Herbs that warm the interior

溫裏藥

The herbs that warm the interior

 Warm and disperse the interior-cold (溫散裏寒)
 Pungent and hot (辛熱) → warm the middle (溫暖中焦), fortify and transport SP/ST (健運脾胃), disperse
cold and stop pain (散寒止痛) + aid or restore Yang (助陽回陽)

Interior-cold (裏寒)
 Exterior-cold invading the interior → obstructing/damaging SP/ST Yang-Qi → epigastric/abdominal cold
pain, vomiting or nausea, diarrhea
 Decline of Yang-Qi → exuberant Yin-cold → chills with cold limbs, pale-white complexion, clear-profuse
urination, pale tongue with white coating, deep-thready pulse
 Profuse sweating causing deserting Yang (大汗亡陽) → reversal cold of the limbs, feeble pulse

Combination
 Exterior evil Qi invading the interior and concurrent exterior condition → combined with the herbs that
release the exterior
 Cold congealing causing Qi stagnation → combined with the herbs that move Qi
 Internal accumulation of cold-damp → combined with the herbs that fortify SP and transform damp
 SP/KI Yang deficiency → combined with the herbs that tonify SP/KI
 Deserting Yang, collapse of Qi → combined with the herbs that greatly tonify the original Qi

Cautions and contraindications

 Pungent and hot (辛熱) + drying (燥) → easily damage body fluids
 Contraindicated or use with great cautions for heat pattern, Yin deficiency pattern, or pregnant women

The herbs in this category are used for treating interior cold, which can either be internally-generated or result
from an invasion of a cold pathogen into the organs. These herbs are mostly acrid, bitter, and warm or hot. They
dispel and disperse interior pathogenic cold, and arouse and stimulate the yang qi. They are most appropriate
for internal invasion of pathogenic cold where the yang qi has been inhibited. In these cases, the yang is
weakened, while the yin becomes overabundant. This may cause the cold to congeal, which leads to qi
stagnation with aches and pains in the abdomen or other signs of Spleen qi deficiency and dysfunction, such as
vomiting, belching, loss of appetite, and diarrhea.

Some of these herbs can also be used to aid the yang and rescue it from collapse, which manifests in such
signs and symptoms as aversion to cold, cold limbs, pale complexion, profuse and clear urine, pale tongue, and
a pulse that is submerged and thin. In more severe cases there will be profuse sweating, frigid extremities, and
a very faint pulse, which can be a sign of devastated yang. Finally, herbs that warm the interior are also often
used to warm the Lungs to transform thin mucus, or warm the Liver to treat bulging disorders.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 1 / 35

Invasion of the cold pathogen into the organs is primarily associated with the pattern of Spleen or Stomach cold.
Associated symptoms, which reflect dysfunction of the digestive tract, include nausea, vomiting, belching,
diarrhea, and feelings of pain and cold in the chest and abdomen.

Because these herbs warm the Spleen and Kidney yang, they are related to the herbs that tonify the yang.
However, they are generally more active in nature and their primary function is to expel interior cold. They are
often used in conjunction with herbs that tonify the yang and those that tonify the qi.

These herbs are acrid, warm, and drying in nature. When prescribed inappropriately, they can readily injure the
fluids. They must therefore be used with the utmost caution, if at all, in cases of heat, blood loss, or yin
deficiency. One should also be careful to avoid using inappropriately large doses. In addition, because many of
the herbs are strongly mobilizing, their use must be carefully evaluated in debilitated or weakened patients;
when they are used in such cases, they must be matched with appropriate tonifying herbs. Finally, some of
these herbs should be used only with the greatest caution during pregnancy.

 Fu Zi (附子; Radix Aconiti Praeparata)

 Gan Jiang (乾薑; Rhizoma Zingiberis)
 Rou Gui (肉桂; Cortex Cinnamomi)
 Wu Zhu Yu (吳茱萸; Fructus Evodiae)
 Hua Jiao (花椒; Pericarpium Zanthoxyli)
 Ding Xiang (丁香; Flos Caryophylli)
 Gao Liang Jiang (高良薑; Rhizoma Alpiniae Officinarum)
 Xiao Hui Xiang (小茴香; Frictus Foeniculi)
 Hu Jiao (胡椒; Fructus Piperis Nigri)

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 2 / 35

 Fu Zi
附子
- Pharmaceutical name: Radix Aconiti Praeparata
- Common English name: aconite, prepared daughter root of common monks' hood
 Properties: hot
 Tastes: pungent
 Channels entered: HT, KI, SP
 Toxicity: toxic

Actions and indications

 Restores Depleted Yang
 Tonifies Yang, Augments Fire
 Warms Channels, Disperses Cold and Dampness, Relieves Pain

Yang failure: Acrid and hot, Fu Zi (Radix Aconiti Lateralis Praeparata) is used in emergency situations in which
there is a complete void of yang energy in the body. This critical condition is characterized by profuse
perspiration with clear and cold sweats, intolerance of cold, faint respiration, icy extremities, diarrhea
containing undigested food, and faint or imperceptible pulse. Fu Zi restores depleted yang by tonifying Heart
yang, thus opening channels and collaterals, and by tonifying Kidney yang to augment fire.
 Intolerance of cold, icy extremities, and diarrhea with undigested food because of depleted yang: use Fu Zi
with Gan Jiang (Rhizoma Zingiberis) and Gan Cao (Radix Glycyrrhizae). Exemplar Formula: Si Ni Tang
(Frigid Extremities Decoction).
 Profuse perspiration with shortness of breath and increased respiration due to depletion of yang with qi
escaping the body: add Ren Shen (Radix Ginseng).

Fu Zi treats any type of yang deficiency, as it warms all of the organs and opens all of the channels and
collaterals. The organs that are most susceptible to yang deficiency are Kidney, Spleen and Heart.

Kidney yang deficiency: Kidney yang deficiency, the most severe of yang deficiencies, is characterized by cold
extremities (especially the lower extremities), intolerance to cold, weakness, coldness and soreness of the low
back and knees, impotence, frequent urination (especially during the night), clear polyuria, pale complexion,
cough, and wheezing. Secondary symptoms may include impotence or spermatorrhea, profuse and clear
leukorrhea, diarrhea (especially during the early morning), edema and infertility.
 Kidney yang deficiency: use Fu Zi with Rou Gui (Cortex Cinnamomi) and Shu Di Huang (Radix Rehmanniae
Preparata). Exemplar Formula: You Gui Wan (Restore the Right [Kidney] Pill), or Ba Wei Di Huang Wan
(Eight-Ingredient Pill with Rehmannia).
 Infertility: use this herb with Lu Jiao (Cornu Cervi), Shu Di Huang (Radix Rehmanniae Preparata), Rou Gui
(Cortex Cinnamomi), Tu Si Zi (Semen Cuscutae), Yang Qi Shi (Actinolitum), Ba Ji Tian (Radix Morindae
Officinalis), Dang Gui (Radicis Angelicae Sinensis) and Gou Qi Zi (Fructus Lycii).
 Impotence: combine it with Tu Si Zi (Semen Cuscutae), Yin Yang Huo (Herba Epimedii) and Rou Gui (Cortex
Cinnamomi).

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 3 / 35

Spleen yang deficiency: Spleen yang deficiency is more severe than Spleen qi deficiency. Patients suffering
from this disorder manifest all signs of Spleen qi deficiency, plus abdominal fullness, coldness and dull pain,
decreased intake of food, loose stools or diarrhea, edema, profuse watery leukorrhea, cold limbs and a
preference for pressure and warmth applied to the abdomen.
 Spleen yang defi ciency: use Fu Zi with Ren Shen (Radix Ginseng), Gan Jiang (Rhizoma Zingiberis) and Bai
Zhu (Rhizoma Atractylodis Macrocephalae). Exemplar Formula: Fu Zi Li Zhong Tang (Prepared Aconite Pill
to Regulate the Middle).
 Spleen and Kidney yang deficiency with edema: use it with Bai Zhu (Rhizoma Atractylodis Macrocephalae)
and Fu Ling (Poria). Exemplar Formula: Zhen Wu Tang (True Warrior Decoction).

Heart yang deficiency: Clinical manifestations include palpitations, shortness of breath, chest pain, dull purplish
complexion, cold extremities, a flabby, pale or dark purple tongue, and a deep, weak pulse. In the range of Heart
conditions, Heart qi deficiency is least serious, followed by Heart yang deficiency, and then Heart yang collapse
being most serious.

