. Poria Cocos (Fu Ling) 9g

4. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 6g

METHOD OF ADMINISTRATION

This formula was originally prescribed in the powder form, 6 to 9 grams each time. However, it can also be taken in the form of decoction.

ACTION:

1. To tonify Qi

2. To strengthen the spleen and stomach

CLINICAL MANIFESTATION

Spleen and stomach Qi deficiency: pale face, low voice, lassitude, weakness of the extremities, poor appetite, loose stool, pale tongue, thready moderate pulse.

EXPLANATION

The spleen and the stomach are highly involved in the process of digestion. If the spleen and stomach become deficient and their digestive function affected, the Qi would become deficient. Lack of nourishment and Qi deficiency would cause pale face, low voice, lassitude. Poor appetite is the result of an impaired digestive system. Loose stool is the result of the spleen’s inability to ascend the water fluid to the Upper Jiao. Since the spleen is related to the muscles, spleen deficiency can result in weakness of the extremities. Pale tongue and thready moderate pulse are common signs of Qi deficiency syndromes. This formula uses Radix Ginseng (Ren Shen) as the principal herb because it tonifies the Yuan (source) Qi as well as the spleen and stomach Qi. Rhizoma Atractylodis Macrocephalae (Bai Zhu), besides tonifying the spleen Qi, can also dry up the dampness in the Middle Jiao to strengthen digestion. Poria Cocos (Fu Ling), the auxiliary herb, can tonify and dispel damp in the Middle Jiao through diuresis. Radix Glycyrrhizae Praeparata, (Zhi Gan Cao) the conductor herb, can both tonify the spleen Qi and harmonize all of the herbs in this formula.

CAUTION/CONTRAINDICATION

1. This formula, although gentle, is still slightly warm. It should be noted that long-term use of this formula may cause dry mouth, dry tongue, thirst, or irritability.

2. Patients who have high fever, deficiency or excess-heat, Qi stagnation, body fluid deficiency, irritability, thirst, or constipation should not use this formula at all or use it very carefully.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: Bl 20, Bl 21, St 36, St 25, Ren 6.

2. Technique: tonification.

3. Explanation: BL 20 nourishes the spleen Yang. BL 21 and St 36 tonify the Middle Jiao and harmonize the stomach. St 25 can regulate the stomach and intestines. Ren 6 tonifies Qi in general.

MODIFICATION

1. Radix Ginseng (Ren Shen) 10g

2. Rz. Atractylodis Macrocephalae (Bai Zhu) 9g

3. Poria Cocos (Fu Ling) 9g

4. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 6g

5. Pericarpium Citri Reticulatae (Chen Pi) 9g

This formula is composed of Si Jun Zi Tang (Four Gentlemen Combination) plus Pericarpium Citri Reticulatae (Chen Pi). The main actions of this formula are to regulate Qi, strengthen spleen, tonify Qi, and harmonize stomach. It is often used for patients with deficiency of spleen and stomach accompanied by Qi stagnation, characterized by such symptoms as no appetite, fullness and discomfort of the chest and epigastrium, vomiting, and diarrhea.

Acupuncture Treatment: Add P 6 and Sp 4.

1. Radix Astragali (Huang Qi) 20g

2. Radix Ginseng (Ren Shen) 20g

3. Cortex Cinnamomi (Rou Gui) 8g

4. Radix Glycyrrhizae (Gan Cao) 5g

5. Rhizoma Zingiberis Recens (Sheng Jiang) 1pc

The main actions of this formula are to tonify Qi and warm up Yang. This formula is generally used for patients with spleen and stomach Qi deficiency accompanied by coldness and damp stagnation in the Middle Jiao. Clinically, the patient may show lethargy and aversion to cold. This formula may also be applied to children with chicken pox characterized by Yang and Source Qi deficiency.

Acupuncture Treatment: Add Bl 23 and Ren 4.

COMPOSITION

1. Radix Ginseng (Ren Shen) 10g

2. Rz. Atractylodis Macrocephalae (Bai Zhu) 9g

3. Poria Cocos (Fu Ling) 9g

4. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 6g

5. Pericarpium Citri Reticulatae (Chen Pi) 9g

6. Rhizoma Pinelliae (Ban Xia) 12g

METHOD OF ADMINISTRATION

This formula is taken in the form of warm decoction.

ACTION:

1. To strengthen the spleen and stomach

2. To regulate Qi and stop vomiting

CLINICAL MANIFESTATION

Spleen and stomach Qi deficiency accompanied with damp and phlegm: no appetite, loose stool, nausea, vomiting, fullness and stuffiness of the chest, coughing, and profuse phlegm that is white and watery.

EXPLANATION

This formula is derived from Si Jun Zi Tang (Four Gentlemen Combination). It used to treat spleen and stomach deficiency accompanied with accumulation of damp and phlegm. Spleen and stomach deficiency may cause indigestion, leading to no appetite and loose stool. Accumulation of damp may block the stomach Qi flow and cause uprising of stomach Qi. As a result, nausea and vomiting may occur. If the damp is stagnated in the chest and interrupts the Qi flow of the lung, stuffy chest and coughing may occur. Profuse white watery phlegm indicates accumulation of damp and phlegm inside the body. Radix Ginseng (Ren Shen), Rhizoma Atractylodis Macrocephalae (Bai Zhu), Poria Cocos (Fu Ling), and Radix Glycyrrhizae Praeparata (Zhi Gan Cao) are used to tonify the spleen and the stomach Qi. Pericarpium Citri Reticulatae (Chen Pi) activates and regulates the Qi flow to dry up the damp. Rhizoma Pinelliae (Ban Xia), besides breaking down the Qi stagnation to relieve chest stuffiness, would also lower the adverse rising stomach Qi to relieve nausea and vomiting.

CAUTION/CONTRAINDICATION

The caution/contraindication for Liu Jun Zi Tang (Six Gentlemen Combination) is the same as Si Jun Zi Tang (Four Gentlemen Combination). It is stated as follows:

1. This formula, although gentle, is still slightly warm. It should be noted that long-term use of this formula may cause dry mouth, dry tongue, thirst, or irritability.

2. Patients who have high fever, deficiency or excess-heat, Qi stagnation, body fluid deficiency, irritability, thirst, or constipation should not use this formula at all or use it very carefully.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: Bl 20, Bl 21, St 36, St 25, Ren 6, Bl 13, St 40.

2. Technique: tonification.

3. Explanation: BL 20 nourishes the spleen Yang. BL 21 and St 36 tonify the Middle Jiao and harmonize the stomach. St 25 can regulate the stomach and intestines. Ren 6 tonifies Qi in general. BL 13 and St 40 are used to dispel damp and phlegm.

COMPOSITION

1. Radix Ginseng (Ren Shen) 10g

2. Rz. Atractylodis Macrocephalae (Bai Zhu) 9g

3. Poria Cocos (Fu Ling) 9g

4. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 6g

5. Pericarpium Citri Reticulatae (Chen Pi) 9g

6. Rhizoma Pinelliae (Ban Xia) 12g

7. Radix Saussureae (Mu Xiang) 6g

8. Fructus Amomi (Sha Ren) 6g

METHOD OF ADMINISTRATION

This formula is taken in the form of warm decoction. The last two herbs may be post-decocted for maximum effect.

ACTION:

1. To strengthen the spleen and stomach

2. To regulate Qi and stop pain

CLINICAL MANIFESTATION

Spleen and stomach Qi deficiency accompanied with cold and damp stagnation in the Middle Jiao: loss of appetite, belching, fullness and/or pain of the abdomen and epigastrium, vomiting, and loose stool.

EXPLANATION

This formula is derived from Si Jun Zi Tang (Four Gentlemen Combination). It is used to treat deficiency of the Middle Jiao with stagnation of coldness and damp. Deficiency of the spleen and the stomach may weaken the digestive system, causing no appetite, belching, and general weakness. Accumulation of damp may cause sluggish movement of Qi, leading to fullness of chest. Stagnation of coldness may block the Qi circulation, causing pain in the chest. Stagnation of damp and coldness may block the descending stomach Qi, causing vomiting. As a result of spleen deficiency, the normally ascending Qi of the spleen may actually descend, resulting in loose stool or diarrhea. This formula consists of Si Jun Zi Tang (Four Gentlemen Combination) plus Rhizoma Pinelliae (Ban Xia), Pericarpium Citri Reticulatae (Chen Pi), Radix Saussureae (Mu Xiang), and Fructus Amomi (Sha Ren). The Si Jun Zi Tang (Four Gentlemen Combination) of Radix Ginseng (Ren Shen), Rhizoma Atractylodis Macrocephalae (Bai Zhu), Poria Cocos (Fu Ling), and Radix Glycyrrhizae Praeparata (Zhi Gan Cao) are used to tonify the spleen and the stomach Qi. Rhizoma Pinelliae (Ban Xia) and Pericarpium Citri Reticulatae (Chen Pi) are used to break the Qi and damp stagnation and reverse the ascending stomach Qi. Radix Saussureae (Mu Xiang) and Fructus Amomi (Sha Ren) warm the Middle Jiao and activate the Qi circulation to dissolve the damp accumulation and relieve the pain.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 20, BL 21, St 36, St 25, Ren 6, Ren 12, Ren 6.

2. Technique: tonification.

3. Explanation: BL 20 nourishes the spleen Yang. BL 21 and St 36 tonify the Middle Jiao and harmonize the stomach. St 25 can regulate the stomach and intestines. Ren 6 tonifies Qi in general. Ren 12 and Ren 6 may enhance the Qi flow of the abdomen and increase the appetite.

COMPOSITION

1. Radix Ginseng (Ren Shen) 100g

2. Rz. Atractylodis Macrocephalae (Bai Zhu) 100g

3. Poria Cocos (Fu Ling) 100g

4. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 100g

5. Semen Dolichoris Album (Bai Bian Dou) 75g

6. Semen Coicis (Yi Yi Ren) 50g

7. Rhizoma Dioscoreae (Shan Yao) 100g

8. Semen Nelumbinis (Lian Zi) 50g

9. Fructus Amomi (Sha Ren) 50g

10. Radix Platycodi (Jie Geng) 50g

METHOD OF ADMINISTRATION

The suggested dosages above are intended for usage in the powder form, which should be taken 6 grams each time with the decoction of Fructus Ziziphi Jujubae (Da Zao). This formula can also be taken in the form of decoction with the dosages adjusted.

ACTION:

1. To tonify Qi and strengthen the spleen

2. To dispel damp and stop diarrhea

CLINICAL MANIFESTATION

Diarrhea with deficiency of both the spleen and the stomach: loose stool or diarrhea, low appetite, weak extremities, loss of weight, sallow facial appearance, fullness of the chest, pale red tongue, white tongue coat, and thready slow pulse or weak slow pulse.

EXPLANATION

This formula is designed to treat loose stool or diarrhea due to deficiency of the spleen and the stomach. Deficiency of the spleen and stomach would weaken the digestive function of the body. The spleen has the function to transform and transport nutrients to the Upper Jiao. When the stomach and the spleen are deficient, food may not be digested and nutrients may not be transported to the Upper Jiao. As a result, food may travel quickly out of the body without being digested or absorbed. A weak digestive system would directly result in low appetite. Lack of nutrients would cause weak extremities, loss of weight, and sallow facial appearance. Deficiency of the spleen may cause damp accumulation, which may obstruct the Qi flow and cause fullness in the chest. The tongue and the pulse conditions both suggest deficiency in the body. This formula uses Radix Ginseng (Ren Shen), Rhizoma Atractylodis Macrocephalae (Bai Zhu), Poria Cocos (Fu Ling), and Radix Glycyrrhizae Praeparata (Zhi Gan Cao) to tonify the spleen and stomach and to dispel the dampness. Semen Dolichoris Album (Bai Bian Dou), Semen Coicis (Yi Yi Ren), Rhizoma Dioscoreae (Shan Yao), and Semen Nelumbinis (Lian Zi) help tonify the Middle Jiao, dispel the dampness, and stop the diarrhea. Fructus Amomi (Sha Ren) is used to warm the Middle Jiao and dry up the dampness to invigorate the function of the spleen and the stomach. Radix Platycodi (Jie Geng), besides relieving the chest fullness, has an ascending characteristic to help relieve the diarrhea.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 20, St 36, Sp 6, Ren 12, St 25.

2. Technique: tonification or moxibustion.

3. Explanation: Sp 20 strengthens the spleen and regulates the spleen Qi flow. St 36 strengthens the spleen and harmonizes the stomach. Sp 6 nourishes the spleen and the stomach to help relieve diarrhea. Ren 12, the Front Mu Point of the stomach, harmonizes the stomach and dissolves stagnation of damp. St 25 regulates and strengthens the spleen and the large intestine.

MODIFICATION

1. Radix Ginseng (Ren Shen) 7g

2. Rz. Atractylodis Macrocephalae (Bai Zhu) 15g

3. Poria Cocos (Bai Fu Ling) 15g

4. Radix Glycyrrhizae (Gan Cao) 3g

5. Folium Pogostemi (Huo Xiang Ye) 15g

6. Radix Saussureae (Mu Xiang) 6g

7. Radix Puerariae (Ge Gen) 15-30g

The main actions of this formula are to strengthen the spleen, stop diarrhea, and dispel dampness. It is often used for patients who have mild fever, thirst, no appetite, and chronic diarrhea due to spleen and stomach deficiency. Acupuncture Treatment: Add P 6 and Sp 9.

This formula is also known as the Ginseng & Astragalus Combination.

COMPOSITION

1. Radix Astragali (Huang Qi) 15-20g PRN

2. Radix Ginseng (Ren Shen) 10g ADJ

3. Rz. Atractylodis Macrocephalae (Bai Zhu) 10g ADJ

4. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 5g ADJ

5. Pericarpium Citri Reticulatae (Chen Pi) 6g AUX

6. Radix Angelicae Sinensis (Dang Gui) 10g AUX

7. Rhizoma Cimicifugae (Sheng Ma) 3g CON

8. Radix Bupleuri (Chai Hu) 3g CON

METHOD OF ADMINISTRATION This formula is taken in the form of decoction or pills. Pills should be taken 10 to 15 grams each time, two to three times daily.

ACTION

1. To tonify the Qi of the Middle Jiao

2. To ascend the Yang Qi and treat various prolapse syndromes

CLINICAL MANIFESTATION 1. Qi deficiency of the spleen and stomach: low grade fever that worsens after exertion, spontaneous perspiration, thirst with preference of warm drinks, low voice, lassitude, weakness of the extremities, pale complexion, loose stool, pale tongue, thin white coat, large weak (forceless) pulse.

