Study Guide - Quiz 2
Herbal Treatment of Disease 2
Dr. He
Internal Heat Damage - singles
Category / Herb / NotesClear Xu Heat / Yin chai hu
Hu huang lian / Plus drain damp heat
Bai wei / Plus cool blood, tonify yin xu type common cold, + urination
Di gu pi / Plus clear lung heat, cool blood, stop cough
Qing hao / Plus clear Summer heat, check malarial disorder
Other categories / Qin jiao / Plus clr excess heat, dispel wind damp
Mu dan pi / Plus clr heat, cool blood, clr Lv fire, invig blood
Zhi mu
Huang bai
Ze xie
Fu xiao mai / Also stops sweating from xu of qi or yin, clr yin xu heat, + ht, calm spirit
Internal Damage Leading to Heat - Syndromes
s Low grade fever fluctuating with emotional stress
s Sensations of heat
s Irritability or anger
s Depression, moodiness, stress
s Bitter taste in the mouth and dry mouth.
s Hypochondria pain
s Sighs
s Impaired appetite
s Dysmenorrhea, irregular menses, PMS sx and breast distention / s Fever or heat sensations in afternoon, night
s Patient’s heat sensations is localized or in an area of injury
s Dry mouth and throat, but no thirst
s Localized pain/masses
s Complexion is dark or ashen – may have dry flakey skin. / s Low fever, worse in afternoon (tidal fever)
s Fullness/oppression of chest and/or abdomen
s Heavy sensation in body
s Poor appetite, nausea/vomit’g
s Thirst, no desire to drink.
s Stool is loose or sticky
May be due to chron stagnation or to trauma, injury, surgery, post-partum. / Often due to irregular diet, can be related to humid environment.
Common syndrome for kids.
Can also present as damp heat with predominating dampness.
T: Red with yellow coat / T: dark or bluish purple, can have dark spots / T: thick or greasy, can be yellow or white
P: wiry, can be rapid / P: choppy or wiry / P: soft or soggy, can be superficial or rapid.
Syn: Liver Qi Stagnation / Syn: Blood Stasis Fever / Syn: Damp Accumulation
Rx: Jia Wei Xiao Yao San / Rx: Xue Fu Zhu Yu Tang / Rx: San Ren Tang
Internal Damage Leading to Heat - Syndromes
s Increased fever after exertion, with exhaustion. Can be just sensations of heat
s Dizziness
s MJ deficiency with loose stool, poor appetite, tiredness, spontaneous sweating, no desire to speak, SOB; also susceptible to cold or wind invasion
s Thirst with desire for warm drink / s Low grade fever
s Dizziness, lassitude, blurred vision, pale face/nails/lips.
s History of chronic bleeding, heavy blood loss, cancer, tumors, trauma, post partum. / s Afternoon/night tidal fever with heat that feels very deep (steaming bone)
s Dry mouth with thirst
s Malar flush, 5palm heat, restless, insomnia, night sweats, irritability, dry stool and scanty urination. / s Chronic/long developing syn with heat sensations. Patient can also feel hot to the touch, though temp is normal or even low. Patient only feels normal in a feverish spell.
Cold in the morning with temperature going up in the afternoon – no other typical yin xu sx.
s Aversion to cold, desire to wrap up, cold limbs, dizzy, somnolent, sore/aching low back/knees,
s Poor appetite, loose stool, pale complexion.
Common syndrome during menopause. / Uncommon presentation for yang xu. More common in elderly, endocrine imbalances,
AIDS, cancer, endstage disease.
T: pale with thin white coat / T: pale / T: thin/red with scanty or no coat / T: pale, swollen with TMs
P: deep, thready, weak / P: thready and weak / P: thready and rapid / P: deep (though can float to surface), thready, forceless.