Bi zheng (painful obstruction syndrome) due to cold: Fu Zi dispels cold and dampness from the peripheral
channels and collaterals to treat bi zheng.

Dosage and processing / administration

 The normal dosage is 3 to 15 grams. Fu Zi must be pre-decocted for 30 to 60 minutes.
 There are two major schools of thought regarding appropriate dosages of Fu Zi. Some scholars have
proposed dosages of up to 100 grams for severe cases. Others proposed small dosages only.
 When prescribing this herb, the condition of the individual must be taken into consideration. An individual
with a weak constitution will react to the toxicity of Fu Zi even when it is prescribed at a low dose. Another
individual with a stronger constitution and thus higher tolerance may not experience adverse effects even
at a large dose. This difference in response depends on the individual constitution as well as geographic,
weather and lifestyle differences. In some areas of China, Fu Zi is commonly used with other vegetables to
make stew. Naturally, these people will have higher tolerance for the toxicity of Fu Zi. In short, the dosage
should be selected cautiously according to the condition of each patient.
 Fu Zi is generally sold in the processed form only, as the unprocessed form is quite toxic. Though there are
multiple ways to process this herb, the most common way is for the manufacturer to cook the herb at
boiling temperature for 4 to 6 hours before drying and distribution. Prior to use, the patient should again
pre-decocted Fu Zi for 30 to 60 minutes before the addition of other herbs.
 Use of unprocessed Fu Zi, or overdose of the herb, are responsible for the majority of possible adverse
reactions.
 Proper processing reduces the toxicity of Fu Zi

Cautions and contraindications

 Fu Zi is contraindicated during pregnancy.
 Fu Zi is contraindicated in patients with yang excess and yin deficiency (also referred to as false cold and
true heat).

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 4 / 35

 Some classic texts have suggested that Fu Zi is incompatible with Bei Mu (Bulbus Fritillaria), Ban Xia
(Rhizoma Pinelliae), Gua Lou Shi (Fructus Trichosanthis), Bai Ji (Rhizoma Bletillae), and Bai Lian (Radix
Ampelopsis).
 Consumption of alcohol is contraindicated with Fu Zi, as absorption of the toxic elements will be greatly
enhanced.
 Side effects and adverse reactions are usually due to overdose, to improper processing, or to
inappropriate combination with other herbs, and/or inaccurate diagnosis.

[Note] Wu Tou (烏頭; Radix Aconiti)

 Inclusive name for Chuan Wu (川烏; Radix Aconiti Preparata) and Cao Wu (草烏; Radix Aconiti Kusnezoffii)
 In the original documentation of this herb in Shen Nang Ben Cao ling (Divine Husbandman's Classic of the
Materia Medica) in the second century, no distinction was made between Chuan Wu and Cao Wu. Later in
history, the aconites from the Sichuan province were given the name Chuan Wu, and the rest, grown in
other regions or wild became known as Cao Wu.
 In the original text, it was stated that Wu Tou can be used in hunting. The juice of Wu Tou applied to the tip of
an arrow will induce paralysis when the arrow penetrates the prey.

 Restores Depleted Yang, Tonifies Yang, Augments Fire, Warms Channels, Disperses Cold and Dampness,
Relieves Pain (回陽救逆, 補火助陽, 散寒止痛)

 Yang collapse (亡陽)

- Spontaneous cold sweating (冷汗自出), cold limbs (四肢厥逆), feeble pulse (脈微欲絶)
- Fu Zi can 1) aid HT Yang to unblock the vessels, 2) tonify KI Yang to make the fire stronger, 3) rescue
dispsering-lost original Yang to restore Yang and rescue the reversal
- Combined with Gan Jiang, Gan Cao → restore Yang and rescue the reversal → Si Ni Tang (四逆湯)
- Profuse sweating, panting, wheezing → declined Yang and collapsed Qi → combined with Ren Shen →
restore Yang and consolidate the collapse → Shen Fu Tang (蔘附湯)
 Yang deficiency (陽虛)
- Tonify fire and aid Yang (補火助陽) → commonly used for Yang deficiency of KI, SP, and/or HT; warm the
whole body’s Yang
- KI Yang deficiency → declined Ming Men fire → afraid of cold, cold limbs, sore/weak lower back and
knees, impotence with frequent urination → combined with Rou Gui, Shu Di Huang, Shan Zhu Yu → Gui
Fu Ba Wei Wan (桂附八味丸)
- Exuberant internal Yin-cold and/or SP Yang deficiency → epigastric/abdominal cold-pain, loose stools
or diarrhea → combined with Ren Shen, Bai Zhu, Gan Jiang → Fu Zi Li Zhong Wan (附子理中丸)
- SP/KI Yang deficiency → retention of water-Qi → inhibited urination, generalized edema → combined
with Bai Zhu, Fu Ling → Zhen Wu Tang (眞武湯)
- HT Yang deficiency → palpitations, shortness of Qi/breath, chest obstruction with pain → combined with
Ren Shen, Gui Zhi
- Wei-Yang deficiency (衛陽虛) → spontaneous sweating → combined with Huang Qi, Gui Zhi
- Yang deficiency complicated with wind-cold invasion → combined with Ma Huang, Xi Xin

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 5 / 35

 Painful Bi (痹痛)
- Fu Zi → remove cold-damp, warm the channels and stop pain (祛除寒濕, 溫經止痛)
- Severe joint pain cold-damp Bi → combined with Gui Zhi, Bai Zhu → Gan Cao Fu Zi Tang (甘草附子湯)

烏頭
 2 types → 川烏, 草烏
 川烏 → 烏頭的塊根
- 辛, 苦, 溫; 大毒; 心, 肝, 脾
- 祛風濕, 散寒止痛
- 寒濕痹痛, 心腹冷痛, 頭風痛, 偏頭痛, 跌打損傷疼痛
- 3 – 9g in decoction; 1 – 2g if powser or medicated-wine
- Boil for 30 to 60 min
 草烏 → 塊根
- same as 川烏 but more toxic; 1.5 – 4.5g

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 6 / 35

 Gan Jiang
乾薑

- Pharmaceutical name: Rhizoma Zingiberis

- Common English name: dried ginger
 Properties: hot
 Tastes: pungent
 Channels entered: SP, ST, HT, LU

Actions and indications

 Warms the Middle Jiao
 Restores Depleted Yang
 Warms the Lung, Dissolves Phlegm
 Warms the Channels, Stops Bleeding
 Dispels Cold and Dampness

Spleen and Stomach cold syndrome: Gan Jiang (Rhizoma Zingiberis) warms the Spleen and Stomach to dispel
cold from the middle jiao. The cause of this cold may be an invasion of cold from the exterior, or yang deficiency
of the Spleen. Common manifestations include epigastric and abdominal coldness and pain, nausea, vomiting,
and diarrhea.

Yang collapse: Gan Jiang tonifies yang and expels cold. When combined with Fu Zi (Radix Aconiti Lateralis
Praeparata), Gan Jiang enhances the overall effect of Fu Zi to restore depleted yang, and minimizes its toxicity.
These two herbs are often paired together for their synergistic action. Classic texts stated that "Fu Zi is not
warm without Gan Jiang."

Cough and dyspnea due to cold accumulation: Gan Jiang warms the Spleen to stop the production of damp, and
warms the Lung to eliminate the accumulation of phlegm. It is commonly used to treat accumulation of cold and
fluids in the Lung characterized by cough and wheezing, aversion to cold, and profuse watery sputum.

Bleeding due to deficiency and cold: Gan Jiang treats various kinds of bleeding caused by deficiency and cold:
hematemesis, hematochezia, hypermenorrhea or abnormal menstrual bleeding. This type of bleeding is
characterized by the presence of blood that is dark in color, and thin in consistency. These patients usually have
cold extremities, a pale tongue, and a thready pulse.

Gan Jiang treats the sensation of heaviness, coldness and pain in the back and lower body, characterized by
cold and dampness.

Dosage and processing / administration

 3 to 10 grams in herbal decoction

Cautions and contraindications

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 7 / 35

 Gan Jiang is contraindicated in cases of interior heat with yin deficiency, or heat in the blood.
 Use Gan Jiang with caution during pregnancy as large quantities may have an abortifacient effect

[Note] Pao Jiang (炮薑; Rhizoma Zingiberis Preparatum; processed ginger)

 Bitter and astringent
 It is the herb of choice to warm channels and stop bleeding. It is often used in patients experiencing
bleeding from deficiency and cold.