2. Prolapse syndromes: prolapse of the anus and uterus, chronic diarrhea, dysentery, malaria, or any other Yang Qi prolapse syndromes.

EXPLANATION

This formula can be used to treat patients with Middle Jiao deficiency by ascending the Yang Qi. Since the Yang Qi can no longer ascend like it normally does, it is surrounded and "seized" by Yin, resulting in fever, spontaneous perspiration, and full weak pulse. The Yang Qi is also no longer able to ascend water, and this would result in thirst and chronic diarrhea. Low voice, lassitude, weakness of the extremities, and pale complexion are results of the spleen’s inability to transport nutrients. The tongue and tongue coat are typical of Middle Jiao deficiency.

This formula is also excellent for treating the various prolapse syndromes caused by Yang Qi deficiency. Radix Astragali (Huang Qi) is used as the principal herb because it both tonifies the Middle Jiao and ascends the Yang Qi. Radix Ginseng (Ren Shen), Rhizoma Atractylodis Macrocephalae (Bai Zhu), and Radix Glycyrrhizae Praeparata (Zhi Gan Cao) tonify the Middle Jiao. The auxiliary herbs of Pericarpium Citri Reticulatae (Chen Pi) and Radix Angelicae Sinensis (Dang Gui) are used to regulate the Qi flow and nourish the blood. Radix Bupleuri (Chai Hu) and Radix Cimicifugae (Sheng Ma) are the conductor herbs used to ascend Yang Qi and add an ascending property to this formula.

CAUTION/CONTRAINDICATION

1. The dosage of Radix Astragali (Huang Qi) should be heavy and the dosages of Radix Bupleuri (Chai Hu) and Radix Cimicifugae (Sheng Ma) should be light.

2. As a general rule, the dosage of this formula should be light. This formula consists of sweet and warm tonic herbs which tend to be heavy and immobile in character. Therefore, a heavy dosage of this formula may actually defeat the purpose of ascending the Yang Qi.

3. Patients with Yin deficiency or interior heat are contraindicated for this formula.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 20, BL 43, Ren 12, Ren 6, St 36, Ren 4, Du 20.

2. Technique: tonification, may also use moxibustion.

3. Explanation: BL 20, BL 43, Ren 12, and Ren 6 are used to tonify the Qi of the Middle Jiao. St 36 can ascend the Qi of the Middle Jiao and relieve diarrhea. Ren 4 strengthens the Yang. Du 20 can ascend the Yang Qi and relieve Qi depression or collapse.

MODIFICATION

1. Radix Astragali (Huang Qi) 10-20g

2. Radix Ginseng (Ren Shen) 10-20g

3. Rz. Atractylodis Macrocephalae (Bai Zhu) 3-6g

4. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 3-6g

5. Rhizoma Cimicifugae (Sheng Ma) 4g

This formula is composed of Bu Zhong Yi Qi Tang (Middle Jiao Strengthening & Qi Benefitting Combination) minusing Pericarpium Citri Reticulatae (Chen Pi), Radix Angelicae Sinensis (Dang Gui), and Radix Bupleuri (Chai Hu). The main actions of this formula are to tonify Qi and ascend Yang. Clinically, it is used for patients who have prominent Qi and Yang deficiency with such symptoms as prolapsed organs and continuous menstrual bleeding. In comparison with Bu Zhong Yi Qi Tang (Middle Jiao Strengthening & Qi Benefitting Combination), Ju Yuan Jian (Source Qi Raising Combination) has a higher dose of Radix Ginseng (Ren Shen), and is therefore more suitable for the more serious types of Qi deficiency and depression. Acupuncture Treatment: Add BL 23 and K 8 for consolidation of the kidney Qi. Add Du 26, Du 25, and K 1 as well as moxibustion on Ren 8 and Ren 4 to resuscitate the Yang.

1. Radix Astragali (Huang Qi) 18g

2. Rhizoma Anemarrhenae (Zhi Mu) 9g

3. Radix Bupleuri (Chai Hu) 5g

4. Radix Platycodi (Jie Geng) 5g

5. Rhizoma Cimicifugae (Sheng Ma) 3g

The main actions of this formula are to tonify Qi and raise the descending Qi in the chest. Clinically, this formula is used for patients who have severe Qi depression in the chest with such symptoms as rapid breathing, shortness of breath, dyspnea, and deep slow pulse.

Acupuncture Treatment: Add P 6, H 7, and moxibustion on Ren 6, Ren 4, and Du 4.

COMPOSITION

1. Radix Ginseng (Ren Shen) 10g PRN

2. Radix Ophiopogonis (Mai Men Dong) 15g ADJ

3. Fructus Schisandrae (Wu Wei Zi) 6g AUX, CON

METHOD OF ADMINISTRATION

This formula is taken in the form of warm decoction three times daily.

ACTION:

1. To tonify Qi and promote body fluid secretion

2. To astringe Yin and stop perspiration

CLINICAL MANIFESTATION

1. Damages of Qi and body fluid due to summer heat and excessive sweating: dry throat, thirst, irritability, lethargy, shortness of breath, thready weak pulse.

2. Damage of Qi and Yin of the lung due to chronic coughing: coughing with little sputum, shortness of breath, spontaneous perspiration, dry mouth, dry thin tongue coat, thready rapid or thready weak pulse.

EXPLANATION

This formula is designed to tonify both the Qi and the Yin. Attack of summer heat may result in excessive perspiration. Excessive perspiration may lead to loss of body fluid, which may result in dry throat, thirst, and irritability. Also, excessive perspiration may cause loss of Qi because Qi may be drawn out of the body as perspiration takes place. As a result of Qi deficiency, lethargy and shortness of breath may occur. This formula can also be used to treat damages of the Qi and the Yin of the lung due to chronic coughing. The lung dominates the Qi and controls the water metabolism of the body. Therefore, chronic coughing may cause damages to the Qi and the Yin. Damage of Yin would result in coughing with little sputum, and damage of Qi would result in shortness of breath, spontaneous sweating, and weak pulse. Radix Ginseng (Ren Shen), the principal herb of this formula, strengthens the lung and tonifies the Yuan (source) Qi. Radix Ophiopogonis (Mai Men Dong) nourishes the Yin of the lung and relieve coughing. Fructus Schisandrae (Wu Wei Zi), an astringent herb, may help prevent further loss of Qi by stopping coughing and perspiration.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 13, BL 15, BL 23, St 36, Sp 6, H 6.

2. Technique: tonification, moxibustion.

3. Explanation: BL 13 nourishes the lung Qi. BL 15 smoothes the heart Qi flow and calms the Shen. BL 23 nourishes the kidney and Yin. St 36 and Sp 6 nourish Qi and blood. H 6 nourishes Yin, calms the Shen, and astringes the body to stop sweating.

COMPOSITION

1. Gecko (Ge Jie) 1 pair

2. Radix Ginseng (Ren Shen) 60g

3. Poria Cocos (Fu Ling) 60g

4. Cortex Mori Radicis (Sang Bai Pi) 60g

5. Semen Armeniacae Amarum (Xing Ren) 150g

6. Bulbus Fritillariae Cirrhosae (Chuan Bei Mu) 60g

7. Rhizoma Anemarrhenae (Zhi Mu) 60g

8. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 150g

METHOD OF ADMINISTRATION

Grind all of the herbs into powder to be taken six grams each time with warm water on empty stomachs.

ACTION:

1. To tonify Qi and clear the lung heat

2. To stop coughing and relieve wheezing

CLINICAL MANIFESTATION

Chronic consumptive lung disease due to deficiency-heat: coughing, wheezing, thick yellow sputum with or without blood, fidgeting, weight loss with or without edema of the face, and superficial deficient pulse at the first position.

EXPLANATION

This formula is designed to treat chronic consumptive lung disease due to deficiency-heat. This syndrome usually originates from chronic coughing. Chronic coughing may weaken the Qi and lead to weight loss. The weakened Qi may cause accumulation of damp and phlegm, leading to coughing with sputum and edema of the face. Chronic coughing may also damage the blood vessels, leading to bloody sputum. Accumulation of damp and phlegm may create interior heat, which may result in thick yellow sputum and fidgeting. Superficial deficient pulse at the first position indicates severe lung Qi deficiency. Since kidney has the function to help descend the lung Qi and regulate breathing, Gecko (Ge Jie) is used in this formula to enter the lung and the kidney to descend the lung Qi and tonify the kidney. Tonifying the kidney is especially necessary in chronic coughing syndromes in which the lung Qi is deficient. Radix Ginseng (Ren Shen) tonifies the lung and the spleen. Poria Cocos (Fu Ling) dispels the damp and phlegm through urination. Cortex Mori Radicis (Sang Bai Pi) and Semen Armeniacae Amarum (Xing Ren) reverse the lung Qi to stop coughing and wheezing. Bulbus Fritillariae Cirrhosae (Chuan Bei Mu) clears lung heat and stops coughing. Rhizoma Anemarrhenae (Zhi Mu) clears the lung heat and moistens the lung. Radix Glycyrrhizae Praeparata (Zhi Gan Cao) helps tonify the Qi and harmonizes the herbs in this formula.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 13, BL 20, St 36, Lung 9, St 40, LI 4, BL 43, Ding-Chuan (extra).

2. Technique: tonification.

3. Explanation: BL 13 tonifies the lung Qi. BL 20 and St 36 strengthen the spleen, dissolve the dampness, and harmonize the stomach. Lung 9, the Yuan-Source point of the lung, is combined with BL 13 to tonify the lung. St 40 and LI 4 dissolve the damp and phlegm and harmonize the Middle Jiao. BL 43 and Ding- Chuan (extra) are both essential points for treating chronic coughing and asthma.

MODIFICATION

1. Radix Ginseng (Ren Shen) 8g

2. Semen Juglandis Regiae (Hu Tao Ren) 5pcs

3. Rhizoma Zingiberis Recens (Sheng Jiang) 5pcs

This formula should be taken in the form of warm decoction three times daily on empty stomachs. The main actions of this formula are to tonify lung and kidney and relieve wheezing. Clinically, the patient may have coughing and wheezing due to lung and kidney Yin deficiency. Both herbal formulas listed above can treat coughing and wheezing due to deficiencies. However, Ren Shen Ge Jie San (Ginseng & Gecko Combination) is a stronger formula that is cold in nature. Hence it is more suitable for prominent coughing and wheezing due to deficient-heat.

Ren Shen Hu Tao Tang (Ginseng & Juglandis Combination), on the other hand, is a gentler formula that is slightly warm in nature, and is thus more suitable for coughing and wheezing due to deficiency-cold.

Acupuncture Treatment:

Eliminate BL 20, St 36, St 40, and LI 4. Add BL 23 and K 3 to help tonify the kidney and the lung.

Blood tonic formulas are composed of blood tonic herbs to treat blood deficiency syndromes. The common clinical manifestations of blood deficiency include dizziness, blurred vision, pale face, sallow facial expression, pale lips, dry and dull nails, palpitation, insomnia, dry stool, delayed menstruation with pale scanty menstrual discharge, pale tongue, and thready pulse.

COMPOSITION

1. Radix Rehmanniae Prep. (Shu Di Huang) 12g PRN

2. Radix Angelicae Sinensis (Dang Gui) 10g ADJ

3. Radix Paeoniae Alba (Bai Shao) 12g AUX

4. Rhizoma Ligustici Wallichii (Chuan Xiong) 8g ADJ

METHOD OF ADMINISTRATION

The original method of administration is to grind the above herbs into coarse granules and decoct nine grams of these granules in approximately 400ml of water each time. Boil until the liquid has decreased to about 200ml. Drink the decoction while it is warm on empty stomachs. This formula can also be decocted without grinding the individual herbs into coarse granules. The same herbs not ground into coarse granules may be decocted three times and taken three times a day on empty stomachs.

ACTION :

1. To nourish blood

2. To regulate blood

CLINICAL MANIFESTATION

1. Deficiency and injury of the Chong and Ren Channels: hypomenorrhea, delayed menstruation with pale red color, or hypermenorrhea, dripping of blood, pain around the umbilicus and the lower abdomen, unstable fetus.

2. General blood deficiency: pale face, pale lips, pale fingernails, sallow appearance, dizziness, black-out of vision, palpitation, insomnia, pale tongue, white tongue coat, thready weak pulse.

EXPLANATION

The Chong Channel and the Ren Channel are closely related to the blood and uterus. Deficiency or injury of these two channels may cause signs of blood deficiency. Menstruation may be delayed and the amount of blood may become scanty (hypomenorrhea). Pale red menstruation suggests deficiency of blood. Also, besides blood deficiency, there may be other complications. If the spleen becomes very deficient and loses the function to keep the blood circulating within the blood vessels, hypermenorrhea may occur. If the kidney becomes deficient, dripping of blood may occur. If there is coldness inside the body and the liver loses its function to smooth the Qi flow of the body, then blood stagnation may occur, causing pain around the umbilicus and the lower abdomen. Since the Ren Channel dominates the uterus, deficiency or injury of the Ren Channel may cause the fetus to be unstable. Blood deficiency, besides being manifested in the areas of menstruation and pregnancy, may also be manifested in other aspects. Pale face, pale lips, pale fingernails, and sallow appearance are caused by the blood unable to nourish the skin. Dizziness, black-out of vision, palpitation, and insomnia occur because the blood is unable to nourish the liver and the heart. Pale tongue and white coat are typical signs of blood deficiency patients. A thready moderate pulse is a sign of blood deficiency. In this formula, Radix Rehmanniae Praeparata (Shu Di Huang), the principal herb, tonifies the blood. It also tonifies the kidney, which may generate the marrow for increased blood production. Radix Angelicae Sinensis (Dang Gui) both tonifies and activates the blood. Radix Paeoniae Alba (Bai Shao) nourishes the blood and consolidates the Yin. Rhizoma Ligustici Wallichii (Chuan Xiong) activates and regulates the blood circulation.

CAUTION/CONTRAINDICATION

Patients with deficiencies of the spleen and stomach should use this formula with caution because the greasy property of Radix Rehmanniae Praeparata (Shu Di Huang) may affect digestion.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 20, BL 21, St 36, BL 15, BL 17, Sp 6.

2. Technique: tonification.

3. Explanation: BL 20, BL 21, and St 36 strengthen the spleen and the stomach to increase the blood volume. BL 15 nourishes the heart blood. BL 17 tonifies blood. Sp 6 nourishes the kidney, spleen, and liver.

