Herbs 4 - Quiz 1 - Release Early Stage Exterior Disorders

Strengths of Tang, San, and Wan

Tang - Decoction

• long cook herbs, tonic herbs

San - powder (for draft or pill)

• invigorating formulas

Wan - pill (honey or water)

• Ease digestion, advance preparation of formulas for emergency

Cong Chi Tang - 1 unique thing?
- actions (2 keywords),
- indications (2)
- ingredients
- preparation - extra
-directions

蔥豉湯 Cōng chǐ tāng
Formulas that release Early-Stage Exterior Disorders
Scallion and Prepared Soybean Decoction
1) Cong Bai (3-5 stalks)
2) Dan Dou Chi
Indication: Early-stage wind heat or wind cold
- short cook 5-10 minutes
- provide 1-2 doses. if no resolution, reevaluate and try new formula

Indications for Exterior Wind Cold from Deficiency (Xu)

5 indications

3 treatment principles

WFMU - weaker, floating, mild, unproductive (sweat) + tongue
1) Weaker patient - more frequently ill

2) Milder symptoms, lingering

3) untherapeutic (unproductive) sweat

4) Tongue-Pink/Light Red, thin white coat tongue

5) Pulse - Floating/Superficial, moderate

6) Tx Principle-
a) Release exterior
b) harmonize ying and wei,
c) release muscle layer to resolve cold pathogen

Indication: Early-stage wind heat or wind cold

1) Appropriate formula / ingredients
2) preparation
3) directions
4) category

1) 蔥豉湯 Cōng chǐ tāng
Scallion and Prepared Soybean Decoction
Formulas that release Early-Stage Exterior Disorders
- Cong Bai (3-5 stalks)
- Dan Dou Chi
2) short cook 5-10 minutes
3) provide 1-2 doses. if no resolution, revaluate and try new formula

-bi syndrome due to wind cold dampness
-dermatology conditions due to retained cold
-cough and wheezing due to cold
-nosebleed due to cold
-historical dysmennorhea due to cold

Indicated for:

1) Formula
2) Ingredients
3) actions (2-3 keywords)
4) Pattern (2 keywords

SNoW-days - skin, nosebleed, wheezing, dysmenorrhea, BI
1) Ma Huang Tang

2) Ma Huang - 9g - Chief
Gui Zhi - 6g - Deputy
Xing Ren - 9-12g (70 pieces) - Assistant
Zhi Gan Cao - 3g - Assistant

3) Releases exterior cold and arrests wheezing

4) Exterior wind cold excess blocking movement of Wei qi at the surface & dissemination of Lu qi

Ma Huang Tang - unique qualities (2)

1) Indications (4 keywords)
2) Ingredients (4)
3) actions (2-3 keywords)
4) Pattern (2 keywords

Bi and skin

1) SNoW-days - skin, nosebleed, wheezing, dysmenorrhea

• bi syndrome due to wind cold dampness

• dermatology skin conditions due to retained cold

• cough and wheezing due to cold

• nosebleed due to cold

• historical dysmenorrhea due to cold

2)
a] Ma Huang - 9g (WARE) - Chief
b] Gui Zhi - 6g (WARE) - Deputy
c] Xing Ren - 9-12g (70 pieces) (Herbs that Transform Phlegm and Stop Coughing: Herbs that Relieve Coughing and Wheezing - Assistant
d] Zhi Gan Cao - 3g [tonify qi] - Assistant

3) Releases exterior cold and arrests wheezing

4) Exterior wind cold excess blocking movement of Wei qi at the surface & dissemination of Lu qi

 

Sān ào tāng -
1) indication / pattern
2) ingredients
3) actions
4) Preparation - extra
5) Directions to Px - extra

三拗汤 3 unbinding decoction (ao=defy, bend/break
mnemonic: Ao = sound of me coughing (phlegm damp LU) and howling at moon (bed)
1) ind: ext wind cold w/ phlegm-damp affecting LU
2)
- Ma Huang [WARE]
- Xing Ren [Tx phlegm stop cough: Relieve Cough and Wheeze]
- Gan Cao [tonify qi]
3) Actions: disseminates LU qi and Releases Exterior

4) Preparation: Equal doses. Cook as draft w/ Sheng Jiang
5) Px should go to bed and stay under covers unit light sweat

Da Qing Long Tang - unique quality?
1) indication / pattern
2) ingredients (7)
3) actions (3)