[Note] Gan Jiang, Pao Jiang, and Sheng Jiang

 They have similar yet different functions.
 Gan Jiang is acrid and hot, and it warms the middle jiao to restore normal digestive functions. It treats
interior cold.
 Pao Jiang is bitter and astringent, and it warms channels and stops bleeding. It treats deficiency and cold.
 Sheng Jiang is acrid and warm, and it warms the middle jiao to relieve nausea and vomiting. It treats
exterior wind-cold.

 Warms the Middle Jiao, Restores Depleted Yang, Warms the Lung and Dissolves Phlegm (溫中, 回陽,
溫肺化飮)

 SP/ST cold (脾胃寒證)

- Epigastric/abdominal cold-pain, vomiting, diarrhea
- Gan Jiang may remove SP/ST cold-evil, aid SP/ST Yang-Qi → may be used for any SP/ST cold patterns
(caused by internal/external or excess/deficiency)
- Powdered Gan Jiang → watery-diarrhea, acute-severe epigastric/abdominal pain caused by
cold-strike (中寒)
- ST cold → vomiting → combined with Ban Xia → Ban Xia Gan Jiang San (半夏乾薑散)
- SP/ST empty-cold → combined with Ren Shen, Bai Zhu, Gan Cao → Li Zhong Wan (理中丸)
 Yang collapse (亡陽)
- Gan Jiang → pungent and hot → unblock HT and aid Yang, remove interior-cold (通心助陽, 除祛裏寒)
→ when combined with Fu Zi, increases the effect of restoring Yang and rescuing the reversal and
also descreases the toxicity of Fu Zi → Si Ni Tang (四逆湯)
 Cold-fluids hidden in LU (寒飮伏肺)
- Cough, panting, wheezing, feeling cold and cold back, clear-watery-profuse phlegm
- Warm-remove LU cold and transform phlegm-fluids (溫散肺寒而化痰飮) → combined with Ma Huang,
Xi Xin, Wu Wei Zi → Xiao Qing Long Tang (小靑龍湯)

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 8 / 35

 Rou Gui
肉桂
- Alternative name:桂心;官桂
- Pharmaceutical name: cinnamon bark, cassia bark
- Common English name: Cortex Cinnamomi
 Properties: hot
 Tastes: pungent, sweet
 Channels entered: KI, SP, HT, LV

Actions and indications

 Tonifies Kidney Yang, Augments Ming Men (life Gate) Fire
 Dispels Cold, Warms the Spleen and Relieves Pain
 Dispels Cold, Relieves Pain, Opens Channels and Vessels

Declining ming men (life gate) fire: Rou Gui (Cortex Cinnamomi) treats a wide variety of disorders characterized
by Kidney yang deficiency and insufficient ming men fire. This condition is characterized by intolerance to cold,
cold extremities, weakness, soreness and coldness of the low back and knees, impotence, lack of libido,
polyuria and loose stools. In addition, Kidney deficiency affects the Lung. Kidney deficiency and its inability to
grasp qi downwards causes symptoms such as wheezing, dyspnea, profuse phlegm and cold extremities. Cold
in the lower jiao may manifest as false yang rising, with symptoms of dizziness, flushed face, sore throat and
coldness of the lower extremities. Fortifying in nature, Rou Gui is not dispersing and is one of the best herbs to
warm the yang of the lower jiao.

Epigastric and abdominal coldness and pain, vomiting or diarrhea: Rou Gui warms the middle jiao and treats
digestive disorders that are cold in nature. The volatile oils in this herb have a mild stimulating effect to
promote digestion, dispel gas and relieve spasmodic pain in the stomach and intestines.

Hernial Pain: With its analgesic and warming effect, Rou Gui treats hernial pain caused by cold.
 Cold hernial disorder with abdominal pain: use Rou Gui with Wu Zhu Yu (Fructus Evodiae) and Xiao Hui
Xiang (Fructus Foeniculi).

Coldness in the channels: When cold invades the xue (blood) level, the channels and collaterals constrict. This
results in blood stagnation, causing symptoms of irregular menstruation, amenorrhea, dysmenorrhea and
postpartum pain. Rou Gui infuses warmth to the peripheral channels and collaterals to move qi and blood
circulation. It treats pain characterized by cold in the blood, such as gynecological disorders, external or
traumatic
injuries, or obstruction of cold and dampness in the channels and collaterals. This herb dilates the central and
peripheral vessels and increases blood circulation.

Yin sores: Rou Gui warms the channels and collaterals to treat deep-rooted sores. It promotes the generation
of flesh and enhances recovery.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 9 / 35

A small quantity of Rou Gui is often added to qi and blood tonics to enhance the movement of yang qi in the body
and encourage the production of blood and qi. Exemplar Formula: Ren Shen Yang Ying Tang (Ginseng Decoction
to Nourish the Nutritive Qi) and Shi Quan Da Bu Tang (All-Inclusive Great Tonifying Decoction).

Dosage and processing / administration

 2 to 5 grams in herbal decoction, 1 to 2 grams in herbal powder.
 Rou Gui should be added in the last 5 to 10 minutes of the cooking process, to avoid loss of active
constituents from over-exposure to heat.

Cautions and contraindications

 Use of Rou Gui is contraindicated during pregnancy, or in cases of excess heat, yin-deficient fire, or
bleeding caused by heat in the blood.
 Rou Gui is counteracted by Chi Shi Zhi
 Rou Gui is hot, and generally considered to be an herb with pure yang energy. When used improperly for
patients affected by pathogenic heat, or prescribed in excessive amounts, it can induce rising of fire,
resulting in a flushed face, red eyes, dry mouth and tongue and, in severe cases, bleeding.

[Note] Gui Xin (桂心; Cortex Rasus Cinnamomi) and Tu Rou Gui (土肉桂; Cortex Cinnamomum Burmannii),
 Gui Xin in the thin layer of tree cortex that remains after the outer layer of bark has been removed. Gui Xin
is not drying in nature and is best used for Heart and Kidney yang deficiencies.
 Tu Rou Gui, derived from the plant Cinnamomum burmannii (Nees) Bl. (Tian Zhu Gui), is the type of
cinnamon used for cooking to add flavor. It is acrid and warm and warms the Spleen and Stomach.
However, it is mild in nature and cannot be used therapeutically to warm the body.
 Rou Gui, derived from the plant Cinnamomum cassia Presl., is much stronger and has the therapeutic
potency to warm the body and dispel cold.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 10 / 35

 Wu Zhu Yu
吳茱萸
- Pharmaceutical name: Fructus Evodiae
- Common English name: evodia, medicinal evodia fruit
 Properties: hot
 Tastes (五味): pungent, bitter
 Channels entered: LV, SP, ST
 Toxicity: slightly toxic (小毒)

Actions and indications

 Dispels Cold, Dries Dampness, Activates Qi Circulation, Relieves Pain
 Spreads the Liver, Descends Qi
 Warms Middle Jiao, Relieves Diarrhea
 Directs Fire Downwards

Epigastric and abdominal pain, and jueyin headache: Wu Zhu Yu (Fructus Evodiae) treats pain characterized by
stagnation of cold, damp and qi. It dispels cold to relieve epigastric and abdominal pain. It warms and dispels
cold in the jueyin Liver channel and relieves hernia pain, dysmenorrhea, leg qi and vertex headache. This is the
best herb for migraine or vertex headaches with nausea and vomiting, as it warms the deficient middle jiao and
dispels cold in the Liver and Stomach channels.

Acid reflux, vomiting: Wu Zhu Yu is one of the most effective herbs to treat vomiting and acid reflux caused by
Liver overacting on the Stomach. Other symptoms may include hypochondriac pain, stomach pain and nausea.

Diarrhea or dysentery due to cold and dampness: Wu Zhu Yu treats chronic diarrhea from accumulation of cold
and dampness, or from deficiency and cold of the Spleen and Kidney. Patients with accumulation of cold and
dampness have diarrhea throughout the day, while patients with deficiency and cold of the Spleen and Kidney
experience diarrhea in the early morning hours. Chronic diarrhea from deficiency and cold of the Spleen and
Kidney: combine Wu Zhu Yu with Rou Dou Kou (Semen Myristicae), Bu Gu Zhi (Fructus Psoraleae) and Wu Wei Zi
(Fructus Schisandrae Chinensis). Exemplar Formula: Si Shen Wan (Four-Miracle Pill).
 Chronic dysentery because of the accumulation of cold and dampness affecting the Spleen: use this herb
with Huang Lian (Rhizoma Coptidis) and Bai Shao (Radix Paeoniae Alba).

Hypertension, oral ulcers: Wu Zhu Yu treats heat conditions, such as ulceration of the tongue and mouth, and
hypertension, by directing heat downwards.
 Oral ulcers and hypertension: mix powdered Wu Zhu Yu with vinegar and place it on the center of the soles
of the feet.
 Eczema or sores on the scalp: apply Wu Zhu Yu in liquid form topically, or mix the powder of the herb with
water and apply topically.

Dosage and processing / administration

 1.5 to 5 grams.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 11 / 35

 Unprocessed Wu Zhu Yu is often used topically, while the processed herb is often used internally.
 Processing is done by cooking the herb with Gan Cao (Radix Glycyrrhizae) to eliminate its drying effect and
toxicity.

Cautions and contraindications

 Wu Zhu Yu is contraindicated in cases of yin deficiency with heat.
 Wu Zhu Yu is not recommended for long-term use, or for use in large doses, due to toxicity.

[Note] Wu Zhu Yu (吳茱萸)

 Wu Zhu Yu and Gan Jiang are both interior-warming herbs, but focus on different parts of the body. Wu Zhu
Yu, acrid, bitter, hot, dispersing and descending in nature, enters the Liver and Stomach to primarily treat
middle and lower jiao disorders such as epigastric and abdominal coldness and pain, hernia and
dysmenorrhea. Gan Jiang, acrid, hot and dry, enters the Spleen, Stomach, Heart and Lung. Its main effects
are focused on the upper and middle jiaos to disperse coldness, warm the interior and dispel phlegm to
treat dyspnea, phlegm, wheezing and yang collapse symptoms.
 Wu Zhu Yu and Gao Ben (Rhizoma Ligustici) are both acrid and hot, and treat vertex headaches. Wu Zhu Yu
enters the jueyin Liver channel and is best at dispelling cold, relieving pain and regulating Liver qi
circulation. It is best for vertex headache with vomiting or nausea because of coldness and phlegm
accumulation. Gao Ben enters the taiyang Urinary Bladder channel and is best at dispelling wind, cold, and
damp and relieving pain. It is for vertex headaches associated with wind-cold invasion.
 Optimal treatment of headache requires the use of channel-guiding herbs to deliver the therapeutic effect
of the herbs to the affected area. The following is a list of commonly used channel-guiding herbs:
- Taiyang channels: Qiang Huo (Rhizoma et Radix Notopterygii)
- Shaoyang channels: Chai Hu (Radix Bupleuri)
- Yangming channels: Bai Zhi (Radix Angelicae Dahuricae)
- Taiyin channels: Cang Zhu (Rhizoma Atractylodis)
- Shaoyin channels: Xi Xin (Herba Asari)
- jueyin channels: Wu Zhu Yu (Fructus Evodiae)

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 12 / 35

 Hua Jiao
花椒
- Alternative name: Chuan Jiao (川椒); Shu Jiao (蜀椒)
- Pharmaceutical name: Pericarpium Zanthoxyli
- Common English name: zanthoxylum, prickly ash pepper tree peel, bunge prickly ash peel
 Properties: hot
 Tastes: pungent
 Channels entered: SP, ST, KI
 Toxicity : slightly toxic

Actions and indications

 Warms the Middle Jiao, Stops Pain and Relieves Diarrhea
 Kills Parasites

Epigastric and abdominal coldness and pain, toothache, diarrhea: Hua Jiao (Pericarpium Zanthoxyli) warms the
Spleen and Stomach to treat excess accumulation of cold in the middle jiao.

Parasites and itching of the skin: Hua Jiao treats parasitic infestations in the intestines that are causing
vomiting and abdominal pain. It also treats parasitic infection of the skin manifesting in pruritus and eczema.

Dosage and processing / administration

 2 to 5 grams in herbal decoction.
 Hua Jiao may be used both internally and topically.

Cautions and contraindications

 Hua jiao is contraindicated in the presence of excess fire, or of yin deficiency.
 Use Hua Jiao with caution during pregnancy.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 13 / 35

 Ding Xiang
丁香
- Pharmaceutical name: Flos Caryophylli
- Common English name: clove
 Properties: warm
 Tastes: pungent
 Channels entered: SP, ST, KI

Actions and indications

 Warms the Middle Jiao, Relieves Pain and Reverses Rising Stomach Qi
 Tonifies Kidney Yang

Epigastric and abdominal coldness and pain, vomiting, hiccups: Ding Xiang (Fios Caryophylli) is the key herb for
treating abnormal rising of Stomach qi caused by cold ness that is manifesting in vomiting, nausea and hiccups.
Other clinical applications include epigastric and abdominal coldness and pain, abdominal fullness and
distention that occurs when the individual is exposed to cold.

Ding Xiang treats impotence, cold body and extremities, and weakness and soreness of the back and knees
caused by Kidney yang deficiency.
 Kidney yang deficiency: use Ding Xiang with Fu Zi (Radix Aconiti Lateralis Praeparata), Rou Gui (Cortex
Cinnamomi) and Ba Ji Tian (Radix Morindae Officinalis).

Ding Xiang, soaked in rubbing alcohol and applied topically, has been used to treat various fungal infections.

Dosage and processing / administration

 2 to 5 grams

Cautions and contraindications

 Ding Xiang is contraindicated in cases of febrile disorders, or in interior heat with yin deficiency.
 Ding Xiang is counteracted by Yu Jin (Radix Curcumae).
 Potential side effects of Ding Xiang include dizziness, palpitations, chest oppression, headache,
perspiration, decreased blood pressure, and skin rash.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 14 / 35

 Gao Liang Jiang
高良薑
- Pharmaceutical name: Rhizoma Alpiniae Officinarum
- Common English name: alpinia, galanga, lesser galangal rhizome
 Properties: hot
 Tastes: pungent
 Channels entered: SP, ST

Actions and indications

 Warms the Spleen and Stomach

The major strength of Gao Liang Jiang (Rhizoma Alpiniae Officinarum) is in dispelling cold from the middle jiao
to treat epigastric and abdominal pain, nausea, vomiting, food stagnation, intestinal cramps and diarrhea. It can
be used alone, or with other interior-warming herbs to enhance the overall effect.

Dosage and processing / administration

 3 to 10g

Cautions and contraindications

 Gao Liang Jiang is contraindicated in cases of interior heat with yin deficiency.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 15 / 35

 Xiao Hui Xiang
小茴香
- Alternative name: 茴香
- Pharmaceutical name: Frictus Foeniculi
- Common English name: fennel seed, fennel fruit
 Properties: warm
 Tastes: pungent
 Channels entered : LV, KI, SP, ST

Actions and indications

 Disperses Cold, Warms the Liver and Kidney, Relieves Pain
 Regulates Qi, Improves Appetite

Abdominal pain, hernial pain: Xiao Hui Xiang (Fructus Foeniculi) treats hernial disorders by dispelling cold from
the Liver and Kidney channels. Clinical applications include abdominal pain, prolapse sensations in the
abdomen, and testicular swelling and pain.

Low back pain caused by Kidney deficiency: The lower back houses the Kidney; when Kidney energy is deficient,
patients will feel soreness, weakness and pain. Xiao Hui Xiang warms the Kidney and relieves pain.
 Low back pain: use this herb with Du Zhong (Cortex Eucommiae), Hu Lu Ba (Semen Trigonellae), and Bu Gu
Zhi (Fructus Psoraleae).

Epigastric, hypochondriac, abdominal and intercostal pain, vomiting and decreased intake of food: Xiao Hui
Xiang treats qi stagnation in the middle jiao, characterized by bloating pain in different parts of the abdomen,
lack of appetite, nausea, abdominal fullness after meals, indigestion and vomiting.

Dosage and processing / administration

 3 to 8 grams
 Unprocessed Xiao Hui Xiang has the strongest function to regulate qi.
 Salt-fried Xiao Hui Xiang has moderate acrid and dispersing effects.
 Frying with salt also increases its effect to warm the Kidney and Liver, to treat disorders of the lower jiao,
such as hernial pain.

Cautions and contraindications

 Use Xiao Hui Xiang with caution in cases of yin deficiency with fire.
 Use Xiao Hui Xiang with caution during pregnancy because of its emmenagogic effect

[Note] 八角茴香
 Aka. 大茴香
 Actions/indications and dosage: same as 小茴香

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 16 / 35

 Hu Jiao
胡椒
- Pharmaceutical name: Fructus Piperis Nigri
- Common English name: pepper, black pepper
 Properties: hot
 Tastes: pungent
 Channels entered: ST, LI

Actions and indications

 Warms the Middle and Relieves Pain

Hu Jiao (Fructus Piper) disperses cold in the gastrointestinal system and relieves vomiting, nausea, epigastric
and abdominal cold and pain, poor appetite and diarrhea.
 Gastrointestinal symptoms due to cold: use Hu Jiao with Sheng Jiang (Rhizoma Zingiberis Recens), and
Gao Liang Jiang (Rhizoma Alpiniae Officinarum).
 Vomiting and nausea: use it with Ban Xia (Rhizoma Pinelliae) and Sheng Jiang (Rhizoma Zingiberis Recens).

The powder of Hu Jiao can be applied to the umbilicus to warm the middle jiao, or applied topically for toothache

Dosage and processing / administration

 2 to 3 grams in decoction
 0.5 to 1 gram in powder.

Cautions and contraindications

 Hu Jiao is contraindicated in patients with yin deficiency or heat.
 Hu Jiao should be used with caution during pregnancy, due to its abortifacient effect

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 17 / 35

 Herbs that regulate Qi
理氣藥

Herbs that regulate Qi

 Generally warm, pungent, bitter → move or disperse (行散), purge or descend (泄降)
 Prohibited Qi mechanism causing Qi stagnation or Qi reversal → harmonize Qi and fortify SP, move Qi and
stop pain, moderate and descend reversal Qi, unblock LV and relases stagnation, break up and disperse Qi

Herbs that regulate the qi facilitate the proper workings of the qi dynamic (also known as the Qi mechanism),
thereby helping it work smoothly and freely as a means of eliminating qi stagnation or rebellious qi. The qi
dynamic plays an important role in Chinese medicine, as noted in a passage from the fourteenth-century work,
Teachings of [Zhu] Dan-Xi:
“When the qi and blood are flush and harmonious, the myriad diseases cannot arise. Once they become
restrained and constrained, various diseases arise from that. Thus, among the various human diseases,
most arise from constraint.”

Most of the herbs that regulate the qi are aromatic and warm, and are acrid or bitter in nature. They promote
movement, disperse, or drain downward. They are used to promote the movement of qi, reduce distention,
smooth the flow of qi, expand the chest, relieve constraint, stop pain, and direct rebellious qi downward to stop
vomiting or calm wheezing.

From the perspective of the Organs, the most important involved in the qi dynamic are the Lungs, which govern
the qi; the Liver, which governs dredging and draining; the Spleen, which governs transformation and
transportation; and the Stomach, which governs receiving and taking in. These functions can be disrupted by a
variety of factors: emotional constraint or excessive thinking, overexposure to heat and cold, dampness or
phlegm, trauma, or improper diet. When this occurs, these herbs are used to adjust the Spleen qi, harmonize
the Stomach, dredge the Liver qi, or regulate the Lung qi.

The two principal types of dysfunction are stagnation and rebellion. Stagnation is marked by sensations
associated with blockage such as pain, distention, or stifling. Rebellion is manifested in an upward movement of
qi which should otherwise move downward: belching, nausea, vomiting, and wheezing, together with other
forms of dyspnea.

There are three major types of stagnant qi, which are differentiated according to the Organs that are primarily
involved:
 Stagnant Spleen and Stomach qi. Symptoms include epigastric and abdominal fullness, distention, and pain,
belching, gas, acid regurgitation, nausea, vomiting, loss of appetite, and diarrhea or constipation.
 Constrained Liver qi. Symptoms include a stifling sensation in the chest, pain in the flanks, Joss of appetite,
depression, irritability, and (in severe cases) bulging disorders. In women this problem can also present as
irregular menstruation or swollen, tender breasts.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 18 / 35

 Stagnant Lung qi leading to loss of dissemination and descending. Major symptoms include cough and
wheezing accompanied by labored breathing, shortness of breath, and a stifling sensation in the chest.

The herbs in this chapter are used to unblock stagnant qi, especially in the Organs. Pain occurs when the flow of
qi is impeded. Pain due to blockage in the channels can occur anywhere in the body, but is usually found in the
head or extremities. Appropriate herbs for treating blockage in the channels are generally those that expel
wind-dampness. On the other hand, stagnant qi that affects the Organs generally manifests as pain in the chest
and abdomen. Treatment is directed at reestablishing the natural flow and movement of qi.

The herbs here are rarely used by themselves; rather, they are combined with others based upon the specific
nature of the disorder. For example, if stagnant Spleen and Stomach qi is accompanied by cold-dampness,
herbs that unblock stagnant qi are combined with others that warm and dry; if there is concurrent food
stagnation, herbs that reduce and conduct are added; and if there is also deficiency, herbs that augment and
strengthen are added to the prescription.

When using these herbs, it is important to remember that most of them are aromatic and dry in nature;
long-term use may deplete the yin. By definition, they also disperse the qi, and should therefore be used with
caution in those with qi deficiency.

 Ju Pi (橘皮; Pericarpium Citri Reticulatae) [Chen Pi (陳皮)]

 Qing Pi (靑皮; Pericarppium Citri Reticulatae Viride)
 Zhi Shi (枳實; Fructus Aurantii Immaturus)
 Zhi Ke (枳殼; Fructus Aurantii)
 Fo Shou (佛手; Fructus Citri Sarcodactylis)
 Mu Xiang (木香; Radix Aucklandiae)
 Xiang Fu (香附; Rhizoma Cyperi)
 Wu Yao (烏藥; Radix Linderae)
 Chen Xiang (沉香; Lignum Aquilariae Resinatum)
 Chuan Lian Zi (川楝子; Fructus Meliae Toosendan)
 Li Zhi He (荔枝核; Semen Litchi)
 Xie Bai (薤白; Bulbus Allii Macrostemi)
 Tan Xiang (檀香; Lignum Santali Albi)
 Shi Di (柿蒂; Calyx Kaki)
 Da Fu Pi (大腹皮; Pericarpium Arecae)

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 19 / 35

 Ju Pi
橘皮
- Alternative name: Chen Pi (陳皮), 廣陳皮, 新會皮
- Pharmaceutical name: Pericarpium Citri Reticulatae
- Common English name: citrus peel, orange peel, tangerine peel
 Properties: warm
 Tastes: pungent, bitter
 Channels entered: SP, LU

Actions and indications

 Regulates Qi, Adjusts the Middle Jiao
 Dries Dampness, Dissolves Phlegm
 Relieves Cough

Qi stagnation of the Spleen and Stomach: Qi stagnation creates an upwards reversal of qi, leading to nausea and
vomiting. Chen Pi (Pericarpium Citri Reticulatae) has moving and descending properties to treat disharmony of
the middle jiao that manifests in abdominal fullness and distention, belching, nausea, and vomiting. One aspect
of disharmony of the middle jiao is characterized by the Liver over-acting on the Spleen, resulting in abdominal
pain and diarrhea.

Indigestion from Spleen and Stomach deficiencies: Chen Pi regulates qi circulation of the Spleen and Stomach
and treats indigestion with bloating, and distention or poor appetite.

Damp accumulation in the middle jiao: Chen Pi warms yang in the middle jiao to eliminate the accumulation of
dampness and phlegm, a condition characterized by feelings of oppression in the chest, abdominal fullness,
loss of appetite, fatigue, loose stools, and a thick, greasy tongue coat. Chen Pi is also added to various tonic
formulas to aid in their digestion and prevent stagnation.

Cough with phlegm: Damp obstruction of the middle jiao arising from inadequate functioning of the Spleen leads
to accumulation of phlegm in the Lung. The qi and phlegm stagnation in the Lung leads to failure of Lung qi to
descend, causing cough, dyspnea or wheezing, stifling sensations in the chest, and profuse sputum. Chen Pi
dries dampness, dissolves phlegm, and indirectly relieves cough.
 Cough caused by accumulation of dampness and phlegm: use Chen Pi with Ban Xia (Rhizoma Pinelliae) and
Fu Ling (Poria). Exemplar Formula: Er Chen Tang (Two-Cured Decoction).

Dosage and processing / administration

 3 to 10 grams
 Chen Pi is usually used as decoction or in pills.

Cautions and contraindications

 Acrid, bitter, warm, and drying, Chen Pi should be used with caution in patients with fluid deficiencies,
excess heat in the interior, and/or cough caused by qi or yin deficiencies.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 20 / 35

 Qing Pi
靑皮
- Pharmaceutical name: Pericarppium Citri Reticulatae Viride
- Common English name: citrus viride, immature orange peel, green tangerine peel
 Properties: warm
 Tastes: bitter, pungent
 Channels entered: LV, GB, ST

Actions and indications

 Spreads Liver Qi, Breaks Up Qi Stagnation
 Disperses Nodules, Resolves Stagnation

Liver qi stagnation: Clinical symptoms include hypochondriac distention and pain, breast distention and pain,
breast nodules, and hernia. There may also be emotional distress, frequent sighing, irritability, irregular
menstruation and pre-menstrual syndrome, abdominal bloating or pain, poor appetite, and reversal of Stomach
qi
causing hiccups, belching, nausea or vomiting. Patients with Liver qi stagnation often become agitated easily.
Qing Pi (Pericarpium Citri Reticulatae Viride) enters the Liver and Gallbladder channels to spread Liver qi and
break up qi stagnation. Qing Pi is relatively strong, suitable for patients with strong constitutions or acute
conditions.

Food stagnation: This manifests as indigestion, epigastric or abdominal fullness, distention and pain, belching
marked by a sour or rotten smell, acid regurgitation, constipation or diarrhea with foul or rotten smell. Qing Pi
effectively eliminates food stagnation.
 Food stagnation and indigestion: combine Qing Pi with Shan Zha (Fructus Crataegi), Mai Ya (Fructus Ho rdei
Germinatus) and Shen Qu (Massa Fermentata).

Mass formation due to qi or blood stasis: Qing Pi is often used with qi- and blood-invigorating herbs to enhance
the overall function of breaking stagnation that manifests as masses, nodules or tumors.
 Nodules caused by qi or blood stasis: use this herb with San Leng (Rhi zoma Sparganii), E Zhu (Rhizoma
Curcumae), and Yu Jin (Radix Curcumae).

Dosage and processing / administration

 3 to 10 grams in decoction.
 Qing Pi may also be used in pills or powder. The unprocessed herb has a strong, drastic action to move qi
and break up qi stagnation. Vinegar-processing moderates the strong effect and minimizes possible side
effects.

Cautions and contraindications

 Use Qing Pi with caution for patients with qi deficiency, as the strong dispersing quality may consume qi.
 Long- term use or large doses of Qing Pi are not recommended.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 21 / 35

 Zhi Shi
枳實
- Pharmaceutical name: Fructus Aurantii Immaturus
- Common English name: aurantium immaturus, immature bitter orange, immature sweet orange
 Properties: cool
 Tastes: bitter, pungent
 Channels entered: SP, ST, LI

Actions and indications

 Breaks Up Stagnant Qi, Resolves Accumulation
 Dissolves Phlegm, Relieves Distention

Gastrointestinal disorders: Gastrointestinal disorders caused by stagnant qi in the middle jiao is characterized
by indigestion, epigastric and abdominal fullness, distention, belching, and foul breath. Zhi Shi (Fructus Aurantii
Immaturus) is one of the most potent qi-regulating herbs. It breaks up stagnant qi to treat food accumulation,
abdominal hardness, distention and pain, constipation, dysentery and rectal tenesmus.

Spleen and Stomach deficiencies: Qi stagnation may occur in patients who have an underlying deficiency. In
cases of Spleen and Stomach deficiencies with compromised transformation and transportation functions,
epigastric and abdominal fullness and distention will often develop after meals. If the underlying cause is
deficiency and cold of the Spleen, the patient will express fatigue with preference for warm drinks and food.
 Epigastric and abdominal fullness and distention secondary to Spleen and Stomach deficiencies: use Zhi
Shi with Bai Zhu (Rhizoma Atractylodis Macrocephalae) and Su Geng (Caulis Perillae).

Phlegm obstruction with chest and epigastric distention: Zhi Shi activates qi circulation, dissolves phlegm, and
relieves distention. It treats xiong bi (painful obstruction of the chest), coronary heart disorders or angina
caused by Heart yang deficiency and accumulation of cold phlegm. Symptoms include stifling sensations and
pain in the chest and epigastric area, poor appetite, shortness of breath, fatigue and weakness.

Cholecystitis: Zhi Shi is one of the best herbs to relieve distention and hardness of the epigastric area caused by
cholecystitis.

Dosage and processing / administration

 3 to 10 grams in decoction. The maximum dosage of Zhi Shi is 15 grams.
 Apply as powder for topical use.
 Unprocessed Zhi Shi has a potent ability to break up stagnant qi and resolve accumulation. However, such
impact is often associated with consumption of qi and irritation of the Spleen and Stomach. Dry-frying
increases the warmth and moderates the harsh nature of Zhi Shi, therefore minimizing potential side
effects.

Cautions and contraindications

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 22 / 35

 Use Zhi Shi with caution during pregnancy.
 Zhi Shi should not be used as a single remedy when treating patients with Spleen and Stomach deficiencies,
since its qi-regulating potency may disperse and consume qi. Patients with Spleen and Stomach
deficiencies should be treated with both qi-tonics and qi-regulating herbs.
 Zhi Shi should be used with caution in patients who have gastric or duodenal peptic ulcers, because the
acidity of the herb may irritate the gastrointestinal tract

[Note] Zhi Ke (枳殼)

- Pharmaceutical name: Fructus Aurantii
- Common English name: aurantium fruit, bitter orange
 Same properties, taste, channels entered, actions/indicaions and dosage as Zhi Shi
 Comparing to Zhi Shi, mild in action and mainly for moving Qi and removing distenting sensation
 Zhi Ke (Fructus Aurantii) activates qi circulation to relieve abdominal distention and pressure. The
qi-regulating function of Zhi Ke is mild, and is most helpful for patients who are weak or deficient.
 Although Zhi Ke is mild in action, it breaks up stagnant qi in mild-to-moderate cases of stagnation and
accumulation, and expands the chest to relieve congestion.
- Chest congestion: use Zhi Ke with Jie Geng (Radix Platycodonis).
- Itching of the skin: combine this herb with Jing Jie (Herba Schizonepetae), Fang Feng (Radix
Saposhnikoviae), Hong Hua (Fios Carthami) and Chi Shao (Radix Paeoniae Rubrae).

Dosage and processing / administration

 3 to 10 grams
 Dry-frying Zhi Ke reduces its drying tendencies

Cautions and contraindications

 Zhi Ke should be used with caution during pregnancy.
 Zhi Ke should be used with caution in cases of Spleen and Stomach deficiencies.
 Zhi Ke should be used with caution in patients who have gastric or duodenal ulcers, because the acidity of
this herb may irritate the gastrointestinal tract

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 23 / 35

 Fo Shou
佛手
- Pharmaceutical name: Fructus Citri Sarcodactylis
- Common English name: citrus sarcodactylus, finger citron

 Properties: warm
 Tastes: pungent, bitter
 Channels entered: LV, ST, SP, LU

Actions and indications

 Spreads Liver Qi and Regulates Qi
 Harmonizes the Middle Jiao, Dissolves Phlegm and Relieves Cough

Liver qi stagnation: Clinical manifestations of Liver qi stagnation include hypochondriac and abdominal
distention and fullness, belching, hiccups and vomiting. Fo Shou (Fructus Citri Sarcodactylis), acrid yet not
drying in action, is an excellent herb to promote circulation of qi and relieve Liver qi stagnation. Overall, it
effectively activates and regulates qi circulation without drying or consuming yin. However, it only has a mild
function to relieve pain.

Spleen and Stomach qi stagnation: This condition is characterized by poor appetite, epigastric and abdominal
fullness and distention, belching, and vomiting. This pattern of symptoms usually reveals the Wood element
(Liver) overacting on the Earth element (Spleen/Stomach).

Cough with profuse sputum: Fo Shou serves to mildly dissolve phlegm. It is commonly used to treat chronic and
persistent cough with profuse sputum and chest pain. It is not, however, suitable for the initial stage of cough
characteristic of an exterior condition.

Dosage and processing / administration

 3 to 10 grams in decoction.
 Fo Shou is commonly used as an herbal decoction or tea.

Cautions and contraindications

 Use Fo Shou with caution for patients who have yin-deficient fire, or do not have qi stagnation.

[Note] Fo Shou Hua (佛手花; Flos Citri Sarcodactylis)

 It is derived from the flower of the same plant as Fo Shou.
 The function of Fo Shou is more focused on the middle jiao in relieving nausea, vomiting and epigastric
pain.
 Fo Shou Hua has a similar but weaker function, and is better at relieving qi stagnation in the chest, that
manifests in congestion and pain.
 The recommended dosage of Fo Shou Hua is 3 to 6 grams in decoction.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 24 / 35

 Mu Xiang
木香
- Pharmaceutical name: Radix Aucklandiae
- Common English name: saussurea, aucklandia, cestus root
 Properties: warm
 Tastes: pungent, bitter
 Channels entered: SP, ST, LI, GB

Actions and indications

 Unblocks Qi Stagnation, Regulates the Middle Jiao and Relieves Pain
 Dispels Damp-Heat, Harmonizes the Liver and Spleen
 Regulates Qi Circulation, Prevents Stagnation

Qi stagnation of the Spleen and Stomach: This condition is characterized by poor appetite, indigestion, food
stagnation, epigastric and abdominal fullness, bloating, distention and pain, diarrhea and/or rectal tenesmus.
The warm, acrid, bitter properties of Mu Xiang (Radix Aucklandiae) help to move and dear stagnation, restore
appropriate functioning of the middle jiao, and relieve pain.

Liver qi stagnation: Disharmony between the Liver and Spleen interferes with the normal transformation and
transportation functions of the Spleen. When the flow of water becomes stagnant, damp-heat begins to
accumulate, leading to distention and pain in the hypochondriac region, a bitter taste in the mouth, a yellow
tongue coat, and possibly jaundice.

Spleen qi deficiency: The chief manifestations of Spleen qi deficiency include epigastric and abdominal fullness,
distention, bloating, pain, poor appetite, vomiting, diarrhea, preference for warmth and pressure applied to the
abdomen, and white, greasy, tongue coating. Mu Xiang also activates and regulates qi circulation to prevent
stagnation and the bloating sensations associated with the use of herbs that tonify qi. Qi-activating herbs are
commonly used with qi-tonic herbs to treat symptoms and signs that accompany Spleen and Stomach
deficiencies.

Dosage and processing / administration

 3 to 10 grams.
 Mu Xiang may be used in herbal decoction, powder or pill forms.
 The unprocessed herb is better for treating qi stagnation.
 The roasted herb more effectively treats diarrhea and rectal tenesmus.

Cautions and contraindications

 Acrid, warm and drying, Mu Xiang should be used with caution for patients experiencing yin deficiency, fluid
deficiency, or excess fire.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 25 / 35

 Xiang Fu
香附

- Pharmaceutical name: Rhizoma Cyperi
- Common English name: cyperus, nutgrass rhizome
 Properties: neutral
 Tastes: pungent, slightly bitter, slightly sweet
 Channels entered: LV, SJ

Actions and indications

 Spreads the Liver, Regulates Qi
 Regulates Menstruation, Relieves Pain

Liver qi stagnation: Clinically, Xiang Fu (Rhizoma Cyperi) is commonly used to treat Liver qi stagnation
characterized by hypochondriac pain and epigastric and abdominal fullness and pain. Secondary symptoms
include emotional disturbances and poor appetite, chest congestion and frequent sighing. This herb is also
excellent in relieving stomach pain caused by stress, as is seen in patients with peptic or duodenal ulcers.

Hernial pain: Xiang Fu can also be used to treat cold stagnation along the Liver channel that manifests in
abdominal and hernial pain.

Irregular menstruation, dysmenorrhea and breast distention: Xiang Fu is commonly used to treat menstrual
disorders or pre-menstrual syndrome arising from Liver qi stagnation. This is an herb that regulates qi in the
xue (blood) level and can also lead blood to the qi (energy) level to help generate blood. Because of this unique
trait, it is often used in pregnant and postpartum women who are blood-deficient. Xiang Fu is considered one of
the most important herbs for treatment of obstetric/gynecologic disorders.

Dosage and processing / administration

 6 to 12 grams
 Xiang Fu can be used as herbal decoction, powder, or pills.
 Frying the herb with vinegar enhances its function to reduce accumulations and relieve pain.
 Frying the herb- with grain-based liquor increases its function to open channels and collaterals.
 Frying the herb with ginger potentiates its action to dissolve phlegm stagnation and unblock Liver qi
stagnation.

Cautions and contraindications

 Use Xiang Fu with caution for patients experiencing qi deficiency in the absence of stagnation, or yin
deficiency with heat in the blood.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 26 / 35

 Wu Yao
烏藥
- Pharmaceutical name: Radix Linderae
- Common English name: lindera root
 Properties: warm
 Tastes: pungent
 Channels entered: LU, SP, KI, BL

Actions and indications

 Regulates Qi and Relieves Pain
 Warms the Kidney, Disperses Cold

Qi stagnation and cold accumulation: Wu Yao (Radix Linderae) activates qi circulation, disperses cold, and
relieves pain in the chest, abdomen, hypochondriac and epigastric areas.

Enuresis caused by Kidney yang deficiency, or by deficiency and cold of the Urinary Bladder: With deficiency of
the Kidney and Urinary Bladder, the bladder cannot retain urine, resulting in enuresis. There may be
accompanying soreness, coldness and weakness of the low back and knees, pale complexion, frequent
urination during the night, fatigue, spermatorrhea in men, and profuse, clear, vaginal discharge in women.

Dosage and processing / administration

 3 to 10 grams
 Wu Yao may be used in herbal decoction or pills.

Cautions and contraindications

 The use of this acrid, warm and drying herb may consume qi and blood. Thus, Wu Yao is not recommended
in cases of qi and blood deficiencies or in patients who have interior heat.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 27 / 35

 Chen Xiang
沉香
- Pharmaceutical name: Lignum Aquilariae Resinatum
- Common English name: aquila ria, Chinese eaglewood
 Properties: warm, aromatic
 Tastes: pungent, bitter
 Channels entered: SP, ST, KI

Actions and indications

 Moves Qi, Relieves Pain
 Warms the Middle Jiao, Relieves Vomiting
 Warms the Kidney, Grasps Qi Downwards

Qi stagnation and cold accumulation with chest and abdominal distention and pain: Chen Xiang (Lignum
Aquilariae Resinatum) warms the body, dispels cold, and moves qi to relieve pain in the chest and abdominal
regions. It is commonly used to treat pain characterized by cold and stagnation.

Stomach qi reversal due to cold: Chen Xiang warms and harmonizes the middle jiao to treat chronic nausea,
hiccups and vomiting from deficiency and cold of the Spleen and Stomach.
 Nausea and vomiting: combine Chen Xiang with Ding Xiang (Flos Caryophylli), Bai Dou Kou (Fructus Amomi
Rotundus), Zi Su Ye (Folium Perillae) and Sheng Jiang (Rhizoma Zingiberis Recens).

Kidney yang deficiency with inability to grasp qi downwards: The chief clinical manifestations of this deficiency
include wheezing and dyspnea with more difficulty in inhalation than exhalation. Other symptoms may include
coldness, soreness and weakness of the lower back and knees, weak Kidney pulse, and spermatorrhea in men.

Dosage and processing / administration

 1.0 to 1.5 grams. Add powder to warm decoction
 Chen Xiang should be post-decocted to ensure its effectiveness.
 It is also taken in powder concurrently with a decoction, or made into pills.

Cautions and contraindications

 Use Chen Xiang with caution in the presence of yin-deficient fire, or organ prolapse due to qi deficiency.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 28 / 35

 Chuan Lian Zi
川楝子
- Alternative name: Jin Ling Zi (金鈴子), Ku Lian Zi (苦楝子)
- Pharmaceutical name: Fructus Meliae Toosendan
- Common English name: melia, Sichuan china berry fruit
 Properties: cold
 Tastes: bitter
 Channels entered: LV, ST, SI, BL
 Toxicity: slightly toxic

Actions and indications

 Moves Qi and Relieves Pain
 Kills Parasites and Fungus

Liver qi stagnation: With bitter taste and cold thermal property, Chuan Lian Zi (Fructus Toosendan) regulates
Liver qi and relieves stagnation to treat hypochondriac distention and pain, and abdominal pain with heat signs
of irritability, insomnia, red face and eyes, and short temper.

Disharmony of Liver and Stomach: When Wood overacts on Earth, the Spleen and Stomach are affected. Typical
symptoms include poor appetite, bloating, distention and pain.
 Bloating: use Chuan Lian Zi with Mu Xiang (Radix Aucklandiae) and Xiang Fu (Rhizoma Cyperi).

Hernial pain with lower abdominal coldness and distention:

Chuan Lian Zi kills intestinal parasites and relieves pain. It is most effective for roundworms and hookworms.
 Parasitic infection: use Chuan Lian Zi with Bing Lang (Semen Arecae) and Shi Jun Zi (Fructus Quisqualis).

Chuan Lian Zi kills fungi, and is used topically as an herbal paste to treat fungal infections of the scalp. The
herbal paste is prepared by roasting the herb, grinding it to powder, and mixing the powder with sesame oil. The
affected area should be cleaned with salt water prior to application of the herbal paste.

Dosage and processing / administration

 3 to 10 grams
 Chuan Lian Zi is commonly used in herbal decoctions, pills, and topical creams/ointments.
 Bitter and cold, the unprocessed herb is slightly toxic. Dry-frying increases its warmth, minimizes toxicity,
and reduces irritation to the Spleen and Stomach.
 Dry-frying with salt enhances its ability to enter the Kidney, and this form is commonly used to relieve pain
in the lower jiao, such as hernial pain.

Cautions and contraindications

 Use Chuan Lian Zi with caution in cases of deficiency and cold of the Spleen and Stomach.
 Large dosages of Chuan Lian Zi are not recommended as it is slightly toxic

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 29 / 35

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 30 / 35
 Li Zhi He
荔枝核
- Pharmaceutical name: Semen Litchi
- Common English name: litchi seed, lychee seed
 Properties: warm
 Tastes: sweet, astringent
 Channels entered: LV, ST

Actions and indications

 Moves Qi, Relieves Pain
 Disperses Cold, Regulates Liver Qi

Hernial pain: Li Zhi He (Semen Litchi) is an excellent herb to treat cold hernial disorders with testicular swelling
and pain.

Ben tun (running piglet) sensation: This is an upward shooting sensation of qi from the lower abdomen to the
epigastric or chest region, causing pain.
 Ben tun sensation: use Li Zhi He with Mu Xiang (Radix Aucklandiae), Wu Zhu Yu (Fructus Evodiae) and Rou
Gui (Cortex Cinnamomi). Use Rou Gui only if there are signs of cold.

Chronic epigastric pain: Li Zhi He regu

lates Liver qi, dispels cold, and relieves chronic epigastric pain.
 Chronic epigastric pain from Liver qi stagnation: use Li Zhi He with Mu Xiang (Radix Aucklandiae), Yan Hu
Suo (Rhizoma Corydalis) and Chuan Lian Zi (Fructus Toosendan).

Pre-menstrual or postpartum abdominal pain because of qi and blood stagnation.

 Abdominal pain: add Xiang Fu (Rhizoma Cyperi).

Dosage and processing / administration

 10 to 15 grams.
 Li Zhi He may be used in decoction or pills.
 Frying with salt directs the function of the herb downwards to the lower jiao and potentiates its ability to
treat hernia and pain.

Cautions and contraindications

 Li Zhi He is contraindicated in patients who do not exhibit cold and damp accumulation.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 31 / 35

 Xie Bai
薤白
- Pharmaceutical name: Bulbus Allii Macrostemi
- Common English name: bakeri, long-stamen onion bulb
 Properties: warm
 Tastes: pungent, bitter
 Channels entered: LU, ST, LI

Actions and indications

 Opens Yang Qi, Disperses Stagnation due to Cold Phlegm
 Moves Qi and Eliminates Stagnation

Chest pain: Xiong bi (painful obstruction of the chest), or angina, often occurs as a result of cold phlegm in the
chest obstructing the flow and smooth circulation of yang qi. Clinically, xiong bi is characterized by feelings of
oppression and pain in the chest, shortness of breath, coughing and wheezing. Xie Bai (Bulbus Allii
Macrostemonis) is one of the best herbs to treat xiong bi as it opens yang qi and disperses stagnation.

Diarrhea or dysentery with rectal tenesmus: Rectal tenesmus is usually caused by qi stagnation. Comparatively
speaking, if there is more qi stagnation than heat, the prominent signs would be diarrhea with gas, and bloating
and pain that are relieved by defecation. If damp-heat is more prominent than qi stagnation, there would be
burning sensations of the anus, along with a feeling of incomplete evacuation.

Dosage and processing / administration

 5 to 10 grams in decoction, powder, or pills.
 Xie Bai may be used either internally or topically.

Cautions and contraindications

 Use of Xie Bai is not recommended in cases where there is qi deficiency but no stagnation, or for patients
with poor appetite.
 Those who are hypersensitive to Xie Bai should avoid using it.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 32 / 35

 Tan Xiang
檀香
- Pharmaceutical name: Lignum Santali Albi
- Common English name: santalum, sandalwood
 Properties: warm, aromatic
 Tastes: pungent
 Channels entered: SP, ST, LU

Actions and indications

 Regulates Qi, Harmonizes the Middle Jiao
 Disperses Cold and Relieves Pain

Abdominal pain due to cold and qi stagnation: Acrid and dispersing, Tan Xiang (Lignum Santali Albi) regulates qi
in the diaphragm and aromatically wakes up the Spleen to treat epigastric or abdominal coldness and pain, and
vomiting of clear fluids. Secondary symptoms may include poor appetite and hiccups.

Chest pain from cold and qi stagnation: Cold and qi stagnation constrict the chest and manifest in symptoms of
angina, dyspnea and feelings of oppression in the chest. Tan Xiang disperses cold, and relieves chest
constriction, oppression and pain.

Dosage and processing / administration

 1 to 3 grams in decoction
 Tan Xiang is also taken in pill form.

Cautions and contraindications

 Tan Xiang should be used with caution for patients who have yin-deficient heat or are vomiting because of
heat.
 Use Tan Xiang with caution during pregnancy, due to its abortifacient effect.

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 33 / 35

 Shi Di
柿蒂
- Pharmaceutical name: Calyx Kaki
- Common English name: kaki calyx, persimmon calyx and receptacle
 Properties: neutral
 Tastes: bitter
 Channels entered: ST

Actions and indications

 Descends Qi, Stops Hiccups

Hiccups are caused when disharmony of the Stomach leads qi that would otherwise descend to rise in an
abnormal manner. Shi Di (Calyx Kaki) is a neutral herb that addresses this problem in both hot or cold
conditions.

Dosage and processing / administration

 6 to 10 grams
 Shi Di may be used as herbal decoction or pills

Cautions and contraindications

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 34 / 35

 Da Fu Pi
大腹皮
- Pharmaceutical name: Pericarpium Arecae
- Common English name: areca husk, areca peel, betel nut peel
 Properties: slightly warm
 Tastes: pungent
 Channels entered: SP, ST, LI, SI

Actions and indications

 Directs Qi Downward, Expands the Middle Jiao
 Promotes Diuresis, Relieves Edema

Da Fu Pi (Pericarpium Arecae) regulates qi and expands the middle jiao to treat sensations of oppression,
distention and fullness in the abdomen and epigastrium, and feelings of incomplete evacuation after defecation.
 Accumulation of dampness and qi stagnation: use Da Fu Pi with Hou Po (Cortex Magnoliae Officinalis) and
Chen Pi (Pericarpium Citri Reticulatae).

Da Fu Pi helps to reduce accumulation of water to treat edema and leg qi.

 Edema or leg qi: combine this herb with Fu Ling Pi (Cortex Poria) and Sheng Jiang Pi (Pericarpium
Zingiberis Recens).

Dosage and processing / administration

 3 to 10g

Cautions and contraindications

 Use Da Fu Pi with caution during pregnancy, because of its teratogenic and fetotoxic effects, as shown in
mice

TCM Herbology 2_ Warming, Regulating Qi_Sop/ch 35 / 35