 

MODIFICATION

1. Radix Rehmanniae Prep. (Shu Di Huang) 20g

2. Radix Angelicae Sinensis (Dang Gui) 15g

3. Radix Paeoniae Alba (Bai Shao) 15g

4. Rhizoma Ligustici Wallichii (Chuan Xiong) 8g

5. Radix Ginseng (Ren Shen) 20g

6. Radix Astragli (Huang Qi) 18g

This formula is composed of Si Wu Tang (Four SUbstance Combination) plus Radix Ginseng (Ren Shen) and Radix Astragali (Huang Qi). With the addition of these two herbs, this formula can tonify Qi in addition to tonifying and regulating blood. Clinically, it is often used for female patients with symptoms of both Qi and blood deficiency, such as early menstruation, excessive bleeding that is pale in color, lethargy, and lack of energy.

Acupuncture Treatment: Add BL 43 and Ren 6.

1. Radix Rehmanniae Prep. (Shu Di Huang) 15g

2. Radix Angelicae Sinensis (Dang Gui) 12g

3. Radix Paeoniae Alba (Bai Shao) 10g

4. Rhizoma Ligustici Wallichii (Chuan Xiong) 8g

5. Semen Persicae (Tao Ren) 6g

6. Flos Carthami (Hong Hua) 4g

This formula is composed of Si Wu Tang (Four Substance Combination) plus Semen Persicae (Tao Ren) and Flos Carthami (Hong Hua). With the addition of these two herbs, this formula has the actions to remove blood stagnation in addition to tonifying and regulating blood. Clinically, it is often used for female patients with early menstruation, excessive bleeding that is sticky and purplish in color, or bleeding with blood clots, and abdominal fullness and pain.

Tao Hong Si Wu Tang (Four Substance Combination with Persicae & Carthami) is an ideal formula to tonify blood, regulate blood circulation, and remove blood stagnations. However, it should be kept in mind that since it is quite a potent formula, it may cause excessive menstrual bleeding if it is used too frequently or if it is used after all the symptoms and signs have subsided.

Acupuncture Treatment: Add Sp 10.

COMPOSITION

1. Radix Astragali (Huang Qi) 30g

2. Radix Angelicae Sinensis (Dang Gui) 6g

METHOD OF ADMINISTRATION

This formula is taken in the form of warm decoction three times daily.

ACTION : To tonify Qi and blood

CLINICAL MANIFESTATION Floating of Yang due to Qi and blood deficiency: warm skin, red face, irritability, thirst with a desire to drink water, slow healing of wounds, pale tongue, full but deficient pulse. In women, there may be hypermenorrhea, excessive loss of blood after labor, and slight feverish sensation.

EXPLANATION

This formula is designed to treat floating of Yang due to Qi and blood deficiency, which can be due to over-exertion. Deficiency of Qi may result in failure of the body to retain the Yang in the inside, and deficiency of blood may cause deficiency of Yin. As a result, the Yang may float to the outside of the body, causing symptoms such as warm skin, red face, irritability, and thirst with a desire to drink warm water. Since the Qi is deficient and the body is exhausted, healing of wounds would be slow and the tongue would be pale. Full deficient pulse indicates floating of Yang and deficiency of Qi and blood. In women, since the Qi is deficient and can not properly control the blood, there may be hypermenorrhea and excessive bleeding after labor. This formula uses Radix Astragali (Huang Qi) to tonify the Qi and strengthen the exterior to prevent further leaking of Yang. Also, Radix Astragali (Huang Qi) may help promote healing of wounds. Radix Angelicae Sinensis (Dang Gui) tonifies the blood and regulates menstruation.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: Ren 6, Ren 4, BL 43, BL 20, St 36, BL 23, Sp 6, BL 15, BL 17.

2. Technique: tonification.

3. Explanation: Ren 6, Ren 4, and BL 43 nourish the Yuan Qi. BL 20, St 36, BL 23, and Sp 6 nourish the Qi and blood. BL 15 and BL 17 nourish and regulate the blood.

This formula is also known as the Ginseng & Longan Combination.

COMPOSITION

1. Radix Ginseng (Ren Shen) 15g

2. Radix Astragali (Huang Qi) 30g

3. Rz. Atractylodis Macrocephalae (Bai Zhu) 30g

4. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 8g

5. Radix Angelicae Sinensis (Dang Gui) 20g

6. Poria Cocos (Fu Shen) 30g

7. Semen Ziziphi Spinosae (Suan Zao Ren) 30g

8. Arillus Longanae (Long Yan Rou) 30g

9. Radix Polygalae (Yuan Zhi) 15g

10. Radix Saussureae (Mu Xiang) 15g

METHOD OF ADMINISTRATION

This formula can be taken in the form of pills or decoction. The pills should weigh 15 grams each, to be taken one at a time for up to three times daily on empty stomachs. To administer this formula in the form of decoction, decoct the above herbs with 6 grams of Rhizoma Zingiberis Recens (Sheng Jiang) and 3 to 5 pieces of Fructus Ziziphi Jujubae (Da Zao).

ACTION

1. To tonify Qi and nourish blood 2. To strengthen the spleen and nourish the heart

CLINICAL MANIFESTATION

1. Heart and spleen deficiency: palpitation, forgetfulness, insomnia, night sweating, deficiency heat, low appetite, lassitude, sallow facial complexion, pale tongue, thin white tongue coat, thready moderate pulse.

2. Spleen unable to keep the blood circulating within the vessels: hematochezia, scanty or massive uterine bleeding, early menstruation, hypermenorrhea of pale blood, prolonged menstrual period, leukorrhea of thick white vaginal discharge.

 

EXPLANATION

This formula is renowned for treating heart (blood) and spleen (Qi) deficiency. The usual cause of this syndrome is over-thinking or excessive worrying. The heart houses the mind and dominates blood. If the heart’s function of housing the mind is impaired, then palpitation, forgetfulness, and insomnia can occur. If the heart blood is deficient, then night sweating and other signs of deficiency-heat can occur. Low appetite and lassitude are due to spleen Qi deficiency. Sallow facial complexion, pale tongue, and thready moderate pulse all suggest Qi and blood deficiency. Six herbs in this formula are used to warm and tonify the spleen Qi: Radix Ginseng (Ren Shen), Radix Astragali (Huang Qi), Rhizoma Atractylodis Macrocephalae (Bai Zhu), Radix Glycyrrhizae Praeparata (Zhi Gan Cao), Rhizoma Zingiberis Recens (Sheng Jiang), and Fructus Ziziphi Jujubae (Da Zao). Radix Angelicae Sinensis (Dang Gui) nourishes the liver, tonifies the heart blood, and regulates the blood circulation. Poria Cocos (Fu Shen), Semen Ziziphi Spinosae (Suan Zao Ren), and Arillus Longanae (Long Yan Rou) nourish the heart to help house the mind. Arillus Longanae (Long Yan Rou) also tonifies the blood. Radix Polygalae (Yuan Zhi) strengthens the relationship between the heart and the kidney to help house the mind. Radix Saussureae (Mu Xiang) invigorates the spleen function and Qi circulation to prevent the greasiness of the other herbs from impairing the digestive function of the spleen and stomach. Indeed, this formula is to nourish the heart, strengthen the spleen, and tonify both Qi and blood. This formula can also be used to treat failure of the spleen to keep blood circulating inside the vessels. This condition may occur due to Qi deficiency of the spleen. Symptoms of bleeding such as hematochezia may occur. In women, uterine bleeding, early menstruation, and hypermenorrhea with pale blood with no clots may occur. If the spleen is deficient and is unable to dry up the dampness in the body, then leukorrhea of thick white vaginal discharge may occur as a result of dampness descending to the lower body. Today, this formula is widely used to treat neurological disorders, heart disease, anemia, and functional endometrorrhagia. In any case, signs of heart and spleen deficiency must be present.

CAUTION/CONTRAINDICATION

This formula should not be used if there is interior heat or Yin deficiency in the body.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 15, BL 20, St 36, Sp 6, H 7.

2. Technique: tonification.

3. Explanation: BL 15 and BL 20 can nourish and regulate the blood circulation. St 36 tonifies the spleen Qi and blood. Sp 6 nourishes Yin and blood. H 7 is combined with BL 15 to calm the Shen and nourish the blood.

COMPOSITION

1. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 12g

2. Radix Ginseng (Ren Shen) 6g

3. Fructus Ziziphi Jujubae (Da Zao) 5-10pcs

4. Radix Rehmanniae (Sheng Di Huang) 30g

5. Radix Ophiopogonis (Mai Men Dong) 10g

6. Colla Corii Asini (E Jiao) 6g

7. Semen et Fructus Cannabis (Huo Ma Ren) 10g

8. Rhizoma Zingiberis Recens (Sheng Jiang) 9g

9. Ramulus Cinnamomi (Gui Zhi) 9g

 

METHOD OF ADMINISTRATION

Decoct all of the herbs above except Colla Corii Asini (E Jiao), which should be melted in the hot decoction of other herbs. After Colla Corii Asini (E Jiao) is completely dissolved, add 10 ml of wine to the decoction and drink the decoction while warm. This formula should be taken three times daily.

ACTION

1. To tonify Qi and Yin

2. To nourish blood and generate pulse

CLINICAL MANIFESTATION

1. Qi and blood deficiency: knotted or intermittent pulse, palpitation, weak physical condition, shortness of breath, and pale tongue with a mirrior-like and dry surface.

2. Lung deficiency due to over-exertion: dry coughing with little or no sputum, bloody streaks within the sputum, fidgeting, disturbed sleep, spontaneous perspiration or night sweating, dry throat, dry tongue, difficult defecation, and weak rapid pulse.

EXPLANATION

This formula is designed to treat knotted or intermittent pulse due to Qi and blood deficiency. Palpitation, weak physical condition, and shortness of breath are all signs of Qi and blood deficiency. Pale tongue with a mirrior-like dry surface indicates near-collapse of Qi and exhaustion of blood. Also, this formula can be used to treat lung deficiency due to over-exertion. Over-exertion may cause Yin deficiency of the lung, resulting in dry coughing with little or no sputum, fidgeting, night sweating, etc. Over-exertion may also cause Qi deficiency of the lung, resulting in spontaneous sweating. This formula uses Radix Glycyrrhizae Praeparata (Zhi Gan Cao), Radix Ginseng (Ren Shen), and Fructus Ziziphi Jujubae (Da Zao) to tonify the heart and the spleen Qi. Radix Rehmanniae (Sheng Di Huang), Radix Ophiopogonis (Mai Men Dong), Colla Corii Asini (E Jiao), and Semen et Fructus Cannabis (Huo Ma Ren) nourish the heart blood and the lung Yin. Rhizoma Zingiberis Recens (Sheng Jiang), Ramulus Cinnamomi (Gui Zhi), and the wine are all used to activate the Yang and the Qi flow in order to revitalize the body. Although this formula can be used for treating lung deficiency due to over-exertion, the dosages of Rhizoma Zingiberis Recens (Sheng Jiang), Ramulus Cinnamomi (Gui Zhi), and the wine should be decreased if there are severe symptoms of Yin deficiency. This formula is also known as Fu Mai Tang (Pulse Regenerating Combination) for its ability to bring back normal rhythmic pulse.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: Lung 9, BL 13, BL 43, BL 20, St 36, Sp 6, K 3, BL 17, BL 44.

2. Technique: tonification.

3. Explanation: Lung 9 and BL 13 are combined to nourish the lung. BL 43 is an essential point for all kinds of deficiency syndromes. BL 20, St 36, and Sp 6 nourish the Middle Jiao to increase the production of blood. K 3 nourishes the kidney Yin. BL 17 and BL 44 nourish the blood and heart.

MODIFICATION

1. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 5g

2. Radix Paeoniae Alba (Bai Shao) 18g

3. Radix Rehmanniae (Sheng Di Huang) 20g

4. Radix Ophiopogonis (Mai Men Dong) 15g

5. Colla Corii Asini (E Jiao) 10g

6. Semen et Fructus Cannabis (Huo Ma Ren) 10g

The main actions of this formula are to nourish blood, astringe Yin, tonify body fluid and moisten dryness. Clinically, this formula is often used for patients who have Yangming excess syndrome in which the excess heat has been cleared, but the interior deficiency still persists. The patient may show deficient big pulse with warm palms and soles, which indicate Yin deficiency and possibly some deficiency-heat. Therefore, a successful treatment in this case would require tonifying interior deficiencies without generating heat. Using Zhi Gan Cao Tang (Glycyrrhizae Combination) as a fundamental formula, Radix Paeoniae Alba (Bai Shao) is added to enhance the overall function of tonifying blood, Yin, and body fluid. Furthermore, Radix Ginseng (Ren Shen), Fructus Ziziphi Jujubae (Da Zao), Rhizoma Zingiberis Recens (Sheng Jiang), and Ramulus Cinnamomi (Gui Zhi) are taken away to prevent possible heat formation or other side-effects.

Acupuncture Treatment: Eliminate BL 17, BL 44, BL 43. Add K 7.

Qi and blood tonic formulas are composed of Qi and blood tonic herbs for treating Qi and blood deficiencies simultaneously.

COMPOSITION

1. Radix Ginseng (Ren Shen) 3g

2. Rz. Atractylodis Macrocephalae (Bai Zhu) 10g

3. Poria Cocos (Fu Ling) 8g

4. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 5g

5. Radix Rehmanniae Prep. (Shu Di Huang) 15g

6. Radix Angelicae Sinensis (Dang Gui) 10g

7. Radix Paeoniae Alba (Bai Shao) 8g

8. Rhizoma Ligustici Wallichii (Chuan Xiong) 5g

METHOD OF ADMINISTRATION

This formula should be decocted with three pieces of Rhizoma Zingiberis Recens (Sheng Jiang) and two pieces of Fructus Ziziphi Jujubae (Da Zao). The decoction should be taken while warm on an empty stomach.

ACTION: To tonify Qi and blood

CLINICAL MANIFESTATION

Qi and blood deficiency: pale or sallow facial appearance, weakness of the extremities, shortness of breath, poor appetite, palpitation, dizziness, pale tongue, thin white coat, and thready weak pulse.

EXPLANATION

This formula is the combination of Si Jun Zi Tang (Four Gentlemen Combination) and Si Wu Tang (Four Substance Combination). Originally designed to treat Qi and blood deficiencies due to excessive bleeding, this formula can be applied in any condition with deficiencies of both Qi and blood. Pale face is a sign of Qi or blood deficiency. Sallow facial expression is a sign of blood deficiency. Weak extremities, shortness of breath, and low appetite are all due to Qi deficiency. Palpitation and dizziness are signs of blood deficiency. The tongue and the pulse conditions both indicate a deficiency syndrome. Radix Ginseng (Ren Shen), Rhizoma Atractylodis Macrocephalae (Bai Zhu), Poria Cocos (Fu Ling), and Radix Glycyrrhizae Praeparata (Zhi Gan Cao) are used to tonify the Qi. Radix Rehmanniae Praeparata (Shu Di Huang), Radix Angelicae Sinensis (Dang Gui), Radix Paeoniae Alba (Bai Shao), and Rhizoma Ligustici Wallichii (Chuan Xiong) are used to nourish the blood. Rhizoma Zingiberis Recens (Sheng Jiang) and Fructus Ziziphi Jujubae (Da Zao) nourish the spleen and the stomach to increase the digestive function of the body.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 15, BL 18, BL 17, Ren 6, BL 20, BL 21, St 36, Sp 6.