Syn: Qi Deficiency / Syn: Blood Deficiency / Syn: Yin Deficiency / Syn: Kidney Yang Deficiency
Rx: Bu Zhong Yi Qi Tang / Rx: Gui Pi Tang / Rx: Qing Gu San / Rx: Jin Gui Shen Qi Wan
Deficient heat clearing formulas from strongest to weakest:
1. Dang Gui Liu Huang Tang
2. Da Bu Yin Wan
3. Zhi Bai Di Huang Wan
4. Liu Wei Di Huang Wan
5. Zuo Gui Wan
Sweating Disorders – singles
Ma huang gen / Sweating due to either qi or yin xu
Fu xiao mai / Sweating from xu of qi or yin, clears yin xu heat, nourish heart, calm spirit
Nuo dao gen xu / Sweating from xu of qi or yin, clears yin xu heat
Huang qi / Stabilize exterior, tonify qi, raise yang qi of middle
Wu wei zi / Inhibit sweating. Generates fluids, tonify kidneys, calm spirit
Long gu and mu li / Prevent fluid leakage including spontaneous and night sweats. Best to use the calcified form. Also calms liver, anchors floating yang. Long gu calms spirit
Shan zhu yu / Stops excessive sweat due to devastated yang/qi collapse. Tonifies liver and kidneys
Spontaneous Sweating / Night Sweating
s Spontaneous sweating worse with slight exertion.
s Aversion to wind, susceptible to common cold.
s Lassitude, lusterless complexion / s Spontaneous sweating, may be in a localized area of the body or on only on half (left/right, upper/lower)
s Aversion to wind, body aches and soreness, intermittent chills/fever. Might have sx of catching a cold. / s Night sweating or spontaneous sweating with strong sweat.
s Feverish sensations of hands, feet and chest. Tidal fever, malar flush, dry mouth and dry stool / ß
Yin xu with less heat:
Liu Wei Di Huang Wan
Yin xu with night sweats:
Zhi Bai Di Huang Wan
ß
T: thin white coat / T: thin white coating / T: thin and red with scanty coat
P: thready, weak / P: moderate or soft-even / P: thready, rapid
Syn: Wei Qi Deficiency
Or Lung Qi Xu / Syn: Disharmony of Ying
and Wei / Syn: Yin Deficiency with Heat
Rx: Yu Ping Feng San / Rx: Gui Zhi Tang / Rx: Dang Gui Liu Huang Tang
Deficient heat clearing formulas from strongest to weakest:
1. Dang Gui Liu Huang Tang
2. Da Bu Yin Wan
3. Zhi Bai Di Huang Wan
4. Liu Wei Di Huang Wan
5. Zuo Gui Wan
Other Types of Sweatings Spontaneous and/or night sweats
s Palpitations, insomnia, lassitude, SOB, pale and lusterless complexion. / s Continuous profuse sweating creating a yellow stain. Sweat may be thick and sticky.
s Red face, heat sensations, irritability, restlessness, bitter taste in the mouth, yellow dark smelly urine. / ß
Excess Dampness.
Patient just has the smelly sweat minus the emotions
Si Miao Wan
Excess Heat.
Patient has more excessive heat, less damp
Bai Hu Tang
ß
Fairly rare differentiation for excess sweating / Less often seen in “air conditioned” cultures. This rx best for emotional sx + the smelly sweat.
T: pale / T: yellow coating
P: thready / P: wiry, rapid
Syn: Heart Qi and Blood Xu / Syn: Damp Heat in the Interior
Rx: Gui Pi Tang / Rx: Long Dan Xie Gan Tang
Trembling Disorder – Single Herbs
Wind / Jiang can
Di long
Wu gong
Quan xie
Chan tui / All critter bits. Extinguish wind, stop spasms/convulsions due to excesses.
Wu gong and quan xie unblock collaterals/stop pain
Jiang can transforms phlegm
Di long drains heat, unblks collats, stop spain
Chan tui disperses w/h, vents rashes, clears eyes.
Tian ma
Gou teng / Extinguish lv wind, ctrl spasms/convulsions.
Gou teng clears excess lv fire while tian ma disperses painful obstrx and is good for both excess and xu.
Shi jue ming
Mu li
Long Gu
Zhen zhu mu
Dai zhe shi / All shells except for dai zhe shi – all are full of minerals. Use with caution – all are for excesses.
Calm liver, anchor floating yang, absorb acidity.
+ Ki, yin, essence / Gui ban / Nourish yin/anchor yang, + Ki/bones, nourishes Ht.
Nu zhen zi
Gou gi zi / Contain many antioxidants to help vs cellular damage.
Nu zhen zi + Ki/Lv yin and vision while Gou qi zi + Ki/Lv yin.
Shu di huang / + Yin and essence, + blood
+ Qi and Blood / Dan shen / Invig blood, calm spirit. Also used now in cerebrovascular conditions as well as for blood xu.
Dang gui / Tonify and invig blood and alleviate pain
Ji xue teng / Tonifies and moves blood, invig’s channels and relaxes the sinews (great for extremity problems too)
Huang qi
Ren shen / Both benefit qi to benefit blood, stimulate adrenals and thyroid.
Huang qi also raises yang qi, tonifies spleen and lungs. Ren shen benefits yuan qi, heart, lungs, spleen.
Blood Stasis / Dan shen
Jie xue teng / See above
Tao ren
Hong hua / Combined will invig blood, dispel stasis. Use for excesses.
Phlegm / Zhu ru
Zhu li / Clear heat/phlegm. Zhu li also opens orifices, sedates spasms
Shi chang pu / Opens orifices, vaporizes phlegm, transform turbid damp, quiet spirit
Yuan zhi / Expel phlegm, open orifices, calm spirit
Trembling Disorders
s Tremors and spasms
s Dizziness, tinnitus
s Weak or aching low back/knees
s May have fever, irritability, headache, flushed face, bitter taste in mouth, red or dry eyes / s Chronic onset of trembling
s Elderly or premature aging (graying hair, deaf, etc.)
s Reduced cognitive function like poor memory and dementia, deafness, tinnitus, weak low back and knees, seminal emissions. / s Chronic onset trembling
s Premature again, sequelae to illness or trauma. Dizziness, fatigue, weakness, poor appetite. / s Heart and spleen xu syndrome with sx like palps, poor memory, insomnia. / s Trembling head, numbness/tremor of extremities
s Dizziness, blurring of vision. Suffocation/distention of chest and epi, bitter taste and sticky sensations in mouth, possible sticky foamy phlegm in mouth.
More frequently seen in men. / This is an excess only condition, often due to alcohol, meds, and/or greasy/sugary diets.
T: red with scanty coat / T: pale or red / T: pale / T: red body, swollen with TMs. Coat is yellow, sticky
P: wiry, can be weak in 3rd / P: thready / P: thready, weak / P: wiry, slippery and rapid. Maybe choppy
Syn: Lv Wind d/t Yang Rising / Syn: Ki Essence Xu / Syn: Qi/Blood Deficiency / Syn: Ht/Sp Deficiency / Syn: Internal Wind d/t
Phlegm Heat
Rx: Tian Ma Gou Teng Yin / Rx: Gui Lu Er Xian Jiao
Add 9g tian ma / Rx: Bu Zhong Yi Qi Tang / Rx: Gui Pi Tang / Rx: Dao Tan Tang
Tinnitus – Single Herbs
Lightly Dispersing / Chan tui
Bo he
Ju hua / All disperse wind heat. Chan tui extinguishes internal wind. Bo he clears heat/spreads Lv qi. Ju hua subdues Lv yang and clears Lv heat.
Upper Burner / Fang feng / Release exterior, expel wind, expel w/d
Shi chang pu / Opens orifices, vaporizes phlegm, trx turbid damp
Xin yi hua / Opens ear orifices, unblocks w/d/c in sinuses/nasopharynx regions.
