class 5: Qi Stagnation

Liver Qi stagnation.

Yang or hot-type inversion (阳厥, Yang Jue) due

to internal constraint of Yang Qi marked by:

cold fingers and toes while the body and head are

warm

This may be accompanied by a sensation of

irritability and fullness in the chest and

epigastrium or cough or urinary difficulty,

abdominal pain or severe diarrhea

a red tongue with a yellow coating, and a wiry

pulse.

Frigid Extremities Powder

Si Ni San

Release constraint,

Spreads the Liver Qi, and softens the Liver

Harmonizes the Liver and Spleen

Regulates the Spleen

Corrects the qi mechanism

caution for frigid extremities powder

Contraindicated for cold extremities associated with yang

or blood deficiency. Not suitable for very weak or deficient

patients.

Liver Qi constraint with Spleen Qi deficiency and Liver blood

deficiency marked by:

hypochondriac pain (usually spasmodic),

headache, and vertigo,

a bitter taste in the mouth,

dry mouth and throat,

fatigue, reduced appetite,

irregular menstruation or distended breasts,

A pink (pale-red) tongue, and a wiry or deficient pulse.

Xiao Yao San/Wan 逍遥散/丸

Rambling Powder or

Free and Easy Wanderer Pill

Soften the Liver,

Spreads the Liver Qi,

Nourishes the blood.

Strengthens the Spleen

Harmonies the Liver and Spleen

Hypochondriac pain (usually spasmodic), fatigue, reduced

appetite, irregular menstruation, a wiry, deficient pulse.

caution of Rambling Powder or Free & Easy Wanderer Pill

The chief herb, Chaihu (Radix Bupleuri) in this formula,

dredges the Liver and vents heat. The formula is thus

unsuitable for treating purely deficient disorders.

Furthermore, while the formula is effective for treating

psycho-emotional disorders that manifest as Liver qi

constraint, it does not address causes that go beyond a

physiological disposition to express problems in this

particular way.

For liver constraint with spleen deficiency that

transforms into heat characterized by:

Irritability, short temper with possible tidal fever and

sweating,

Red eyes, dry mouth, bitter taste

Palpitation

Lower abdominal pressure,

Difficult, painful urination

Increased menstrual flow or uterine bleeding.

Painful menstruation,

hard and painful breast prior to menstruation,

Tenderness of the lower abdomen on palpation.

(blood stasis)

Jia Wei Xiao Yao San /Wan加味逍遥散

丸 Augmented Rambling Powder/Pill

-Clearing heat +

Xiao Yao San’s action

(Spreads liver qi, strengthen spleen, nourishes blood)

caution for Augnmented Rambling Powder Pill

Caution during pregnancy. Very occasionally a sensitive

patient may experience mild nausea, diarrhea or loose stools

in the early days of treatment. This can be alleviated by

reducing the dose for by adding a few pills of Xiang Sha Liu

Jun Zi Wan.

Constraint and clumping of the Liver Qi marked by:

Hypochondriac, and flank pain,

a stifling sensation in the chest, causing one to have deep sighs and to

suppressed emotions and feelings of frustration that easily give rise to

anger,

Belching, abdominal distention and fullness,

Gastrointestinal pain, distension and spasm, gas build up or ulceration from

Liver qi constraint and Liver invading the Spleen or Stomach.

Gynecological disorders of a Liver qi constraint type. Useful following

lumpectomy or mastectomy to prevent complications and future stagnation.

a wiry pulse reflects the stagnation of liver qi.

Poor peripheral circulation associated with constraint qi – usually only the

fingers and toes are cold and the body is warm.

Depression, mood swings, irritability, “plum pit qi” (globus hystericus).

Chai Hu Shu Gan San / 柴胡疏肝散

Bupleurum Powder to Dredge the Liver

-Spreads the Liver Qi,

harmonizes the blood, and

alleviates pain

caution for Buplleurum Powder to Dredge the Liver

This formula is aromatic, acrid, and drying. It readily injures the qi

and yin and is therefore contraindicated for long term use or in patients

with Liver qi stagnation-type pain due to qi or yin deficiency.

Not suitable for weak or deficient patient.

Focal distention and a stifling sensation in the chest and

abdomen,

fixed pain in the hypochondria,

belching, vomiting,

acid reflux,

mild coughing with copious sputum,

reduced appetite, and indigestion.

Yue Ju Wan / 越鞠丸

Escape Restraint Pill

Pill for Relieving Stagnation

-promotes the movement of Qi & releases constraint

Caution for Escape Restraint Pill

Although this formula can be modified in many ways, it is

contraindicated in cases of stagnation due to deficiency. To

treat such conditions, one should begin with a base formula

such as Six-gentlemen Decoction with Xiang Sha Liu Jun Zi

Tang (Aucklandia and Amomum).

A feeling of something caught in the throat that can neither be

swallowed nor ejected,

A stifling sensation in the chest and hypochondria,

A moist or greasy, white tongue coating, and

A wiry, slow or wiry, slippery pulse.

There may also be coughing and vomiting.

Ban Xia Hou Po Wan 半夏厚朴丸

Pinellia and Magnolia Bark Pill

-Promotes the movement of qi,

Dissipates clumps,

Directs rebellious qi downward, and

Transforms phlegm.

caution for Pinellia and Magnolia Bark Pill

This formula is comprised of warm, acrid or fragrant substances,

which are drying and dispersing in nature and can readily injure the yin

and fluids. Thus, the formula is appropriate only in cases of

constrained qi and phlegm. It is contraindicated in patients presenting

with a flushed face, a bitter tase in the mouth, and a red tongue with

scanty coating.

is indicated for syndromes of

cough and asthma with excess syndrome in the upper and

deficiency syndrome in the lower, marked by cough,

asthma, white sputum in large amount, fullness and choking

sensation in the chest and hypochondrium, or lumbago and

weakness of feet, or edema of limbs, white slippery or

greasy tongue coating, taut (wiry) and smooth (slippery)

pulse. It is applicable to symptoms of chest distress, profuse

white sputum, white slippery or greasy tongue coating, as

seen in chronic bronchitis, pulmonary emphysema and

bronchial asthma.

Su Zi Jiang Qi Wan 苏子降气丸

Pill of Perilla Seed for Descending Qi

-Descending the abnormally ascending qi to relieve dyspnea,

Eliminating phlegm to relieve cough.

caution for Pill of Perilla Seed for Descending Qi

Most ingredients in this formula are warm and dry in nature,

so it is contraindicated for cough and asthma due to yin

deficiency of the lung and kidney or asthma due to phlegm

and lung heat.