2. Technique: tonification.

3. Explanation: BL 15, BL 18, and BL 17 are combined to nourish the blood. Ren 6 nourishes the Qi. BL 20, BL 21, St 36, and Sp 6 nourish the Middle Jiao to increase the Qi and blood.

COMPOSITION

1. Radix Ginseng (Ren Shen) 30g

2. Radix Astragali (Huang Qi) 30g

3. Rz. Atractylodis Macrocephalae (Bai Zhu) 30g

4. Radix Rehmanniae Prep. (Shu Di Huang) 20g

5. Radix Angelicae Sinensis (Dang Gui) 30g

6. Radix Paeoniae Alba (Bai Shao) 90g

7. Fructus Schisandrae (Wu Wei Zi) 20g

8. Poria Cocos (Fu Ling) 20g

9. Radix Polygalae (Yuan Zhi) 15g

10. Pericarpium Citri Reticulatae (Chen Pi) 30g

11. Cortex Cinnamomi (Rou Gui) 30g

12. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 30g

METHOD OF ADMINISTRATION

Decoct the above herbs with three pieces of Rhizoma Zingiberis Recens (Sheng Jiang) and two pieces of Fructus Ziziphi Jujubae (Da Zao). Drink the decoction while warm.

ACTION

1. To tonify both the Qi and blood

2. To nourish the heart the calm the spirit

CLINICAL MANIFESTATION

Exhaustion of the body due to consumptive diseases: lassitude, weakness and shortness of breath, dizziness, palpitation, insomnia, dry throat and lips.

EXPLANATION

This formula is designed to treat the syndrome of Qi and blood deficiency accompanied with instability of the heart. This syndrome usually results from exhaustion of the body in chronic consumptive diseases, in which both the Qi and the blood are depleted. Deficiency of the Qi may lead to lassitude and weakness and shortness of breath. Deficiency of the blood and instability of the heart may lead to dizziness, palpitation, and insomnia. Depletion of the blood may lead to Yin/blood deficiency, which may then result in dry throat and lips. In this formula, Radix Ginseng (Ren Shen), Radix Astragali (Huang Qi), and Rhizoma Atractylodis Macrocephalae (Bai Zhu) are used to tonify the Qi. Radix Rehmanniae Praeparata (Shu Di Huang), Radix Angelicae Sinensis (Dang Gui), and Radix Paeoniae Alba (Bai Shao) are used to tonify the blood. Fructus Schisandrae (Wu Wei Zi), Poria Cocos (Fu Ling), and Radix Polygalae (Yuan Zhi) nourish the heart and calm the spirit. Pericarpium Citri Reticulatae (Chen Pi) regulates the Qi flow of the body to counteract the stagnant properties of the other tonic herbs. Cortex Cinnamomi (Rou Gui) tonifies the Yang to help the regeneration of Qi and blood. Radix Glycyrrhizae Praeparata (Zhi Gan Cao) tonifies Qi and harmonizes all of the herbs in this formula. Rhizoma Zingiberis Recens (Sheng Jiang) and Fructus Ziziphi Jujubae (Da Zao) regulate the Middle Jiao and help tonify the Qi and blood.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 15, BL 18, BL 17, Ren 6, BL 20, BL 21, St 36, Sp 6, H 7.

2. Technique: tonification.

3. Explanation: BL 15, BL 18, and BL 17 are combined to nourish the blood. Ren 6 nourishes the Qi. BL 20, BL 21, St 36, and Sp 6 nourish the Middle Jiao to increase the Qi and blood. H 7 may calm the Shen.

COMPOSITION

1. Radix Ginseng (Ren Shen) 8g

2. Rz. Atractylodis Macrocephalae (Bai Zhu) 10g

3. Poria Cocos (Fu Ling) 8g

4. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 5g

5. Radix Rehmanniae Prep. (Shu Di Huang) 15g

6. Radix Angelicae Sinensis (Dang Gui) 10g

7. Radix Paeoniae Alba (Bai Shao) 8g

8. Rhizoma Ligustici Wallichii (Chuan Xiong) 5g

9. Radix Astragali (Huang Qi) 15g

10. Cortex Cinnamomi (Rou Gui) 8g

METHOD OF ADMINISTRATION

This formula is taken in the form of warm decoction. Grind the above herbs into coarse granules. Decoct six grams of the granules with three pieces of Rhizoma Zingiberis Recens (Sheng Jiang) and two pieces of Fructus Ziziphi Jujubae (Da Zao) each time. Use approximately 270ml of water to boil to 190ml. The decoction can be taken anytime during the day.

ACTION :To warm and tonify the Qi and blood

CLINICAL MANIFESTATION

1. Deficiency of Qi and blood accompanied by Yang deficiency and cold manifestations: lassitude, low appetite, pale face, palpitation, insomnia, dizziness, aversion to cold.

2. General deficiency of the body: deficiency cough, poor appetite, spermatorrhea, sallow appearance, weakness of the legs and knees, chronic ulcer or prolonged unhealed wounds, menstrual disorders.

EXPLANATION

This formula consists of Si Jun Zi Tang (Four Gentlemen Combination), Si Wu Tang (Four Substance Combination), Radix Astragali (Huang Qi), and Cortex Cinnamomi (Rou Gui). It can be used to treat patients of Qi and blood deficiency accompanied by Yang deficiency and coldness in the body. Si Jun Zi Tang (Four Gentlemen Combination) is used to treat the Qi deficiency. Si Wu Tang (Four Substance Combination) is used to treat the blood deficiency. Radix Astragali (Huang Qi) is used to tonify Qi and ascend Yang Qi to improve the general body condition. Radix Astragali (Huang Qi) also has the action to help heal prolonged unhealed wounds. Cortex Cinnamomi (Rou Gui) is used to warm the Yang and dispel cold. This formula can also be used to treat general deficiency of the body. It is often used in deficiency cases caused by over-exertion, injuries, and chronic illnesses. In the original text, it was stated that this formula has a wide range of effects and can be used to treat a variety of syndromes marked of deficiency.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 15, BL 18, BL 17, Ren 6, BL 20, BL 21, St 36, Sp 6, BL 13, BL 23, Ren 4.

2. Technique: tonification, moxibustion on Ren 4.

3. Explanation: BL 15, BL 18, and BL 17 are combined to nourish blood. Ren 6 nourishes the Qi. BL 20, BL 21, St 36, and Sp 6 nourish the Middle Jiao to increase the Qi and blood. BL 13, BL 23, and Ren 4 may be added to nourish the Qi and blood. Moxibustion on Ren 4 may increase the Yang.

COMPOSITION

1. Radix Ginseng (Ren Shen) 3-5g

2. Radix Astragali (Huang Qi) 15g

3. Rz. Atractylodis Macrocephalae (Bai Zhu) 10g

4. Rx. Glycyrrhizae Praeparata (Zhi Gan Cao) 4g

5. Radix Rehmanniae Praeparata (Shu Di Huang) 10g

6. Radix Angelicae Sinensis (Dang Gui) 8g

7. Radix Paeoniae Alba (Shao Yao) 6g

8. Radix Dipsaci (Xu Duan) 5g

9. Radix Scutellariae (Huang Qin) 5g

10. Fructus Amomi (Sha Ren) 4g

11. Rhizoma Ligustici Wallichii (Chuan Xiong) 4g

12. Semen Oryzae (Jing Mi) 5g

METHOD OF ADMINISTRATION

This formula is to be taken three times daily on empty stomachs.

ACTION:

1. To tonify the Qi and strengthen the spleen

2. To nourish the blood and stabilize the fetus

CLINICAL MANIFESTATION

Qi and blood deficiency with instability of the fetus: instability of the fetus, pale face, lassitude, general weakness, no appetite, pale tongue, thin white tongue coat, slippery weak or deep weak pulse.

EXPLANATION

This formula is designed to treat instability of the fetus due to Qi and blood deficiency. Pale face, lassitude, general weakness, and no appetite are common signs of Qi and blood deficiency. Slippery weak pulse indicates pregnancy and deficiency, and deep weak pulse indicates serious deficiency of Qi and blood. In this formula, Radix Ginseng (Ren Shen), Radix Astragali (Huang Qi), Rhizoma Atractylodis Macrocephalae (Bai Zhu), and Radix Glycyrrhizae Praeparata (Zhi Gan Cao) are used to tonify the Qi and strengthen the spleen. Radix Rehmanniae Praeparata (Shu Di Huang), Radix Angelicae Sinensis (Dang Gui), Radix Paeoniae Alba (Bai Shao), and Radix Dipsaci (Xu Duan) nourish the blood and tonify the liver and the kidney. Radix Scutellariae (Huang Qin) is to be combined with Radix Atractylodis Macrocephalae (Bai Zhu) to stabilize the fetus. Fructus Amomi (Sha Ren) regulates Qi and stabilizes the fetus. Rhizoma Ligustici Wallichii (Chuan Xiong) activates blood circulation. Semen Oryzae (Jing Mi) nourishes the spleen and the stomach to ensure a healthy digestive system. Today, this formula is widely used on pregnant women to prevent miscarriages.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 20, BL 21, St 36, Sp 6, Ren 6, Ren 4, BL 23, K 8. 2. Technique: tonification.

3. Explanation: BL 20, BL 21, St 36, Sp 6, and Ren 6 tonify the Qi, blood, and spleen. Sp 6 can also tonify the Chong and the Ren Channel when combined with Ren 4. BL 23 and K 8 can consolidate the kidney.

Yin tonic formulas are composed of Yin tonic herbs for treating Yin deficiency syndromes. The common clinical manifestations include emaciated appearance of the face and body, dry throat and mouth, fidgeting, irritability, dry stool, scanty yellow urine, even bone-steaming sensation, night sweating, tidal fever, red cheeks, seminal emission, sore back, red tongue, scanty tongue coat, and deep thready rapid pulse.

COMPOSITION

1. Radix Rehmanniae Prep. (Shu Di Huang) 24g PRN

2. Fructus Corni (Shan Zhu Yu) 12g ADJ

3. Radix Dioscoreae (Shan Yao) 12g ADJ

4. Rhizoma Alismatis (Ze Xie) 9g AUX

5. Cortex Moutan Radicis (Mu Dan Pi) 9g AUX

6. Poria Cocos (Fu Ling) 9g AUX

METHOD OF ADMINISTRATION

This formula can be taken in the form of pills or standard decoction. The pills, weighing 15 grams each, should be taken one at a time for up to three times daily on empty stomachs.

ACTION: To nourish the liver and kidney Yin

CLINICAL MANIFESTATION

Yin deficiency of the liver and kidney: dizziness, vertigo, tinnitus, deafness, blurred vision, soreness of the lower back and knees, night sweating, nocturnal emission, tidal fever, heat sensation in the palm and soles, thirst, toothache, dry mouth and throat, red tongue, scanty coat, thready rapid pulse.

EXPLANATION

Kidney dominates the bone and produces marrow, with the brain being "the sea of the marrow." Therefore, deficiency of the kidney can affect the brain, causing dizziness and vertigo. Since the ear is the sense organ that belongs to the kidney, tinnitus and deafness may occur as a result of kidney deficiency. Blurred vision is mainly due to deficiency of the liver, which opens into the eyes. Deficient kidney causes soreness of the lower back because of its relative location. Night sweating is a sign of general Yin deficiency, and nocturnal emission is a sign of kidney Yin deficiency. If deficiency-fire becomes active as a result of Yin deficiency, symptoms such as tidal fever, heat sensation in the palm and soles, thirst, toothache, and dry mouth and throat may occur. Red tongue with scanty coat suggests Yin deficiency with uprising of fire. Thready rapid pulse is typical of deficiency-fire. This formula consists of three tonic and three sedative herbs. Radix Rehmanniae Praeparata (Shu Di Huang), the principal herb, tonifies the kidney Yin and essence. Fructus Corni (Shan Zhu Yu) is astringent and nourishes the liver and the kidney. Radix Dioscoreae (Shan Yao) tonifies both the spleen and the kidney. Radix Alismatis (Ze Xie) is used to sedate the turbidity of the kidney and control the greasy property of Radix Rehmanniae Praeparata (Shu Di Huang). Cortex Moutan Radicis (Mu Dan Pi) is used to sedate the deficiency-fire of the liver; hence it is used in conjunction with Fructus Corni (Shan Zhu Yu). Poria Cocos (Fu Ling), as the sedating herb used with Radix Dioscoreae (Shan Yao), is used to dispel damp through urination and tonify the Middle Jiao. One significant characteristic of this formula is that it sedates while it tonifies. The purpose of sedation is to eradicate the turbidity inside the body and to further prevent the stagnant properties of the tonic herbs from harming the body. However, the purpose of this formula is to tonify, not to sedate. Therefore, the dosage of the sedating herbs is lower than that of the tonic herbs. This formula is widely used to treat chronic nephritis, hypertension, and diabetes. However, the patient must present clinical manifestations of liver and kidney Yin deficiency.

CAUTION/CONTRAINDICATION

1. This formula should not be used on patients who have Yang deficiency, cold extremities, common cold, high fever, or alternate spells of fever and chills.

2. This formula should be used with caution if the weather is hot and humid.

3. Because this formula is greasy in character, patients who have spleen deficiency should use this formula with caution, otherwise loose stool may result.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 18, BL 23, BL 20, K 3, K 6, Sp 9, Liver 2.

2. Technique: tonification.

3. Explanation: BL 18, BL 23, and BL 20 tonify the Yin of the liver, kidney, and spleen. K 3 and K 6 mainly tonify the kidney Yin. Sp 9 strengthens the spleen and eliminates damp. Liver 2 sedates the liver fire and other turbidity.

COMPOSITION

1. Radix Rehmanniae Prep. (Shu Di Huang) 24g

2. Fructus Corni (Shan Zhu Yu) 12g

3. Radix Dioscoreae (Shan Yao) 12g

4. Rhizoma Alismatis (Ze Xie) 9g

5. Cortex Moutan Radicis (Mu Dan Pi) 9g

6. Poria Cocos (Fu Ling) 9g

7. Rhizoma Anemarrhenae (Zhi Mu) 9g

8. Cortex Phellodendri (Huang Bai) 9g

METHOD OF ADMINISTRATION

This formula can be taken in the form of pills or standard decoction. The pills, weighing 15 grams each, should be taken one at a time for up to three times daily on empty stomachs.