Dà qīnglóng tāng 大青龙汤. Large Blue Dragon Decoction
Greater dragon = 7 ing. int. heat. Lesser dragon = excess water 8 ing.
{1) Ext. Cold w/ Heat from constraint in the interior
{2)
Many eXcited Generals Shot Zesty Soldiers Daringly
a. Ma Huang (ware)
b. Xing Ren (Tx phlegm - Relieve cough and Wheeze)
c. Gui Zhi (ware)
d. Shi Gao (cear heat and drain fire: qi stage)
e. Zhi Gan Cao (tonify qi)
f. Sheng Jiang (ware)
g. Da Zao (tonify qi)
{3)
a. promotes sweating
b. releases exterior
c. clears interior heat

pattern: ext wind cold w/ phlegm-damp affecting LU

indicated for what formula?
1) ingredients
2) actions (2)
3) preparation - extra
4) Directions to Px - extra

三拗汤 3 unbinding decoction (ao=defy, bend/break
mnemonic: Ao = sound of me coughing (phlegm damp LU) and howling at moon (bed)

1) ind: ext wind cold w/ phlegm-damp affecting LU
2)
- Ma Huang [WARE]
- Xing Ren [Tx phlegm stop cough: Relieve Cough and Wheeze]
- Gan Cao [tonify qi]
3) Actions: disseminates LU qi and Releases Exterior

4) Preparation: Equal doses. Cook as draft w/ Sheng Jiang
5) Px should go to bed and stay under covers unit light sweat

Ext. Cold w/ Heat from constraint in the interior
indicated for what formula?
1) ingredients
2) actions (2)
3) preparation - extra
4) Directions to Px - extra

Dà qīnglóng tāng 大青龙汤. Large Blue Dragon Decoction
Many eXcited Generals Shot Zesty Soldiers Daringly
(1)
a. Ma Huang (ware)
b. Xing Ren (Tx phlegm - Relieve cough and Wheeze)
c. Gui Zhi (ware)
d. Shi Gao (cear heat and drain fire: qi stage)
e. Zhi Gan Cao (tonify qi)
f. Sheng Jiang (ware)
g. Da Zao (tonify qi)
{2) Bluegreen dragon = sweat = interior heat
a. promotes sweating
b. releases exterior
c. clears interior heat
3) Cook Ma Huang first. decant froth. add others
4) consume in small doses. stop as soon as sweat
(Da → small doses.

Gui Zhi Tang
1) pattern (1-2)
2) indication (1-2)
3) ingredients (5)
4) actions (2)
5) preparation
6) direction

Guì zhī tāng 桂枝湯 Cinnamon Twig Decoction

1) pattern - wind strike
2) indication - postpartum recovery w/ loss of regulation between ying and wei
3) ingredients
- Gui Zhi - 9g (ware)
- Bai Shao 9g (tonify blood)
- Sheng Jiang - 9g (ware)
- Da Zao - 12 pc (tonify qi)
- Zhi Gan Cao - 6g (tonify qi)
4) actions
-release PF from muscle layer
-harmonize ying and wei
5) preparation - coarse grind <20 min before decoct
6) direction - if lil sweat, repeat 1-2x close together

pattern - wind strike
indication - postpartum recovery w/ loss of regulation between ying and wei

Indicated for what formula?
1) ingredients (5)
2) actions (2)
3) preparation - extra
4) Directions to Px - extra

Guì zhī tāng 桂枝湯 Cinnamon Twig Decoction
1) ingredients
- Gui Zhi - 9g (ware)
- Bai Shao 9g (tonify blood)
- Sheng Jiang - 9g (ware)
- Da Zao - 12 pc (tonify qi)
- Zhi Gan Cao - 6g (tonify qi)
2) actions
-release PF from muscle layer
-harmonize ying and wei
3) preparation - coarse grind <20 min before decoct
4) direction - if lil sweat, repeat 1-2x close together

Ge Gen Tang
mnemonic?
1) pattern (2 key phrases)
2) indications (2 key words)
3) Ingredients
4) Actions (2+1special keyword)

Gégēn tāng 葛根湯 - Kudzu Decoction (coarse grass/linen+root)
SINUSTYS - Sensitivity, Neck, Tai Yang
1) Ext wind-cold affect the Tai Yang Channel (wry neck)
2) Transitional rhinitis/sinusitis w/ mucosal swelling & sensitivity to cold and drafts
3) Ge Gen (care) - 12g
Ma Huang (ware) - 9g
Gui Zhi (ware) - 6g
Shan Yao (Bai Shao) - 6g
Sheng Jiang (ware) - 6-9g
Da Zao (tonify qi) - 12g
Zhi Gan Cao (tonify qi) - 6g

