Shang Han Lun

Dr. Kenneth Wang OMD, Ph.D., L.Ac.

E-mail: [email protected]
acuherb.us
A. Shang Han Lun(Cold Damage)
1. He outlined the symptom & signs of the febrile disease in the same way as in the Canon
of Medicine, ex., the three Yang & three Yin. The basic symptoms & signs of each of
the Six Channels are as follow:
(1)Taiyang syndrome: Evil invades the exterior.
Floating pulse, headache, stiff neck, and a feeling of chill are always the general
symptom and signs of Taiyang syndrome.

(2) Shaoyang: Evil can shift out to the Taiyang and into Shaoyang
The symptoms and signs of the Shaoyang are invariably bitterness in the mouth, a
parched throat and vertigo, alternating aversion to cold and fever, chest and rib side
fullness,taciturnity with no desire to eat or drink, heart vexation, a pulse is thin and
wiry.

(3) Yangming syndrome: The cause of the Yangming syndrome is stomach excess.
Aversion to heat, fever, spontaneous sweating, thirst with desire to drink, abdominal
fullness, distention, and pain, inability to defecate, delirious speech, yellowing.
 (4)Taiyin: spleen yang deficiency with dampness.
Abdominal fullness with periodic pain,inability to get food down,
yellowing, diarrhea, vomiting, pulse is moderate or weak.

(5) Shaoyin: KI and HT yang or Yin deficiency.

Absence of heat and aversion to cold, reversal cold of the limbs, clear-food diarrhea,
a feeble and weak pulse and a tendency for the patient to fall asleep.

(6) Jueyin: cold and heat complex.

Thirst, qi surging up to the heart, pain and vexation in the heart, hunger with no
desire to eat, and vomiting of roundworms, great thirst with frequent urination, an
uncomfortable.

2. Each kind of disease or syndrome is treated by a representative

formula and the formula is modified with the changes of disease or syndrome.
3. He pioneered diagnosis & treatment based on overall analysis of patient’s condition.
4.there are 112 formulae in Shang Han Lun
 Chapter 1 Tai Yang Bing
1. 1 Principle of the Tai Yang syndrome
In Tai Yang syndrome, the pulse is floating, the head and nape
are stiff and painful, aversion to cold(1).

Exterior Tai yang is a surface of body-exterior invades , first effecting it.

Tai Yang syndrome

syndrome Charges Wei-wind cold invades Wei, is exterior syndrome

  Taiyang-first meridian of 6 channels, relating to other channels
Pulse &
Syndrome Floating pulse-exterior in skin, Zeng qi defense at outside

Stiffness of neck-three yang meets at head, neck is a road of Taiyang

Evils in exterior, blocking meridians, qi is stagnation.
Aversion to chill-wind cold in exterior, Wei yang is blocked, yang
can’t go out.
1.1.1 Classification of Tai yang syndrome

Wind strike
 
Shan Han (damage cold)
 
Wen Bing(warm syndrome)
Tai Yang disease, fever and sweating, aversion to
wind, pulse is moderate, it is called wind strike(2).

Tai Yang disease, whether fever or not, as long as

there is aversion to cold, with aching pain, retching
counterflow, and yin and Yang pulse tight, is called
cold damage(shang han. 3).
 

Tai Yang disease, fever and thirst, without aversion to

cold, it is warm disease.,,,,,,.(6)
1.2 Primary syndromes of Tai Yang
1.2.1 Wind strike due to exterior deficiency
Tai Yang syndrome, yang is floating while yin is
weak, yang floating causes fever spontaneously,
yin weak causes sweating spontaneously, slight
aversion to chill and wind, slight fever, sneezing
and dry heaves, Gui Zhi Tang(12).
 
Gui Zhi Tang(Cinnamon twig decoction)
Ingredients:
Gui Zhi (cassia twig) 9g
Shao Yao (Radix Paeoniae Lactiflorae) 9g
Sheng Jiang(fresh ginger) 9g
Da Zao 12 pieces
Zhi Gan cao (Fired Roasted licorice) 6g
  1.Monarch: Being pungent and sweet flavors and warm nature,
acting on the Urinary Bladder Meridian. Cassia twig is the main
herb to reinforce the defensive qi and activate the nutrient qi for
expelling the exterior wind-cold evil.
2.Minister: With sour and bitter flavors and slight cold nature,
white peony root acts as the Minister herb to nourish the nutrient
qi and astringe yin. The cooperation of cassia twig and white
peony root is to harmonize the nutrient and defensive qi by
means of dispersing and astringing simultaneously.
3.Zuo: Fresh ginger and Chinese date together also can assist cassia
twig and white peony root to harmonize the nutrient and
defensive qi.
4.Shi: Roasted licorice acts as the dispatcher herb to
harmonize all the components. Besides ,it
can reinforce yang to relieve muscles
by cooperating with cassia twig as well
as nourish yin to harmonize the nutrient
qi by cooperating with white peony
root.

 
Gui Zhi Tang Points formula
Du 14—cross of 3yang meridians, similar to the functions
of Gui Zhi, Bai Shao.
GB 20—cross of Shao Yang and Yang Wei for expelling
wind and treating chills and fever.
St 36, LI11—regulate sp and st, similar to the Jiang,
Zhao, and Cao.
.
Notes
1. This formula specially harmonize the nutrient and defensive qi and strengthen
the genuine to expel evils ,so it is different from the other diaphoretic
formulae.
2. In addition to the exterior deficient syndrome due to wind and cold ,it can also be
applied to miscellaneous internal diseases, rehabilitation of illness or delivery
manifested by symptoms of disharmony between the nutrient and defensive
qi such as fever, sweating, aversion to wind, floating loose pulse.