ACTION:

1. To nourish the liver and kidney

2. To clear deficiency-fire of the liver and the kidney

CLINICAL MANIFESTATION

Yin deficiency of the liver and kidney: dizziness, vertigo, tinnitus, deafness, blurred vision, soreness of the lower back and knees, night sweating, nocturnal emission, irritability, fidgeting, tidal fever, heat sensation in the palm and soles, thirst, toothache, dry mouth and throat, red tongue, scanty coat, thready rapid pulse.

EXPLANATION

This formula is derived from Liu Wei Di Huang Wan (Rehmanniae Six Combination). Its actions are basically the same as that of Liu Wei Di Huang Wan (Rehmanniae Six Combination) except that this formula has a stronger action to sedate the deficiency-fire of the liver and the kidney. Therefore, it has a stronger effect to relieve night sweating, irritability, and toothache, etc. This formula consists of the six herbs of Liu Wei Di Huang Wan (Rehmanniae Six Combination) plus Rhizoma Anemarrhenae (Zhi Mu) and Cortex Phellodendri (Huang Bai). Rhizoma Anemarrhenae (Zhi Mu) and Cortex Phellodendri (Huang Bai) are excellent herbs for sedating deficiency-fire of the liver and kidney. For a more detailed explanation of the clinical manifestations and the functions of each herb in this formula, please refer to Liu Wei Di Huang Wan (Rehmanniae Six Combination).

CAUTION/CONTRAINDICATION Please refer to Liu Wei Di Huang Wan (Rehmanniae Six Combination).

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 18, BL 23, BL 20, K 3, K 6, Sp 9, Liver 2, H 6, K 10.

2. Technique: tonification.

3. Explanation: BL 18, BL 23, and BL 20 tonify the Yin of the liver, kidney, and spleen. K 3 and K 6 mainly tonify the kidney Yin. Sp 9 strengthens the spleen and eliminates damp. Liver 2 sedates the liver fire and other turbidity. H 6 and K 10 nourish Yin and clear the fire.

COMPOSITION

1. Radix Rehmanniae Prep. (Shu Di Huang) 24g

2. Fructus Corni (Shan Zhu Yu) 12g

3. Radix Dioscoreae (Shan Yao) 12g

4. Rhizoma Alismatis (Ze Xie) 9g

5. Cortex Moutan Radicis (Mu Dan Pi) 9g

6. Poria Cocos (Fu Ling) 9g

7. Fructus Lycii (Gou Qi Zi) 9g

8. Flos Chrysanthemi (Ju Hua) 9g

METHOD OF ADMINISTRATION

This formula can be taken in the form of pills or standard decoction. The pills, weighing 15 grams each, should be taken one at a time for up to three times daily on empty stomachs.

ACTION: To nourish the liver and kidney Yin

CLINICAL MANIFESTATION

Blurred vision due to Yin deficiency of the liver and kidney: blurred vision, dizziness, vertigo, tinnitus, soreness of the lower back and knees, red tongue, scanty coat, thready rapid pulse.

EXPLANATION

This formula is derived from Liu Wei Di Huang Wan (Rehmanniae Six Combination). This formula, besides tonifying the kidney and liver Yin, is able to brighten the eyes and improve vision. Compared to Liu Wei Di Huang Wan (Rehmanniae Six Combination), this formula has a stronger effect for nourishing the liver and the eyes. Due to this reason, the main clinical manifestation of this formula is blurred vision, which is caused by Yin deficiency of the liver. This formula consists of Liu Wei Di Huang Wan (Rehmanniae Six Combination) plus Fructus Lycii (Gou Qi Zi) and Flos Chrysanthemi (Ju Hua). Liu Wei Di Huang Wan (Rehmanniae Six Combination) is used to tonify the liver and kidney Yin. Fructus Lycii (Gou Qi Zi) and Flos Chrysanthemi (Ju Hua) are used to tonify the liver Yin and improve the vision. For more information, please refer to Liu Wei Di Huang Wan (Rehmanniae Six Combination).

CAUTION/CONTRAINDICATION Please refer to Liu Wei Di Huang Wan (Rehmanniae Six Combination).

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 18, BL 23, BL 20, K 3, K 6, Sp 9, Liver 2, BL 1, BL 2, SI 6.

2. Technique: tonification. 3. Explanation::

BL 18, BL 23, and BL 20 tonify the Yin of the liver, kidney, and spleen. K 3 and K 6 mainly tonify the kidney Yin. Sp 9 strengthens the spleen and eliminates damp. Liver 2 sedates the liver fire and other turbidity. BL 1, BL 2, and SI 6 may clarify the vision.

COMPOSITION

1. Fructus Schisandrae (Wu Wei Zi) 6g

2. Radix Rehmanniae Prep. (Shu Di Huang) 24g

3. Fructus Corni (Shan Zhu Yu) 12g

4. Radix Dioscoreae (Shan Yao) 12g

5. Rhizoma Alismatis (Ze Xie) 9g

6. Cortex Moutan Radicis (Mu Dan Pi) 9g

7. Poria Cocos (Fu Ling) 9g METHOD OF

ADMINISTRATION: Please refer to Liu Wei Di Huang Wan (Rehmanniae Six Combination).

ACTION:

1. To nourish the kidney Yin

2. To improve respiration by invigorating the kidney Qi

CLINICAL MANIFESTATION

Yin deficiency of the kidney accompanied by coughing and wheezing: dizziness, tinnitus, sore back, weak knees, coughing, wheezing.

EXPLANATION

This formula derived from Liu Wei Di Huang Wan (Rehmanniae Six Combination). Besides tonifying the Yin of the kidney, this formula is able to improve respiration by invigorating the kidney Qi. The kidney has the function to help descend the lung Qi for normal inspiration. If the kidney is deficient, the lung Qi may not be able to descend and clinical manifestations such as coughing and wheezing would occur. In addition to coughing and wheezing, other manifestations of kidney Yin deficiency such as dizziness, tinnitus, sore back, and weak knees would also occur. This formula consists of the six herbs of Liu Wei Di Huang Wan (Rehmanniae Six Combination) plus Fructus Schisandrae (Wu Wei Zi). Liu Wei Di Huang Wan (Rehmanniae Six Combination) tonifies the kidney Yin to invigorate the kidney’s function to descend the lung Qi. Fructus Schisandrae (Wu Wei Zi), a sour herb, may tonify the kidney and astringe the lung Qi to relieve coughing and wheezing. For more information of the functions of each individual herb of this formula, please refer to Liu Wei Di Huang Wan (Rehmanniae Six Combination).

CAUTION/CONTRAINDICATION Please refer to Liu Wei Di Huang Wan (Rehmanniae Six Combination).

 

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 18, BL 23, BL 20, K 3, K 6, Sp 9, Liver 2, BL 43, BL 52.

2. Technique: tonification. 3. Explanation::

BL 18, BL 23, and BL 20 tonify the Yin of the liver, kidney, and spleen. K 3 and K 6 mainly tonify the kidney Yin. Sp 9 strengthens the spleen and eliminates damp. Liver 2 sedates the liver fire and other turbidity. BL 43 and BL 52 help consolidate the kidney Qi.

COMPOSITION

1. Radix Ophiopogonis (Mai Men Dong) 9g

1. Fructus Schisandrae (Wu Wei Zi) 6g

2. Radix Rehmanniae Prep. (Shu Di Huang) 24g

3. Fructus Corni (Shan Zhu Yu) 12g

4. Radix Dioscoreae (Shan Yao) 12g

5. Rhizoma Alismatis (Ze Xie) 9g

6. Cortex Moutan Radicis (Mu Dan Pi) 9g

7. Poria Cocos (Fu Ling) 9g

METHOD OF ADMINISTRATION

This formula can be taken as pills or decoction. To make pills, mix the powder of the above herbs with honey. Each individual pill should weigh approximately 15 grams. Take one pill at a time and three times daily with warm water on an empty stomach. For decoction, decoct as usual and take it while it is warm.

ACTION

1. To nourish the kidney Yin

2. To astringe and nourish lung Yin to stop coughing

CLINICAL MANIFESTATION

Yin deficiency of the kidney and the lung accompanied by coughing: coughing, shortness of breath, tidal fever, night sweating plus the clinical manifestations found in Liu Wei Di Huang Wan (Rehmanniae Six Combination).

EXPLANATION

This is a variation formula of Liu Wei Di Huang Wan (Rehmanniae Six Combination). It consists of the original six herbs from Liu Wei Di Huang Wan (Rehmanniae Six Combination) plus Radix Ophiopogonis (Mai Dong) and Fructus Schisandrae (Wu Wei Zi). Therefore, in addition to treating kidney Yin deficiency, this formula can be used to treat lung Yin deficiency as well.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 18, BL 23, BL 20, K 3, K 6, Sp 9, Liver 2, BL 13, BL 43.

2. Technique: tonification. 3. Explanation:

BL 18, BL 23, and BL 20 tonify the Yin of the liver, kidney, and spleen. K 3 and K 6 mainly tonify the kidney Yin. Sp 9 strengthens the spleen and eliminates damp. Liver 2 sedates the liver fire and other turbidity. BL 13 and BL 43 are used to consolidate the lung and the kidney.

COMPOSITION

1. Radix Rehmanniae Prep. (Shu Di Huang) 240g

2. Fructus Lycii (Gou Qi Zi) 120g

3. Fructus Corni (Shan Zhu Yu) 120g

4. Colla Plastrum Testudinis (Gui Jiao) 120g

5. Colla Cornus Cervi (Lu Jiao Jiao) 120g

6. Semen Cuscutae (Tu Si Zi) 120g

7. Radix Achyranthis Bidentatae (Niu Xi) 90g

8. Radix Dioscoreae (Shan Yao) 120g

METHOD OF ADMINISTRATION

This formula can be taken as pills or standard decoction. The pills, made from the powder of the above herbs with honey, should weigh approximately 15 grams each. Take one pill in the morning and one in the evening on empty stomachs with warm water.

ACTION: To nourish Yin of kidney

CLINICAL MANIFESTATION

Yin deficiency of kidney: dizziness, vertigo, weakness of knees, soreness of the lower back, night sweating, dry mouth and throat, thirst, mirrior-like tongue surface with little coating, thready or rapid pulse.

EXPLANATION

This formula is designed to tonify the kidney Yin. Deficiency of the kidney may cause deficiency of the marrow. And since the brain is the sea of marrow, deficiency of the marrow may lead to deficiency of the brain, resulting in dizziness and vertigo. Deficiency of the kidney often causes deficiency of the lower body, leading to weak knees and sore back. Night sweating, dry mouth and throat, and thirst indicate general Yin deficiency and lack of body fluid. Mirrior-like tongue surface with little coating indicates severe Yin deficiency. A thready rapid pulse is a typical sign of Yin deficiency. This formula uses Radix Rehmanniae Praeparata (Shu Di Huang) to tonify the kidney and replenish the kidney essence. Fructus Lycii (Gou Qi Zi) tonifies Yin and improves vision to relieve the dizziness. Fructus Corni (Shan Zhu Yu), with a sour taste, may astringe the Yin and the body fluid to prevent further losses. Colla Plastrum Testudinis (Gui Jiao) and Colla Cornus Cervi (Lu Jiao Jiao) have a very strong effect to nourish the kidney and tonify the Jing (essence) when combined together. Semen Cuscutae (Tu Si Zi) combines with Radix Achyranthis Bidentatae (Niu Xi) to tonify the kidney and strengthen the lower body to relieve sore back and weak knees. Radix Dioscoreae (Shan Yao) gently nourishes the kidney essence.

CAUTION/CONTRAINDICATION This formula consists of most greasy herbs that may easily produce dampness inside the body. Therefore, for patients of spleen Qi deficiency, Qi-activating herbs such as Fructus Amomi (Sha Ren) and Pericarpium Citri Reticulatae (Chen Pi) may be added to prevent accumulation of damp.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 23, K 3, Ren 4, Sp 6, Ren 6, BL 52.

2. Technique: tonification. 3. Explanation:

BL 23 and K 3 tonify the kidney Yin. Ren 4, the meeting point of three Foot Yin Channels and the Ren Channel, nourishes the Yin of the Lower Jiao. Sp 6 nourishes the liver, kidney, and spleen. Ren 6 and BL 52 tonify the Qi and consolidate the essence.

COMPOSITION

1. Radix Rehmanniae Prep. (Shu Di Huang) 180g

2. Plastrum Testudinis (Gui Ban) 180g

3. Cortex Phellodendri (Huang Bai) 120g

4. Rhizoma Anemarrhenae (Zhi Mu) 120g

METHOD OF ADMINISTRATION

This formula can be taken in the form of pills or standard decoction. The pills should weigh 15 grams each and taken one in the morning and one in the evening.

ACTION: To nourish Yin and clear deficiency-fire

CLINICAL MANIFESTATION

Yin deficiency of liver and kidney and flaring-up of deficiency-fire: bone-steaming sensation, tidal fever, night sweating, nocturnal emission, weakness of the knees and legs, coughing, fidgeting, irritability, red tongue with scanty coat, rapid forceful pulse at Chi (third) position.

EXPLANATION

This formula is designed to treat the flaring-up of deficiency-fire caused by Yin deficiency of the liver and kidney. Deficiency of Yin may cause of deficiency-fire, which, when becoming active, may cause a bone-steaming sensation of the body. Tidal fever and night sweating are typical signs of Yin deficiency, and nocturnal emission specifically indicates kidney Yin deficiency. Weakness of knees and sore back are due to deficiency of the lower body, which is the result of kidney Yin deficiency. If the deficiency-fire flares up to affect the lung, coughing may occur. Similarly, if this deficiency-fire flares up to affect the heart, fidgeting and irritability may occur. Red tongue with scanty coat is representative of Yin deficiency. Rapid forceful pulse may be present if the deficiency-fire is flaring up and causing the various acute symptoms. Radix Rehmanniae Praeparata (Shu Di Huang) tonifies the kidney Yin and replenishes the kidney essence. Plastrum Testudinis (Gui Ban) nourishes the Yin to control the deficiency-fire. Cortex Phellodendri (Huang Bai) has a strong function for sedating deficiency-fire and solidifying the Yin. Rhizoma Anemarrhenae (Zhi Mu) clears the deficiency-fire and moisten the lung and the kidney. Indeed this formula consists of strong tonic and sedating herbs to relieve the flaring-up of deficiency-fire.

CAUTION/CONTRAINDICATION

This formula is not suitable for the patients that have low appetite, loose stool, or excess-fire.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 18, BL 23, K 3, K 6, BL 13, K 10, H 6.

2. Technique: tonification. 3. Explanation:

BL 18, BL 23, K 3, and K 6 nourish the Yin to control the fire. BL 13 nourishes the lung Yin. K 10 nourishes Yin. H 6 clears the deficiency-heat to relieve the bone-steaming sensation.

1. Cortex Phellodendri (Huang Bai) 150g .

2. Rhizoma Anemarrhenae (Zhi Mu) 60g

3. Radix Rehmanniae Prep. (Shu Di Huang) 60g

4. Plastrum Testudinis (Gui Ban) 120g

5. Radix Paeoniae Alba (Bai Shao) 60g

6. Os Tigridis (Hu Gu) 30g

7. Herba Cynomorium (Suo Yang) 45g

8. Pericarpium Citri Reticulatae (Chen Pi) 60g

9. Rhizoma Zingiberis (Gan Jiang) 15g

METHOD OF ADMINISTRATION

This formula is taken in the form of pills. The pills should weigh approximately 10 grams each. Take one pill at a time and twice per day with warm water.

ACTION

1. To nourish Yin and clear the deficiency-fire

2. To strengthen bones and tendons

CLINICAL MANIFESTATION

Yin deficiency of liver and kidney with weakness of the bones and tendons: soreness of the lower back and knees, weakness of the bones and tendons, weak legs and weakening of leg muscles, red tongue with little coating, thready weak pulse.

EXPLANATION

This formula is designed to treat Yin deficiency of the kidney and liver with severe weakness of the tendons and bones. The tissue that belongs to the kidney is the bone and the tissue that belongs to the liver is the tendon. If the kidney and the liver are deficient, the bones and the tendons may become weak and deficient also. Weak bones and tendons may lead to soreness of the lower back and knees as well as weak legs and weakening of leg muscles. Red tongue with little coating indicates deficiency-fire, and a thready weak pulse suggests that the bones and the tendons are becoming deficient. This formula uses Cortex Phellodendri (Huang Bai) and Rhizoma Anemarrhenae (Zhi Mu) to clear deficiency-heat and strengthen the Yin. Radix Rehmanniae Praeparata (Shu Di Huang), Plastrum Testudinis (Gui Ban), and Radix Paeoniae Alba (Bai Shao) tonify the Yin and nourish the blood. Os Tigridis (Hu Gu) strengthens the tendons and the bones. Herba Cynomorium (Suo Yang) nourishes the kidney Jing (essence) and the tendons. Pericarpium Citri Reticulatae (Chen Pi) and Rhizoma Zingiberis (Gan Jiang) strengthen the spleen to prevent the cold and the greasy herbs from damaging the Middle Jiao.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 18, BL 23, GB 39, GB 35, St 31, St 34, St 36.

2. Technique: tonification.

3. Explanation: BL 18 and BL 23 tonify the liver and kidney Yin. GB 39, one of the Eight Influential Points that dominates the marrow, can nourish the marrow and the kidney. GB 35 is used to nourish the tendons. Because the Yangming Channel is the channel with more Qi and blood, it is the target channel for treating dystrophy. Therefore, St 31, St 34, and St 36 are all used to strengthen the Qi and blood.

COMPOSITION

1. Fructus Ligustri Lucidi (Nu Zhen Zi)

2. Herba Ecliptae (Han Lian Cao)

3. Fructus Mori (Sang Shen)

METHOD OF ADMINISTRATION

This formula is taken in the form of pills. First decoct an equal amount of Herba Ecliptae (Han Lian Cao) and Fructus Mori (Sang Shen) over a long period of time until the decoction is paste-like. Then mix this decoction with honey and the powder of Fructus Ligustri Lucidi (Nu Zhen Zi) to make the pills weighing approximately 15 grams each. The pills should be taken twice a day with warm water.

ACTION : To tonify the kidney and nourish the liver

CLINICAL MANIFESTATION

Yin deficiency of kidney and liver: bitter taste in mouth, dizziness, blurred vision, dry throat, insomnia, excessive dreaming, soreness and weakness of the lower back and knees, nocturnal emission, and premature gray hair.

EXPLANATION

This formula is designed to treat kidney and liver Yin deficiency. Bitter taste in mouth is due to irregular flow of the bile, which may result in the case of liver Yin deficiency. Since the sense organ that belongs to the liver is the eye, dizziness and blurred vision may occur as a result of liver Yin deficiency. The kidney channel reaches to the throat and the tongue area, which may become dry as a result of kidney Yin deficiency. Deficiency of Yin may lead to unrest of Yang, which would then cause insomnia and frequent dreaming. Since the kidneys are located in the lower back, deficiency of the kidney may lead to weakness and soreness of the lower back and knees. Kidney Yin deficiency may cause unrest of Yang and lead to leaking symptoms such as nocturnal emission. Premature gray hair may also occur because the brilliance of the kidney is at the hair. Fructus Ligustri Lucidi (Nu Zhen Zi) tonifies both the liver and kidney Yin. Herba Ecliptae (Han Lian Cao), sweet, sour, and cold, nourishes the Yin and consolidates the Jing (essence) to stop nocturnal emission. Fructus Mori (Sang Shen) helps tonify the Yin and the blood. This is a mild and non-greasy formula for tonifying the kidney and the liver Yin. Due to the mild nature of this formula, it can be taken for a long period of time if necessary.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 18, BL 23, BL 20, K 3, K 6, Sp 9, Liver 2.

2. Technique: tonification. 3. Explanation: Selection of points in this treatment is the same as that in Liu Wei Di Huang Wan (Rehmanniae Six Combination). BL 18, BL 23, and BL 20 tonify the Yin of the liver, kidney, and spleen. K 3 and K 6 mainly tonify the kidney Yin. Sp 9 strengthens the spleen and eliminates damp. Liver 2 sedates the liver fire and other turbidity.

MODIFICATION

1. Folium Mori (Sang Ye) 300g

2. Semen Sesame Nigrum (Hei Zhi Ma) 120g

3. Honey (Bai Mi) 300g

This formula is designed to be taken in the form of pills, ten grams each time and twice daily. The main actions of this formula are to nourish Yin of liver and kidney and to dispel wind and damp. Clinically, the patient may show deficiencies of Yin and blood, characterized by such symptoms as dizziness, blurred vision, chronic coughing, constipation, dry skin, and numbness of the muscles and joints.

Acupuncture Treatment

Use BL 18, BL 23, K 3, Taiyang (extra), BL 12, and Sp 9 to nourish the liver, kidney, and clarify the wind and damp.

COMPOSITION

1. Radix Rehmanniae (Sheng Di Huang) 30g PRN

2. Radix Glehniae (Sha Shen) 10g ADJ

3. Radix Ophiopogonis (Mai Men Dong) 10g ADJ

4. Radix Angelicae Sinensis (Dang Gui) 10g ADJ

5. Fructus Lycii (Gou Qi Zi) 12g ADJ

6. Fructus Meliae Toosendan (Chuan Lian Zi) 5g AUX, CON

METHOD OF ADMINISTRATION This formula is taken in the form of warm decoction.

ACTION

1. To nourish Yin of the kidney and the liver

2. To regulate the liver Qi

CLINICAL MANIFESTATION Yin deficiency of the kidney and the liver accompanied by liver Qi stagnation: chest and hypochondriac pains, acid regurgitation, sore throat, dry mouth, red tongue with little moisture, thready weak or weak wiry pulse. Occasionally there may also be hernia.

EXPLANATION

This formula is designed to treat Yin deficiency of the kidney and the liver accompanied by liver Qi stagnation. Liver has the function to smooth the Qi flow and disperse any stagnation of the body. If the liver Yin is deficient and the liver becomes malnourished, the liver Qi may become stagnant and invasive. The excessive liver Qi may invade the chest and the hypochondriac region, causing chest and hypochondriac pains. If the excessive liver Qi invades the stomach, acid regurgitation may occur. Sore throat, dry mouth, and red tongue with little moisture are results of deficiency-fire from kidney and liver Yin deficiency. Occasionally hernia may also be present because of Qi stagnation of the liver channel, which passes through the inguinal region. Thready weak pulse suggests Yin deficiency, and weak wiry pulse suggests Yin deficiency and pain. This formula uses Radix Rehmanniae (Sheng Di Huang) as the principal herb to tonify the liver and the kidney Yin. Radix Glehniae (Sha Shen), Radix Ophiopogonis (Mai Men Dong), Radix Angelicae Sinensis (Dang Gui), and Fructus Lycii (Gou Qi Zi) are the adjuvant herbs that nourish the Yin and the blood to soften the liver. Fructus Meliae Toosendan (Chuan Lian Zi) helps smooth the liver Qi flow to relieve the pain and is of cold property to decrease the deficiency-heat of the liver.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 18, BL 23, K 3, Sp 10, Sp 6, Liver 14.

2. Technique: tonification. 3. Explanation: BL 18, BL 23, and K 3 tonify the liver and kidney Yin. Sp 10 and Sp 6 nourish the Yin and blood to calm the liver. Liver 14, the Front-Mu point of the liver, is combined with BL 18, the Back-Shu point of the liver, to smooth and regulate the liver Qi.

COMPOSITION

1. Herba Dendrobii (Shi Hu) 15g

2. Radix Ophiopogonis (Mai Men Dong) 30g

3. Radix Asparagi (Tian Men Dong) 60g

4. Radix Rehmanniae (Sheng Di Huang) 30g

5. Radix Rehmanniae Prep. (Shu Di Huang) 30g

6. Fructus Schisandrae (Wu Wei Zi) 23g

7. Semen Cuscutae (Tu Si Zi) 23g

8. Fructus Lycii (Gou Qi Zi) 23g

9. Radix Achyranthis Bidentatae (Niu Xi) 23g

10. Herba Cistanchis (Rou Cong Rong) 15g

11. Radix Ginseng (Ren Shen) 60g

12. Poria Cocos (Fu Ling) 60g

13. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 15g

14. Radix Dioscoreae (Shan Yao) 23g

15. Fructus Aurantii (Zhi Ke) 15g

16. Rz. Ligustici Wallichii (Chuan Xiong) 15g

17. Flos Chrysanthemi (Ju Hua) 23g

18. Semen Armeniacae Amarum (Xing Ren) 23g

19. Radix Sileris (Fang Feng) 15g

20. Semen Cassiae (Jue Ming Zi) 23g

21. Fructus Tribuli (Bai Ji Li) 15g

22. Semen Celosiae (Qing Xiang Zi) 15g

23. Rhizoma Coptidis (Huang Lian) 15g

24. Cornu Rhinoceri (Xi Jiao) 15g

25. Cornu Antelopis (Ling Yang Jiao) 15g

METHOD OF ADMINISTRATION

This formula is taken in the form of pills, which should weigh approximately 10g each. Take one pill in the morning and another in the evening with warm water daily.

ACTION

1. To soothe the liver and calm the liver wind

2. To nourish Yin and promote clear vision

CLINICAL MANIFESTATION

Yin deficiency of the liver and the kidney leading to internal fire and wind: enlarged pupil, blurred vision, excess tears, dizziness, vertigo, and occasionally there may also be internal oculopathy such as cataracts.

EXPLANATION

This formula is designed to treat deficiency of the liver and the kidney Yin complicated by internal fire and wind. Yin deficiency of the liver and the kidney may lead to deficiency-fire. When deficiency-fire reaches a certain level, internal wind may form. There are many manifestations that may occur as a result of Yin deficiency of the liver and the kidney. However, this formula is specifically designed to treat irregularities of the eyes. The eyes may be malnourished as a result of liver and kidney Yin deficiency, leading to clinical manifestations such as enlarged pupil, blurred vision, excess tears, etc.

This formula consists of 25 herbs, which may be grouped into five different categories. The categories are: blood and body fluid nourishing herbs, liver and kidney Yin nourishing herbs, lung and spleen tonifying herbs, wind-dispersing and heat-clearing herbs, and liver-soothing and wind-calming herbs. Herba Dendrobii (Shi Hu), Radix Ophiopogonis (Mai Men Dong), Radix Asparagi (Tian Men Dong), Radix Rehmanniae (Sheng Di Huang), Radix Rehmanniae Praeparata (Shu Di Huang), and Fructus Schisandrae (Wu Wei Zi) nourish the blood and help produce more body fluid. Semen Cuscutae (Tu Si Zi), Fructus Lycii (Gou Qi Zi), Radix Achyranthis Bidentatae (Niu Xi), and Herba Cistanchis (Rou Cong Rong) nourish the Yin and tonify the liver and the kidney. Since the Gu (grain) Qi has the function to constantly replenish the kidney Jing (essence), the spleen and the lung should be tonified in order to ensure an adequate Gu (grain) Qi. The four herbs that tonify the spleen and the lung are Radix Ginseng (Ren Shen), Poria Cocos (Fu Ling), Radix Glycyrrhizae Praeparata (Zhi Gan Cao), and Radix Dioscoreae. Yin and blood deficiency of the liver and kidney may easily generate wind and heat. To sedate the heat and clear the wind, this formula uses Fructus Aurantii (Zhi Ke), Rhizoma Ligustici Wallichii (Chuan Xiong), Flos Chrysanthemi (Ju Hua), Semen Armeniacae Amarum (Xing Ren), Radix Sileris (Fang Feng), Semen Cassiae (Jue Ming Zi), Fructus Tribuli (Bai Ji Li), and Semen Celosiae (Qing Xiang Zi). Finally, to soothe the liver and calm the liver wind, this formula uses Rhizoma Coptidis (Huang Lian), Cornu Rhinoceri (Xi Jiao), and Cornu Antelopis (Ling Yang Jiao).

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 18, BL 23, Sp 10, Sp 6, GB 20, Liver 3, BL 1, BL 2.

2. Technique: tonification.

3. Explanation: BL 18 and BL 23 tonify the liver and the kidney. Sp 10 and Sp 6 tonify the Yin and blood to soften the liver. GB 20 disperses wind, opens collaterals, and increases blood flow to the head. Liver 3 can regulate the liver Qi flow. BL 1 and BL 2 are used as local points to brighten the vision.

COMPOSITION

1. Colla Corii Asini (E Jiao) 45g

2. Fructus Arctii (Niu Bang Zi) 7.5g

3. Fructus Aristolochiae (Ma Dou Ling) 15g

4. Semen Armeniacae Amarum (Xing Ren) 6g

5. Semen Oryzae (Jing Mi) 30g

6. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 7.5g

METHOD OF ADMINISTRATION Decoct all of the herbs as usual except Colla Corii Asini (E Jiao), which should be melted in the hot decoction.

ACTION

1. To nourish Yin and tonify the lung

2. To stop coughing and bleeding

CLINICAL MANIFESTATION Excess heat invading a deficient lung: coughing, wheezing, dry throat, bloody streaks in the sputum, red tongue with little coat, superficial thready and rapid pulse.

EXPLANATION

This formula is designed to treat the syndrome of excess heat invading a deficient lung. Lung deficiency suggests that the body is vulnerable to attacks of exterior pathogenic factors. Once these exterior pathogenic factors progress to the lung and the interior and become stagnant, they may transform into excess heat. The excess heat may disrupt the normal Qi flow of the lung, causing coughing and wheezing. Dry throat and coughing with bloody sputum indicates that the excess heat has injured the body fluid and the blood. Red tongue with little coat and superficial thready rapid pulse indicate heat and deficiency in the lung. Colla Corii Asini (E Jiao), used heavily in this formula, tonifies the lung Yin, nourishes the blood, and stops the bleeding. Fructus Arctii (Niu Bang Zi) disperses the heat and relieves the dry sore throat. Fructus Aristolochiae (Ma Dou Ling) clears the lung heat, stops the coughing, and dissolves the phlegm. Semen Armeniacae Amarum (Xing Ren) descends the adverse rising Qi of the lung to relieve the coughing and wheezing. According to the Mother-Son law, one should tonify the spleen in case of lung deficiency. Hence Semen Oryzae (Jing Mi) and Radix Glycyrrhizae (Zhi Gan Cao) are added to nourish the spleen. This formula is also known as E Jiao San (Corii Asini Powder) and Bu Fei San (Lung Tonic Powder).

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 13, Lung 9, K 6, Du 14, LI 4, Lung 1, Lung 8.

2. Technique: tonification.

3. Explanation: BL 13 is combined with Lung 9 to nourish the lung Yin and Qi. K 6 nourishes Yin to clear heat. Du 14 and LI 4 disperse wind and heat. Lung 1 can smooth the Qi flow of the lung. Lung 8 can clear the phlegm from the lung and relieve coughing.

MODIFICATION

1. Radix Asparagi (Tian Men Dong) 30g

2. Radix Ophiopogonis (Mai Men Dong) 30g

3. Radix Rehmanniae (Sheng Di Huang) 30g

4. Radix Rehmanniae Prep. (Shu Di Huang) 30g

5. Radix Dioscoreae (Shan Yao) 30g

6. Radix Stemonae (Bai Bu) 30g

7. Radix Glehniae (Sha Shen) 30g

8. Bb. Fritillariae Cirrhosae (Chuan Bei Mu) 30g

9. Colla Corii Asini (E Jiao) 30g

10. Poria Cocos (Fu Ling) 15g

11. Jecur Lutrae (Ta Gan) 15g

12. Radix Pseudoginseng (San Qi) 15g

13. Flos Chrysanthemi (Ju Hua) 60g

14. Folium Mori (Sang Ye) 60g

This formula is to be taken in the pill form, about 15 grams each time three times daily. The main actions of this formula are to tonify the Lung, nourish Yin, stop coughing and bleeding. Clinically, it is often used for patients with Yin deficiency of the lung and the kidney, characterized by chronic coughing with phlegm which may contain streaks of blood. It may also be used in middle or late stages of chronic tuberculosis with such symptoms as tidal fever, dysphoria with feverish sensation in the chest, palms and soles, skinny complexion, dry coughing or productive coughing with streaks of blood in the phlegm, dry mouth, chest stuffiness, lack of appetite, lack of energy, obstructed bowel movement, and scanty urine.

Acupuncture Treatment:

Eliminate K 6, Du 14, LI 4, Lung 1, and Lung 8. Add BL 43, K 3, St 36, Sp 6, and Sp 10 to nourish the lung Yin, relieve coughing, and stop bleeding.

COMPOSITION

1. Cornu Cervi (Lu Jiao) 5kg

2. Plastrum Testudinis (Gui Ban) 2.5kg

3. Radix Ginseng (Ren Shen) 0.5kg

4. Fructus Lycii (Gou Qi Zi) 1.5kg

METHOD OF ADMINISTRATION Decoct all the herbs over a long period of time until the decoction is paste-like. Mix 3 grams of this paste with a little wine and warm water and take it in the morning.

ACTION

1. To tonify Yin and Jing (kidney essence)

2. To strengthen Qi and the kidney Yang

CLINICAL MANIFESTATION Yin and Yang deficiency of the kidney and Jing and blood deficiency of the Du and the Ren Channels: weight loss, seminal emission, impotence, dizziness, soreness and weakness of the lower back and knees. EXPLANATION This formula is designed to treat Yin and Yang deficiency of the kidney and Jing and blood deficiency of the Du and the Ren Channels. This formula can be used to tonify Qi, blood, Yin, and Yang. It is suitable for treating a variety of deficiencies. Cornu Cervi (Lu Jiao) may dredge the Du Channel and tonify the Yang. Plastrum Testudinis (Gui Ban) may dredge the Ren Channel and tonify the Yin. Combined together, these two herbs may nourish the Jing (essence) and tonify the blood. Radix Ginseng (Ren Shen) is used to tonify the Yuan (source) Qi, and Fructus Lycii (Gou Qi Zi) nourishes the Yin.

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 23, K 3, Du 4, Ren 6, Ren 4, Sp 6, BL 20, St 36.

2. Technique: tonification. 3. Explanation: BL 23 and K 3 nourish the kidney Yin and consolidate the kidney Qi. Du 4 and Ren 4 strengthen the Yang. Ren 6 is combined with Du 4 and Ren 4 to tonify Qi of the Lower Jiao. Sp 6 can nourish the Yin of liver, spleen, and kidney. BL 20 and St 36 tonify the Middle Jiao and increase the volume of Qi and blood.

1. Radix Polygoni Multiflori (He Shou Wu) 300g

2. Fructus Lycii (Gou Qi Zi) 150g

3. Semen Cuscutae (Tu Si Zi) 150g

4. Radix Achyranthis Bidentatae (Niu Xi) 150g

5. Radix Angelicae Sinensis (Dang Gui) 150g

6. Poria Cocos (Fu Ling) 150g

7. Fructus Psoraleae (Bu Gu Zhi) 120g

METHOD OF ADMINISTRATION This formula is taken in the form of pills, which should weigh approximately 10g each. Take one pill in the morning and another in the evening per day with warm water.

ACTION :

1. To nourish the kidney Jing (essence)

2. To nourish the liver blood

CLINICAL MANIFESTATION

Deficiency of the liver and the kidney: premature gray hair, loose teeth, seminal emission, and soreness of the lower back and weak knees.

EXPLANATION

This formula is designed to treat deficiency of the liver and the kidney. It is a commonly used formula for treating the premature gray hair that is due to kidney Jing (essence) deficiency. The area of brilliance of the kidney is the hair and the liver has the function to store blood. If the kidney and the liver are deficient, premature gray hair may occur. The kidney produces the marrow, which nourishes the bone and the teeth. Therefore, if the kidney is deficient, the marrow may also become deficient and loose teeth may occur. Deficient kidney may lead to instability and leaking of Jing (essence), which may lead to seminal emission. Soreness of the lower back and weak knees are common clinical manifestations of kidney deficiency because the kidneys are located in the lower body. Radix Polygoni Multiflori (He Shou Wu) is used heavily in this formula to tonify the kidney essence and help produce blood; this herb is famous for its function to nourish the hair. Fructus Lycii (Gou Qi Zi) and Semen Cuscutae (Tu Si Zi) nourish the liver and the kidney to replenish the blood and the kidney Jing (essence). Radix Achyranthis Bidentatae (Niu Xi) tonify the kidney and the liver and strengthen the tendons and the bones to relieve soreness of the lower back and weak knees. Radix Angelicae Sinensis (Dang Gui) tonifies the blood. Fructus Psoraleae (Bu Gu Zhi) is used to tonify the Yang since the Yin-Yang theory states that the Yin and the Yang are dependent on each other. By adding a Yang tonic herb to this formula, the Yin tonic herbs may become more active thus allowing harmony between the Yin and the Yang inside the body. Also, if only tonic herbs are used in this syndrome, turbidity and the greasy property of the tonic herbs may be retained inside the body. Hence Poria Cocos (Fu Ling) is used to promote urination and help prevent turbidity.

SUGGESTED ACUPUNCTURE TREATMENT

Points: BL 18, BL 23, K 3, BL 17, BL 20, St 36. 2. Technique: tonification. 3. Explanation: BL 18, BL 23, and K 3 strengthen the kidney and liver. BL 23 and BL 17 nourish the blood and essence. BL 20 and St 36 nourish the Middle Jiao to provide more Qi and blood.

Yang tonic formulas are composed of Yang tonic herbs to treat Yang deficiency of the kidney. The common clinical manifestations of kidney Yang deficiency include soreness of the lower back, weakness of the knees, cold and weak extremities, scanty or frequent urination, impotence, and deep thready pulse.

COMPOSITION

1. Radix Rehmanniae Prep. (Shu Di Huang) 240g

2. Fructus Corni (Shan Zhu Yu) 120g

3. Radix Dioscoreae (Shan Yao) 120g

4. Rhizoma Alismatis (Ze Xie) 90g

5. Cortex Moutan Radicis (Mu Dan Pi) 90g

6. Poria Cocos (Fu Ling) 90g

7. Ramulus Cinnamomi (Gui Zhi) 30g

8. Radix Aconiti Lateralis Prep. (Fu Zi) 30g

METHOD OF ADMINISTRATION

This formula can be taken in the form of decoction or pills. Each individual pill should weigh approximately 15 grams. Take one pill in the morning and one in the evening with warm water. For decoction, adjust the dosages according to the need of the patient.

ACTION: To warm up and nourish kidney Yang

CLINICAL MANIFESTATION Yang deficiency of the kidney: low back pain, weak legs, cold sensation of the lower body, pain and cramps of the lower abdomen, dysuria or polyuria, pale flabby tongue, thin white tongue, dysuria or polyuria, pale flabby tongue, thin white tongue coat, and deep thready pulse at Chi (kidney) position.

EXPLANATION

This formula is used to treat deficiency of the kidney Yang, or deficiency of the Ming Men (lifegate) fire. Deficiency of the kidney Yang may cause low back pain and weak legs because the kidney is located at the lower body. Cold sensation of the lower back and pain and cramps of the lower abdomen are due to lack of warmth from deficiency of the kidney Yang. Deficiency of the kidney Yang may cause retention of the water fluid since the deficient kidney Yang can no longer recycle the turbid water in the body. As a result of water retention, dysuria and pale flabby tongue may occur. If, as a result of kidney Yang deficiency, the kidney Yin also becomes deficient, then the kidney may lose the control of urination and polyuria may occur as a result. Deep thready pulse at Chi (kidney) position is an indication of kidney Yang deficiency. This formula consists of Liu Wei Di Huang Wan (Rehmanniae Six Combination) plus Ramulus Cinnamomi (Gui Zhi) and Radix Aconiti Lateralis Prep. (Fu Zi). The theory behind this formula is to tonify the kidney Yin to help raise the kidney Yang since the Yin and the Yang are mutually dependent. This formula uses Radix Rehmanniae Praeparata (Shu Di Huang) to tonify the kidney Yin and the Jing (essence). Fructus Corni (Shan Zhu Yu) to tonify the kidney and liver Yin, and Radix Dioscoreae (Shan Yao) tonify the kidney and the spleen. To tonify the kidney Yang, this formula uses a small amount of Ramulus Cinnamomi (Gui Zhi) and Radix Aconiti Lateralis Prep. (Fu Zi). Only a small amount of these two warming herbs are needed to ignite the Ming Men (lifegate) fire and raise the kidney Yang. Rhizoma Alismatis (Ze Xie), Poria Cocos (Fu Ling), and Cortex Moutan Radicis (Mu Dan Pi) are used to sedate the turbidity of the body and prevent the greasiness of the tonic herbs from blocking the Qi flow. This formula is also known as Shen Qi Wan (Kidney Qi Pills), a formula from the book Jin Gui Yao Lue). For a stronger interior-warming and Yang-tonic action, Ramulus Cinnamomi (Gui Zhi) may be substituted by Cortex Cinnamomi (Rou Gui).

SUGGESTED ACUPUNCTURE TREATMENT

Points: BL 23, K 3, Du 4, BL 18, BL 20, Sp 9. 2. Technique: tonification and moxibustion. BL 23 and K 3 can tonify the kidney; moxibustion on these two points would warm the kidney Yang. Du 4 nourishes the Yuan (source) Yang to produce kidney Qi. BL 18 and BL 20 nourish the liver and spleen. Sp 9 tonifies the spleen and dispels damp.

MODIFICATION

1. Radix Rehmanniae Prep. (Shu Di Huang) 15g

2. Fructus Corni (Shan Zhu Yu) 30g

3. Radix Dioscoreae (Shan Yao) 30g

4. Rhizoma Alismatis (Ze Xie) 30g

5. Cortex Moutan Radicis (Mu Dan Pi) 30g

6. Poria Cocos (Fu Ling) 30g

7. Ramulus Cinnamomi (Gui Zhi) 15g

8. Radix Aconiti Lateralis Prep. (Fu Zi) 2pcs

9. Radix Cyathulae (Chuan Niu Xi) 15g

10. Semen Plantaginis (Che Qian Zi) 30g

This formula is also known as the Shen Qi Wan (Kidney Qi Pills from the book Jin Gui Yao Lue)

Jia Wei Shen Qi Wan (Modified Kidney Qi Pills) is composed of Jin Gui Shen Qi Wan (Kidney Qi Pills from the book Jin Gui Yao Lue) plus Radix Cyathulae (Chuan Niu Xi) and Semen Plantaginis (Che Qian Zi). These additional two herbs enable this formula to tonify kidney Yang, promote urination, and relieve edema. The main actions of this formula are to warm and tonify kidney Yang and regulate water and relieve edema. Clinically, the patient may show edema and dysuria in addition to all the symptoms described above under Jin Gui Shen Qi Wan (Kidney Qi Pills from the ‘Jin Gui Yao Lue’).

Acupuncture Treatment:

Eliminate BL 18. Add St 36 and Ren 6 to tonify Qi and Yang and remove the water retention.

SHI BU WAN (Ten Substances Tonic Pills)

1. Radix Rehmanniae Prep. (Shu Di Huang) 30g

2. Fructus Corni (Shan Zhu Yu) 30g

3. Radix Dioscoreae (Shan Yao) 30g

4. Rhizoma Alismatis (Ze Xie) 30g

5. Cortex Moutan Radicis (Mu Dan Pi) 30g

6. Poria Cocos (Fu Ling) 30g

7. Cortex Cinnamomi (Rou Gui) 30g

8. Radix Aconiti Lateralis Prep. (Fu Zi) 60g

9. Fructus Schisandrae (Wu Wei Zi) 60g

10. Cornu Cervi Pantotrichum (Lu Rong) 30g

Shi Bu Wan (Ten Substances Tonic Pills) is composed of Jin Gui Shen Qi Wan (Kidney Qi Pills from the "Jin Gui Yao Lue") plus Fructus Schisandrae (Wu Wei Zi) and Cornu Cervi Pantotrichum (Lu Rong). The addition of these two herbs will enhance its function in tonifying kidney Yang and consolidate the kidney Qi. The main actions of this formula are to warm up and tonify the kidney Yang. Clinically, the patient may show dark facial complexion, cold feet, edema of the lower body, deafness, skinny complexion, weak knees, and dysuria. Acupuncture Treatment:

Eliminate Du 4 and BL 18. Add Ren 4 and Ren 3 to tonify and consolidate the kidney Qi.

COMPOSITION

1. Cortex Cinnamomi (Rou Gui) 60-120g

2. Radix Aconiti Lateralis Prep. (Fu Zi) 60-180g

3. Colla Cornus Cervi (Lu Jiao Jiao) 120g

4. Radix Rehmanniae Prep. (Shu Di Huang) 240g

5. Fructus Corni (Shan Zhu Yu) 90g

6. Radix Dioscoreae (Shan Yao) 120g

7. Semen Cuscutae (Tu Si Zi) 120g

8. Fructus Lycii (Gou Qi Zi) 120g

9. Cortex Eucommiae (Du Zhong) 120g

10. Radix Angelicae Sinensis (Dang Gui) 90g

METHOD OF ADMINISTRATION This formula can be taken as pills or decoction. The pills should weigh approximately 15 grams each. Two pills should be taken daily, one in the morning and another in the evening. For decoction, adjust the above dosages accordingly and decoct as usual.

ACTION

1. To tonify and warm up the Yang of kidney

2. To nourish Jing (essence) and tonify the blood

CLINICAL MANIFESTATION

Yang deficiency of the kidney with deficiency of Ming Men (lifegate) fire: low energy and lethargy due to chronic illness, chills, cold extremities, impotence, premature ejaculation, spermatorrhea, spontaneous urination, weakness of the lower back and knees, edema of the legs, loose stool.

EXPLANATION

This formula is designed to treat Yang deficiency of the kidney. Chronic illness may consume the Yang Qi of the body, causing low energy and lethargy. Deficiency of the kidney Yang may lead to internal coldness, resulting in chills and cold extremities. In males, kidney Yang deficiency often leads to impotence. Kidney Yang deficiency can also cause deficiency of the urinary function of the body, leading to spontaneous urination. Because the kidney is located in the low back, kidney deficiency may cause weakness of the lower back and knees. Kidney Yang deficiency may impair the water- recycling function of the kidney, leading to edema of the lower legs and loose stool. This formula uses Cortex Cinnamomi (Rou Gui), Radix Aconiti Lateralis Prep. (Fu Zi), and Colla Cornus Cervi (Lu Jiao Jiao) are used to warm the kidney Yang and raise the Ming Men (lifegate) fire. According to the Yin-Yang theory of mutual dependence, in order to effectively tonify the kidney Yang, the kidney Yin also needs to be nourished. Therefore, this formula also uses Radix Rehmanniae Praeparata (Shu Di Huang), Fructus Corni (Shan Zhu Yu), Radix Dioscoreae (Shan Yao), Semen Cuscutae (Tu Si Zi), Fructus Lycii (Gou Qi Zi), Cortex Eucommiae (Du Zhong), and Radix Angelicae Sinensis (Dang Gui) to nourish the Yin, Jing (essence), and blood. This formula differs from Jin Gui Shen Qi Wan (Rehmanniae Eight Combination) in the same way as Zuo Gui Wan (Kidney Yin Tonic Pills) differs from Liu Wei Di Huang Wan (Rehmanniae Six Combination). You Gui Wan (Kidney Yang Tonic Pills) and Zuo Gui Wan (Kidney Yin Tonic Pills) tonify without sedation, while Jin Gui Shen Qi Wan (Rehmanniae Eight Combination) and Liu Wei Di Huang Wan (Rehmanniae Six Combination) tonify and sedate at the same time. Hence, if there is turbidity or excessiveness inside the body, Jin Gui Shen Qi Wan (Rehmanniae Eight Combination) and Liu Wei Di Huang Wan (Rehmanniae Six Combination) would be better choices because of their sedative actions.

COMPLICATIONS

1. With severe deficiency of Yang add: Radix Ginseng (Ren Shen)

2. With spermatorrhea add: Fructus Psoraleae (Bu Gu Zhi)

3. With severe diarrhea add: Fructus Schisandrae (Wu Wei Zi), Semen Myristic. (Rou Dou Kou)

4. With severe indigestion and acid regurgitation add: Rhizoma Zingiberis (Gan Jiang)

5. With abdominal pain add: Fructus Evodiae (Wu Zhu Yu)

SUGGESTED ACUPUNCTURE TREATMENT

1. Points: BL 23, K 3, BL 18, BL 20, BL 17, Ren 6, Du 4, Ren 4.

2. Technique: tonification and moxibustion.

3. Explanation: Moxibustion on BL 23 and K 3 can warm the kidney Yang. BL 18 and BL 20 nourish the liver and strengthen the spleen to help tonify the kidney. BL 17 nourishes blood. Ren 6 tonifies Qi and consolidates the kidney. Du 4 and Ren 4 nourish the Yuan (source) Yang to give rise to the kidney Qi.

MODIFICATION

1. Radix Rehmanniae Prep. (Shu Di Huang) 6-30g

2. Radix Dioscoreae (Shan Yao) 6g

3. Fructus Corni (Shan Zhu Yu) 3g

4. Fructus Lycii (Gou Qi Zi) 6g

5. Radix Glycyrrhizae Prep. (Zhi Gan Cao) 6g

6. Cortex Eucommiae (Du Zhong) 6g

7. Cortex Cinnamomi (Rou Gui) 6g

8. Radix Aconiti Lateralis Prep. (Fu Zi) 9g

The main actions of this formula are to warm up the kidney and tonify Jing (essence) of kidney. Clinically, the patient may show lack of energy, lethargy, abdominal pain, soreness of the lower back, cold extremities, and thready pulse. Acupuncture Treatment: BL 23, K 3, BL 18, BL 20, BL 17, Ren 6, Du 4.

Si Jun Zi Tang is the basic formula to tonify Qi and strengthen the spleen and stomach. The clinical manifestations include pale face, low voice, lassitude, poor appetite, loose stool, pale tongue and thready pulse. Liu Jun Zi Tang has the basic actions of Si Jun Zi Tang but adds stronger actions to dispel damp and phlegm. Xiang Sha Liu Jun Zi Tang has the basic functions of Liu Jun Zi Tang but adds stronger actions to dispel cold and relieve pains. Shen Ling Bai Zhu San can tonify the Qi, strengthen spleen, dispel damp and stop diarrhea. It is used for spleen and stomach Qi deficiency causing the impairment in the transportation and transformation function. As the result, symptoms of loose stool or diarrhea, low appetite, loss of weight, sallow facial appearance, pale red tongue, white tongue coat, and thready slow pulse or weak slow pulse can appear. Bu Zhong Yi Qi Tang is the main formula used for spleen Qi deficiency descending of the clear Yang Qi. Clinical manifestations include the usual symptoms of spleen Qi deficiency plus prolapse of anus and uterus, diarrhea, dysentery and other prolapse symptoms. Sheng Mai San can tonify Qi, generate fluid, astringe Yin and stop perspiration. It is used to treat excess heat or chronic cough damaging the Qi and the Yin. Clinical manifestations include dry throat, thirst, irritability, shortness of breath, coughing with little sputum, spontaneous perspiration. Ren Shen Ge Jie San has the action to tonify Qi, clear lung heat, stop coughing and relieve wheezing. Lung Qi deficiency is the cause of the cough and the abundance of the sputum is due to the impairment of the transformation function of the spleen. This formula can also be used for coughs due to kidney not grasping the Qi downward.

Si Wu Tang is the basic formula for tonifying and regulating blood. It is used to treat general blood deficiency and the damage of the Chong and Ren channels. Clinical manifestations include pale face, pale lips, pale fingernails, sallow appearance, dizziness, black-out of vision, pale tongue and thready weak pulse. In women, there may be hypomenorrhea, delayed menstruation with pale red color, hypermenorrhea, dripping of blood, lower abdominal pain. Dang Gui Bu Xue Tang is used to tonify Qi and blood. Due to over-exertion which results in the failure of the body to retain the Yang Qi inside, the symptoms such as warm skin, feverish sensation, red face, irritability, thirst with a strong desire to drink, slow healing of wounds, full but deficient pulse may occur. In women, there may be hypermenorrhea and loss of blood after labor. Gui Pi Tang can tonify Qi, nourish blood, strengthen spleen and nourish the hear. It is used for heart and spleen deficiency which manifests in palpitation, forgetfulness, insomnia and night sweating. This formula can also be used for any type of bleeding due to spleen not being able to keep the blood circulating within the vessels. Zhi Gan Cao Tang is designed to treat knotted or intermittent pulse due to Qi and blood deficiency. It can also treat lung deficiency due to over-exertion. Clinical Manifestations include palpitation, weak physical condition, emaciation, dry cough with little or no sputum, shortness of breath, dry mouth and throat, fidgeting and a mirror tongue.

Ba Zhen Tang is the combination of Si Jun Zi Tang and Si Wu Tang. Therefore, it has the action to tonify Qi and blood. Clinical manifestations include the general Qi and blood deficiency symptoms. Ren Shen Yang Rong Tang is designed to treat Qi and blood deficiency due to chronic consumptive diseases. It has an additional action to calm the spirit. Shi Quan Da Bu Tang has the basic actions of Ba Zhen Tang but adds additional actions to dispel cold. Hence it is more suitable for Qi and blood deficiency accompanied by interior cold. Tai Shan Pan Shi San can tonify Qi, strengthen spleen, nourish blood and stabilize the fetus. With a history of miscarriages, pregnant women having Qi and blood deficiency and instability of the fetus can be treated with this formula.

Liu Wei Di Huang Wan is the Yin tonic representative formula. It can tonify liver and kidney Yin. It strengthens the water element while controlling the wood. Yin deficiency and the deficient fire may manifest in symptoms of soreness and weakness of the lower back and knees, night sweating, heat sensation in the palms and soles, dizziness, vertigo, tinnitus, deafness, nocturnal emission, tidal fever, thirst, red tongue, scanty coat, thready rapid pulse. Zhi Bai Di Huang Wan has the basic actions of Liu Wei Di Huang Wan but adds stronger actions to clear any deficiency- fire that may arise due to Yin deficiency. Qi Ju Di Huang Wan has the basic actions of Liu Wei Di Huang Wan but adds stronger actions to tonify the liver Yin. Hence it would have stronger effects to relieve blurred vision. Du Qi Wan has the basic actions of Liu Wei Di Huang Wan but adds extra actions to relieve wheezing or shortness of breath that may arise due to kidney deficiency. Mai Wei Di Huang Wan has the basic actions of Du Qi Wan but adds stronger actions to relieve lung Yin deficiency. Zuo Gui Wan has a stronger kidney Yin tonic action than that of Liu Wei Di Huang Wan because it does not contain the three sedative herbs found in Liu Wei Di Huang Wan. This formula strictly treats kidney Yin deficiency with injury to the essence and marrow. Since it is heavier and more stagnant than Liu Wei Di Huang Wan in character, it should be used with caution of those who have spleen deficiency. Clinical manifestations of Zuo Gui Wan include dizziness, vertigo, soreness and weakness of the back and knees, night sweating, dry mouth and throat, thirst, mirror tongue. Da Bu Yin Wan is used to treat Yin deficiency of liver and kidney with the flaring up of deficiency-fire. Clinical manifestations include bone-steaming sensation, tidal fever, night sweating, seminal emission, weakness of knees and legs, red tongue with scanty coat, rapid forceful pulse at Chi (third) position. Hu Qian Wan is used to nourish yin, clear deficiency-fire and strengthen bones and tendons. Weakness of bones and tendons are due to the lack of nourishment from kidney Yin. The clinical manifestations include soreness of lower back and knees, weakness of bones and tendons. Er Zhi Wan is also used to treat kidney and liver Yin deficiency. The key manifestations for this formula include bitter mouth, dizziness, blurred vision, and premature gray hair. Yi Guan Jian can regulate liver Qi in addition to tonifying liver and kidney Yin. Clinical manifestations include chest and hypochondriac pains, acid regurgitation, sore throat, dry mouth. Occasionally there may also be hernia. Shi Hu Ye Guang Wan has the action to soothe the liver, clam the liver wind, nourish Yin and promote clear vision. This formula is essentially used to treat Yin deficiency of the liver and kidney which leads to internal fire and wind. Clinical manifestations include enlarged pupil, blurred vision, excess tears, dizziness and vertigo. Occasionally there may also be internal oculopathy. Bu Fei E Jiao Tang can tonify the lung, nourish the Yin, stop coughing and bleeding. Because of wind-heat attacking the already Yin deficient lung, symptoms of coughing, wheezing, dry throat, and bloody sputum may occur. Gui Lu Er Xian Jiao has the action to tonify kidney Yin and Jing, strengthen Qi and kidney Yang. It is used to treat blood and Jing deficiency in the Ren and Du channels, Yin and Yang deficiencies in the kidney. Clinical manifestations include weight loss, seminal emission, impotence, dizziness, soreness and weakness of the lower back and knees. Qi Bao Mei Ran Dan can nourish both kidney Jing and liver blood. This formula emphasizes on treating premature gray hair, loose teeth, seminal emission, and soreness of the lower back and knees.

Jin Gui Shen Qi Wan can tonify kidney Yang. It is used for the deficiency of the Ming Men (lifegate) fire. Clinical manifestations include low back pain, weak legs, cold sensation of the lower body, pain and cramps of the lower abdomen, dysuria or polyuria. You Gui Wan can tonify and warm kidney Yang, nourish the Jing and tonify blood. This formula is used for chronic illness resulting in deficiency of kidney Yang and Ming Men fire. The clinical manifestations include lethargy, chills, cold extremities, impotence, premature ejaculation, spermatorrhea, spontaneous urination, weakness of the lower back and knees, edema of the legs, loose stool. This formula doesn’t contain the "three sedative herbs" and therefore the tonifying action is stronger than that of Jin Gui Shen Qi Wan.

 

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Letzter Update: 02 May 2003