4) Actions: Releases the exterior and muscle layer, and generates fluids

Song for Ma Huang, Gui Zhi Tang, and Ge Gen Tang

For excess Wind-Cold use Ma Huang Tang 

It’s made of Gui Zhi, Xing Ren, Zhi Gan Cao and Ma Huang 

But use Gui Zhi Tang for a Wind-Cold Deficiency

Which has the three sweets, Bai Shao, and Gui Zhi*

For neck pain and fluids Xu,

This is what you do

Add Ge Gen, Shan Yao and Ma Huang 

Plus Gui Zhi Tang to make Ge Gen Tang**

* Gui Zhi, Bai Shao, Sheng Jiang, Da Zao, Zhi Gan Cao

**Ge Gen, Ma Huang, Gui Zhi, Shan Yao(Bai Shao), Sheng Jiang/Gan Jiang, Da Zao , Gan Cao

1) Ext wind-cold affect the Tai Yang Channel (wry neck)
2) Transitional rhinitis/sinusitis w/ mucosal swelling & sensitivity to cold and drafts

a) appropriate formula
b) ingredients (7)
c) actions (2+1 unique keywords)

a) Gégēn tāng 葛根湯 - Kudzu Decoction (coarse grass/linen+root)
SINUSTYS - Sensitivity, Neck, Tai Yang

b) Ge Gen (care) - 12g
Ma Huang (ware) - 9g
Gui Zhi (ware) - 6g
Shan Yao (Bai Shao) - 6g
Sheng Jiang (ware) - 6-9g
Da Zao (tonify qi) - 12g
Zhi Gan Cao (tonify qi) - 6g

c) Actions: Releases the exterior and muscle layer, and generates fluids

Xiao Qing Long Tang - Minor Bluegreen Dragon Decoction
mnemonic (hint: chat gpt came up with it + pinyin)
1) indication / pattern
2) ingredients (8)
3) actions (4)

小青龍湯 Xiǎo qīnglóng tāng (qing = bluegreen = water)
1) Pattern: wind cold fettering the exterior causing excess water
2) Many Grand Generals X-rayed With Brave Zeal Zealously
Ma Huang (ware) - 9g
Gui Zhi (ware) - 9g
Gan Jiang (warm int. expel cold) - 9g
Xi Xin (ware/warm int.) - 9g
Wu Wei Zi (stabilize & bind) - 9g
Bai Shao (tonify blood)
Zhi Ban Xia (transform cold phlegm)
Zhi Gan Cao (tonify qi)
3) Actions -
a) Release the exterior,
b) transforms thin mucus,
c) warms the LU
d) directs rebellious qi downward

1) Pattern: wind cold fettering the exterior causing excess water

Formula name?
2) Ingredients (8)
3) Actions (2+2 unique)

小青龍湯 Xiǎo qīnglóng tāng (qing = bluegreen = water)
1) Pattern: wind cold fettering the exterior causing excess water
2) Many Grand Generals X-rayed With Brave Zeal Zealously
Ma Huang (ware) - 9g
Gui Zhi (ware) - 9g
Gan Jiang (warm int. expel cold) - 9g
Xi Xin (ware/warm int.) - 9g
Wu Wei Zi (stabilize & bind) - 9g
Bai Shao (tonify blood)
Zhi Ban Xia (transform cold phlegm)
Zhi Gan Cao (tonify qi)
3) Actions -
a) Release the exterior,
b) transforms thin mucus,
c) warms the LU
d) directs rebellious qi downward

Jiǔ wèi qiānghuó tāng 九味羌活湯 Nine-Herb Decoction with Notopterygium

1) indication / pattern
2) ingredients
3) action (3 → 3 keywords)
4) direction - extra

1) Indication Ext wind-cold damp w/ interior heat
"Quick Friends Catch Extra Cold Before Heat Settles Gently."
2) Qiang Huo (ware) - 4.5g
Fang Feng (ware) - 4.5g
Cang Zhu (Aro Tx Damp) 4.5g
Xi Xin (ware) - 1.5g
Chuan Xiong (invigorate blood) - 3g
Bai Zhi (ware) - 3g
Huang Qin (Clr. Heat. Dry damp) - 3g
Sheng Di Huang (Clr Heat. Cool Blood) - 3g
Gan Cao (Tx blood) - 3g
3) Action (a) induces sweat (b) dispels dampness (c ) simul. draining interior heat - SID
4) Coarsley grind before decoction

3 Warm Dispersers (Qiang Huo, Fang Feng, Cang Zhu),
3 Head Herbs (Xi Xin, Chuan Xiong, Bai Zhi),
3 Clearing/Tonifying (Huang Qin, Sheng Di Huang, Gan Cao)

Warm and expel → first three
Open orifices / head → next three
Clear and harmonize → last three
"Qiang Huo, Fang Feng, Cang Zhu flies,
Xi Xin sneaks and Chuan Xiong rides,
Bai Zhi bright and Huang Qin clears,
Sheng Di cools, Gan Cao cheers!"

First line — 3 dispersers: Qiang Huo, Fang Feng, Cang Zhu
Second line — 2 warm acrid + 1 moving blood: Xi Xin, Chuan Xiong
Third line — 1 frontal headache herb + 1 clear heat: Bai Zhi, Huang Qin
Fourth line — 1 cool blood + 1 harmonizer: Sheng Di Huang, Gan Cao

1) Indication Ext wind-cold damp w/ interior heat

Appropriate formula?

2) ingredients
3) action (3 → 3 keywords)
4) direction - extra

Jiǔ wèi qiānghuó tāng 九味羌活湯 Nine-Herb Decoction with Notopterygium
This notes damp | Da Qing Long Tang = Ext. Cold w/ Heat from constraint in the interior
"Quick Friends Catch eXtra Cold Before Heat Settles Gently."
2) Qiang Huo (ware) - 4.5g
Fang Feng (ware) - 4.5g
Cang Zhu (Aro Tx Damp) 4.5g
Xi Xin (ware) - 1.5g
Chuan Xiong (invigorate blood) - 3g
Bai Zhi (ware) - 3g
Huang Qin (Clr. Heat. Dry damp) - 3g
Sheng Di Huang (Clr Heat. Cool Blood) - 3g
Gan Cao (Tx blood) - 3g
3) Action (a) induces sweat (b) dispels dampness (c ) while draining interior heat - D.I.D.s
4) Coarsely grind before decoction
3 Warm Dispersers (Qiang Huo, Fang Feng, Cang Zhu),
3 Head Herbs (Xi Xin, Chuan Xiong, Bai Zhi),
3 Clearing/Tonifying (Huang Qin, Sheng Di Huang, Gan Cao)

Warm and expel → first three
Open orifices / head → next three
Clear and harmonize → last three
"Qiang Huo, Fang Feng, Cang Zhu flies,
Xi Xin sneaks and Chuan Xiong rides,
Bai Zhi bright and Huang Qin clears,
Sheng Di cools, Gan Cao cheers!"

First line — 3 dispersers: Qiang Huo, Fang Feng, Cang Zhu
Second line — 2 warm acrid + 1 moving blood: Xi Xin, Chuan Xiong
Third line — 1 frontal headache herb + 1 clear heat: Bai Zhi, Huang Qin
Fourth line — 1 cool blood + 1 harmonizer: Sheng Di Huang, Gan Cao

Xiāng sū sàn

a) indication / pattern (1 unique keyword)
b) ingredients (4)
c) actions (1 + 1 unique keyword)
d) preparation - extra
e) directions - (unique)

Xiāng sū sàn 香蘇散 Augmented Cyperus and Perilla Leaf Powder

a) indication: Ext. wind-cold w/ interior qi constraint
Smooth Flying Clouds Gracefuly - Su, Fu, Chen, Zhi
b) Zi su Ye (ware) - 120gm (6-9gm)
Xiang Fu (regulate qi) - 120gm (6-9gm)
Chen Pi (regulate qi) - 60 gm (3-6gm)
Zhi Gan Cao (tonify qi) - 30gm (3-6gm)
c) actions: Release the exterior, regulates qi
d) preparation: Grind into powder, prepare as draft
e) directions: take 3-6 doses 3x/day

a) indication: Ext. wind-cold w/ interior qi constraint

Formula?
b) ingredients (4)

c) actions (1+1 unique keyword)

d) preparation

e) directions (unique)

Xiāng sū sàn 香蘇散 Augmented Cyperus and Perilla Leaf Powder

a) indication: Ext. wind-cold w/ interior qi constraint
Smooth Flying Clouds Gracefuly - Su, Fu, Chen, Zhi
b) Zi su Ye (ware) - 120gm (6-9gm)
Xiang Fu (regulate qi) - 120gm (6-9gm)
Chen Pi (regulate qi) - 60 gm (3-6gm)
Zhi Gan Cao (tonify qi) - 30gm (3-6gm)
c) actions: Release the exterior, regulates qi
d) preparation: Grind into powder, prepare as draft
e) directions: take 3-6 doses 3x/day