3.It cannot be applied to exterior excessiveness without

sweating, or exterior cold with internal heat marked by
absence of sweat but fidget, or the beginning of warm
diseases manifested by fever, thirst, sore throat, floating
rapid pulse. If it is applied erroneously to syndromes
pertaining to exuberant heat, epistaxis will happen
some times.
1.2.1.1 The contraindications of the Gui Zhi Tang
ASSOCIA TED FORMULAE :
 1. Pueraria plus Cassia Twig Decoction (gui zhi jia
ge gen tang) (14)
Pueraria root 12g, cassia twig 6g, white peony root 6g, fresh ginger 9g ,
Roasted licorice root 6g ,Chinese date 3 pcs.

Gui Zhi Jiao Ge Gen Tang Points formula

+ GB39 is meet of marrow, pass through neck, open meridian
for stiffness of neck.
SI 3 has relation with Du, warm the channel, expel cold.
the 2 points have similar to the Gui Zhi and Ge Gen
Action: relieves muscles and the exterior, moistens vessels and relaxes
tendons.
 Used for: It is applied to Taiyang diseases with symptoms of tight
neck and back, sweating and aversion to wind.
2.Gui zhi jia huo po xing zi tang(magnolia and apricor kernel plus
cassia twig decoction)
cassia twig 12g, white peony root 9g,
fresh ginger 9g , Roasted licorice root 6g ,
Chinese date 3 pcs. Magnolia bark(huo po) 6g
bitter apricot kernel(xing ren) 9g

Gui Zhi Jia Huo Po Xing Zi Tang Points formula

+ St 40, tends to descending, expel phlegm, similar to Huo Po.
Lu 7 & Ding Chuan, open lung qi, relieve asthma similar to Xing
Ren
 Action: relieving muscles and the exterior, lowering
qi to relieve asthma. So it is suitable to the chronic
asthma with attack of wind-cold and symptoms
indicated by Cassia Twig Decoction or to the cases
as the exterior syndrome of wind-cold is erroneously
purged, the exterior syndrome is not relieved but
mild asthma appears.

 Accompanying with Yang qi deficiency(20)

Gui Zhi Jia Fu Zi Tang.
+ warm Du 4.
1.2.2 Shan Han (damage cold) due to exterior
excess
1.2.2.1 Syndrome of Ma Huang Tang
Tai yang syndrome, headache, fever, general
aching, lumbago, arthralgia, aversion to
wind, asthma without sweating, using Ma
Huang Tang (35).
Ma Huang Tang(ephedra decoction)
Use for: exterior excessive syndrome due to
exogenous attack of wind and cold. Lung
fail to disperse & descend
Manifestation: Aversion to cold & fever no sweating,
headache, pain of body, asthma, thin & whitish
coating of tongue, floating & tight pulse.
Action: Inducing sweating to relieve the exterior,
and dispersing lung to relieve asthma.
Ingredients:
Ma Huang (Ephedra) 6g
Gui Zhi (cassia twig) 4g
Xing Ren (bitter apricot kernel) 9g
Zhi Gan Cao (Fried Roasted licorice) 3g

Ma Huang Tang points formula

Du 14, LI 11, LI 3 for promoting sweating, relieve cold exterior.
Lu 7, Ding Chuan for opening lung, relieving asthma.

Notes
1. Decoct ephedra first. After getting rid of the floating foam, add the
other herbs.
2.This is a pungent-warm exterior-relieving formula ,so it is not
suitable for exterior syndrome due to wind-heat.
 Itis prohibited in cases of sores, stranguria ,
epistaxis and blood loss, spontaneous sweating
due to exterior deficiency ,slow pulse on the "chi
" position due to blood deficiency, heaviness of
body with palpitation due to erroneous
purgation,even though there is the exterior
syndrome.
1.2.2.2 Contraindications of Ma Huang Tang
When the patient has dry throat, diaphoresis is prohibited.(83)
 
When the patient has Lin Zheng, diaphoresis is prohibited.
Otherwise, the patient will suffer from hematuria.(84)
 
When the patient has skin sores, even he has aching body,
diaphoresis is prohibited. Otherwise, the patient will suffer
from spasm. (85)
 
When the patient has bleeding, diaphoresis is prohibited.
Otherwise, the patient will suffer from tense, protruding veins
on the forehead, with staring eyeball, and insomnia. (86)
When the patient has hemorrhage, diaphoresis is prohibited.
Otherwise, the patient will suffer from trebling and
shivering with chills. (87)
 
When the patient has sweating, diaphoresis is prohibited.
Otherwise, the patient will suffer from illusive, and
urodynia. Yi Yu Liang Wan. (88)
 
When the patient has stomach deficient cold, diaphoresis is
prohibited. Otherwise, it will cause the stomach colder,
which will ascarides out. (89)
 
……When the patient has palpitation with sweating,
diaphoresis is prohibited. ……(49)
In the present clinic, this formula is
commonly applied to exogenous attack,
influenza , chronic bronchitis and bronchial
asthma pertaining to the exterior excessive
syndrome due to wind and cold.
1.2.2.2 The accompanying with symptoms of Ma
Huang Tang.

Accompanying with stiffness in neck and back (31):

Ge Gen Tang: Gui Zhi Tang + