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all the [symptoms of] taxation fatigue, decrepit and diminished form qi, meager grain qi, obstructed upper burner, and blocked lower duct.

In document Treatise on the Spleen and Stomach (Page 100-105)

Stomach qi becomes hot and hot qi steams the chest causing internal heat

. . . Exuberant yin engenders internal cold. With ascending counterflow

of reversed qi, cold qi accumulates in the chest without being drained.

[With the cold qi] not drained, warm qi has to depart and what is left is

nothing but cold. With cold left alone, blood congeals and stagnates. With

congealed, stagnated blood, the vessels are blocked. The pulse is large, exu-

berant, and rough (or choppy). This is, therefore, called center cold.

The following are Bu Zhong Yi Qi Tang’s contemporary indications: 1) spleen- stomach qi vacuity, 2) qi vacuity downward falling, 3) qi vacuity fever. Debility after prolonged disease, common cold in a person with bodily vacuity, chronic bronchitis, prolapsed uterus, prolapsed rectum, chronic hemorrhoids, gastrop- tosis, hernia, chronic gonorrhea, diarrhea, persistent malaria, habitual miscar- riage, functional uterine bleeding and other hemorrhagic disorders, abnormal vaginal discharge, various postpartum problems, such as urinary incontinence, lochioschesis, and agalactia, chronic hepatitis, peritonitis, tuberculosis, neuras- thenia, impotence, corneal ulcers, cerebral arteriosclerosis, pernicious anemia, leukopenia, chronic nephritis, and myasthenia gravis

The main contemporary signs and symptoms of the three main indicated pat- terns include: 1) Fatigue, lack of strength, poor appetite, spontaneous sweating, shortness of breath, disinclination to speak, dizziness standing up, an ashen white or sallow yellow facial complexion, loose stools, a pale tongue with thin, white fur, and a short; flooding, vacuous; or large, vacuous pulse; 2) anal prolapse, first and second degree uterine prolapse, prolonged diarrhea, prolonged dysentery, and other such complaints due to downward falling of clear yang; 3) fever asso- ciated with fatigue, thirst with a desire for warm drinks, possible lack of warmth in the hands and feet, enduring malaria-like diseases.

Besides the above additions and subtractions originally suggested by Li, there are many others which have become relatively standard in contemporary pro- fessional Chinese medicine. The following are a selection of these.

If blood vacuity is prominent, increase the dosage of Dang Gui (Radix Angelicae Sinensis).

For prolapse, increase the dosage of Huang Qi (Radix Astragali Membranacei) and add Zhi Shi (Fructus Immaturus Citri Aurantii).

For uterine prolapse, add Yi Zhi Ren (Fructus Alpiniae Oxyphyllae), Ai Ye (Folium Artemisiae Argyii), and Wu Wei Zi (Fructus Schisandrae Chinensis).

For headache with vertigo and dizziness, add Chuan Xiong (Radix Ligustici Wallichii) and Ban Xia (Rhizoma Pinelliae Ternatae).

For vertigo and vomiting, add Ge Gen (Radix Puerariae) and Ze Xie (Rhizoma Alismatis Orientalis).

shortness of breath, etc. due to qi stagnation and damp accumulation, replace

Bai Zhu (Rhizoma Atractylodis Macrocephalae) with Cang Zhu (Rhizoma

Atractylodis), subtract Dang Gui (Radix Angelicae Sinensis), and add Bai Shao (Radix Albus Paeoniae Lactiflorae). This results in Tiao Zhong Yi Qi Tang (Regulate the Center & Boost the Qi Decoction), another of Li’s famous formulas. For myasthenia gravis, increase the dosages of Huang Qi (Radix Astragali Membranacei) and Sheng Ma (Rhizoma Cimicifugae).

For diarrhea due to excessive thinking and worry resulting in liver-spleen dishar- mony, add Mu Xiang (Radix Auklandiae Lappae).

For diarrhea due to dampness, subtract Dang Gui (Radix Angelicae Sinensis) and add Fu Ling (Sclerotium Poriae Cocos), Cang Zhu (Rhizoma Atractylodis), and Yi

Zhi Ren (Fructus Alpiniae Oxyphyllae).

Prolonged diarrhea with intestinal qi loss of securing and astringency, add He Zi (Fructus Terminaliae Chebulae), Rou Dou Kou (Semen Myristicae Fragrantis), Wu

Wei Zi (Fructus Schisandrae Chinensis), and Wu Mei (Fructus Pruni Mume).

For dysentery with tenesmus, subtract Dang Gui (Radix Angelicae Sinensis) and add Mu Xiang (Radix Auklandiae Lappae).

For dysentery after the blood and pus have resolved but there is still foamy mucus, add Pao Jiang (blast-fried Rhizoma Zingiberis Officinalis) and Chi Shi Zhi (Hallyositum Rubrum).

After dysentery when there is still tenesmus and mucus in the stools but consti- pation, add Fang Feng (Radix Ledebouriellae Divaricatae).

For cold stomach with qi stagnation, add Qing Pi (Pericarpium Citri Reticulatae Viride), Sha Ren (Fructus Amomi), Mu Xiang (Radix Auklandiae Lappae), and Yi

Zhi Ren (Fructus Alpiniae Oxyphyllae).

For ringing in the ears or loss of hearing due to spleen-kidney qi vacuity, add Shan Zhu Yu (Fructus Corni Officinalis) and Yi Zhi Ren (Fructus Alpiniae Oxyphyllae). For diminished eyesight or blurred vision due to spleen qi and liver blood vacuity, add Gou Qi Zi (Fructus Lycii Chinensis) and Chuan Xiong (Radix Ligustici Wallichii). For habitual miscarriage due to spleen-kidney dual vacuity, add Du Zhong (Cortex Eucommiae Ulmoidis) and Tu Si Zi (Semen Cuscutae Chinensis).

For restless fetus and threatened abortion, add E Jiao (Gelatinum Corii Asini) and

Ai Ye (Folium Artemisiae Argyii). This modification can then be made even stronger

by adding Xu Duan (Radix Dipsaci) and Sang Ji Sheng (Ramulus Loranthi Seu Visci). For abnormal vaginal discharge, add Er Miao San (Two Wonders Powder), i.e.,

Cang Zhu (Rhizoma Atractylodis) and Huang Bai (Cortex Phellodendri).

For abdominal distention, add Zhi Shi (Fructus Immaturus Citri Aurantii), Hou Po (Cortex Magnoliae Officinalis), Mu Xiang (Radix Auklandiae Lappae), and Sha

Ren (Fructus Amomi).

For mounting disorders, add Ju He (Semen Citri Reticulatae), Xiao Hui Xiang (Fructus Foeniculi Vulgaris), and Li Zhi He (Semen Litchi Chinensis).

For constipation, add processed Da Huang (Radix Et Rhizoma Rhei). For constipation due to spleen vacuity, add honey and sesame oil.

For painful urinary strangury in the elderly due to fallen yang qi, add Ze Xie (Rhizoma Alismatis Orientalis) and Mu Tong (Caulis Akebiae).

For taxation strangury with heat, add Zhi Bai Di Huang Wan (Anemarrhena & Phellodendron Rehmannia Pills), i.e., Zhi Mu (Rhizoma Anemarrhenae Aspheloidis),

Huang Bai (Cortex Phellodendri), Shu Di (cooked Radix Rehmanniae Glutinosae), Shan Yao (Radix Dioscoreae Oppositae), Shan Zhu Yu (Fructus Corni Officinalis), Fu Ling (Sclerotium Poriae Cocos), Ze Xie (Rhizoma Alismatis Orientalis), and Dan Pi (Cortex Radicis Moutan).

Also for taxation strangury without heat, add Liu Wei Di Huang Wan (Six Flavors Rehmannia Pills), i.e., Shu Di (cooked Radix Rehmanniae Glutinosae), Shan Yao (Radix Dioscoreae Oppositae), Shan Zhu Yu (Fructus Corni Officinalis), Fu Ling (Sclerotium Poriae Cocos), Ze Xie (Rhizoma Alismatis Orientalis), and Dan Pi (Cortex Radicis Moutan), plus Mai Men Dong (Tuber Ophiopogonis Japonici) and Wu Wei

Zi (Fructus Schisandrae Chinensis).

For frequent urination aggravated by exertion, add Shan Yao (Radix Dioscoreae Oppositae) and Wu Wei Zi (Fructus Schisandrae Chinensis).

For dark yellow, concentrated urination after diarrhea due to damaged fluids, add Mai Men Dong (Tuber Ophiopogonis Japonici) and Wu Wei Zi (Fructus Schisandrae Chinensis).

For premenstrual diarrhea, add Pao Jiang (blast-fried Rhizoma Zingiberis Officinalis) and Huang Lian (Rhizoma Coptidis Chinensis).

For pediatric bed-wetting, add Sang Piao Xiao (Ootheca Mantidis) and Yi Zhi Ren (Fructus Alpiniae Oxyphyllae).

For chronic rhinitis, add Cang Er Zi (Fructus Xanthii Sibirici) and Xin Yi Hua (Flos Magnoliae).

For corneal ulcers, add Gu Jing Cao (Scapus Eriocaulonis Buergeriani), Jue Ming

Zi (Semen Cassiae Torae), and Shan Yao (Radix Dioscoreae Oppositae).

If there is concomitant yin vacuity, either subtract Chai Hu (Radix Bupleuri) and

Sheng Ma (Rhizoma Cimicifugae) or reduce their dosages and add Zhi Mu (Rhizoma

Anemarrhenae Aspheloidis) and Huang Bai (Cortex Phellodendri).

Also for yin vacuity, subtract Chai Hu (Radix Bupleuri) and Sheng Ma (Rhizoma Cimicifugae) and add Shan Zhu Yu (Fructus Corni Officinalis), Shan Yao (Radix Dioscoreae Oppositae), and Shu Di (cooked Radix Rehmanniae Glutinosae). For qi vacuity fever, add Zhi Mu (Rhizoma Anemarrhenae Aspheloidis) and Di Gu

Pi (Cortex Radicis Lycii Chinensis).

Also for qi vacuity fever, increase the dosage of Chai Hu (Radix Bupleuri) and add

Huang Qin (Radix Scutellariae Baicalensis) and Ge Gen (Radix Puerariae).

For coronary heart disease with exertional angina pectoris due to concomitant blood stasis, add Dan Shen (Radix Salviae Miltiorrhizae), Chuan Xiong (Radix Ligustici Wallichii), Chi Shao (Radix Rubrus Paeoniae Lactiflorae), Hong Hua (Flos Carthami Tinctorii), and Jiang Xiang (Lignum Dalbergiae Odoriferae).

For chronic sore throat, add Jie Geng (Radix Platycodi Grandiflori).

For profuse menstruation, add wine-fried Bai Shao (Radix Albus Paeoniae Lacti- florae). If there is liver heat, also add Huang Qin (Radix Scutellariae Baicalensis). For flooding and leaking, add Di Yu (Radix Sanguisorbae) for damp or replete heat, Ai Ye (Folium Artemisiae Argyii) and E Jiao (Gelatinum Corii Asini) for qi vacuity, Sheng Di (uncooked Radix Rehmanniae Glutinosae) for vacuity heat, and

Hai Piao Xiao (Os Sepiae Seu Sepiellae) for loss of securing and astringing.

panied by heart palpitations, shortness of breath, faint, forceless speech, fatigue, and a sagging, dragging feeling in the lower abdomen, subtract Dang Gui (Radix Angelicae Sinensis), Chai Hu (Radix Bupleuri), and Chen Pi (Pericarpium Citri Reticulatae). This results in Ju Yuan Jian (Lift the Source Decoction). This formula can then be augmented by adding Hai Piao Xiao (Os Sepiae Seu Sepiellae), Qian

Cao (Radix Rubiae Cordifoliae), and Wu Mei (Fructus Pruni Mume). If there is liver

heat, also add Huang Qin (Radix Scutellariae Baicalensis).

For numbness of the fingers and face due to qi vacuity with exuberant wind, subtract Dang Gui (Radix Angelicae Sinensis), Bai Zhu (Rhizoma Atractylodis Macrocephalae), and Chen Pi (Pericarpium Citri Reticulatae), and add Bai Shao (Radix Albus Paeoniae Lactiflorae) and Wu Wei Zi (Fructus Schisandrae Chinensis). For numbness accompanying bodily weakness, dry, flaky skin, and itching, add

Shu Di (cooked Radix Rehmanniae Glutinosae) and Bai Shao (Radix Albus Paeoniae

Lactiflorae) to nourish the blood.

For concomitant restlessness of the heart spirit, add Long Gu (Os Draconis), Mu

Li (Concha Ostreae), and Ye Jiao Teng (Caulis Polygoni Multiflori).

These recommendations do not come close to exhausting the possibilities of modifying this hugely important formula. This formula is one of my five most commonly used formulas.

The pattern of center heat disease at the onset arises because the fire of the pen-

In document Treatise on the Spleen and Stomach (Page 100-105)