Middle Burner / Huang qi / Tonify qi, raise yang of MJ
Sheng ma / Release exterior, clear heat, raise Spleen yang
Chai hu / Disperse w/h, spread Lv qi, relieves constraint, raises Spleen yang
Lower Burner / Ci shi / Nourish Lv/Ki, improve hearing/vision, anchors/calms, calms lv/yang, aids Ki to grasp qi.
Wu wei zi / Tonify ki, astringe qi/essence, calm spirit
Liver Yang Rising / Tian ma
Gou teng
Zhen zhu mu
Shi jue ming / Tian ma calms Lv/yang rising, exting wind, disperses w/d for painful obstrx and channel block. Gou teng clears Lv fire, pacifies yang rising, extinguishes wind. Zhen zhu mu and Shi jue ming calm Lv, anchors yang and improves vision.
Drain Damp/heat / Yi yi ren
Huang bai / Yi yi ren also promotes urination/leaching damp and heat, expels wind damp bi.
Huang bai clears heat, dries damp, drains fire/xu heat, relieves toxicity.
Tinnitus Sydromes
s Sudden onset tinnitus. High pitched or can sound like waves. Usually related to stress/emo’s. Onset is aggravated by anger, irritability, frustration or strong upset.
s May have deafness as well
s Headache, dizziness, hypertension, easily irritated, ear ache, bitter taste in the mouth and dry mouth, constipation, dark urine. / s Tinnitus with fullness or distending pain. Ear feels blocked, may have congestion. Often with stress, swimmer’s ear, ear infection, allergies, environment.
s May have dizziness, heavy sensation in head, chest oppression, bitter taste inmouth, irritability, sticky smelly constipation, smelly dark urine. / s Tinnitus + common cold and/or flu with distension and obstruction of ears, impaired hearing.
s Headache, dizziness, aversion to wind, fever, chills. / s Tinnitus
s Thick sensation, heavy head, oppression or congestion. Low energy, poor appetite or nausea, dizziness, banded headache. Cloudy thinking, sticky stool.
History of poor diet – greasy foods, alcohol, smoking / Initially will have itching of throat, ears, eyes, nose. Leads to congestion.
Sx often worse with air travel.
T: red with yellow coating / T: red with thick greasy yellow coat / T: pale red + thin coat that can be yellow or white depending on progression / T: swollen with thick or sticky coat
P: wiry, rapid / P: wiry, slippery, rapid / P: floating / P: slippery or soggy
Syn: Liver Gallbladder Fire / Syn: Phlegm Heat / Syn: Wind Heat Invasion / Syn: Phlegm Heat Damp
Accumulation
Rx: Long Dan Xie Gan Tang / Rx: Huang Lian
Wen Dan Tang / Rx: Yin Qiao San / Rx: Ban Xia Bai Zhu
Tian Ma Tang
Tinnitus Syndromes
s Chronic tinnitus with gradual onset – can be low or high pitched. High pitched indicates more heat. May have slowly diminished hearing
s Probably middle aged +, history of stressful lifestyle, dizziness, pain or weak low back/knees. Possibly worse at night. 5 palm heat, insomnia, restlessness / ß
Kidney xu with heat:
Zhi Bai Di Huang Wan
ß / s Chronic slow onset tinnitus, aggravated by overwork. Comes and goes in waves, better with rest.
s Low energy, lassitude, loose stool, poor appetite, sallow complexion.
Common presentation! / Can occur after long illness, blood loss, or with chronic fatigue.
T: red with scanty coat / T: pale and swollen with thin white coat
P: thready, can be rapid / P: weak
Syn: Kidney Deficiency / Syn: Clear Yang Not Ascending
Rx: Er Long Zuo Ci Wan / Rx: Yi Qi Cong Ming Tang
Deficient and Consumptive Diseases – Single Herbs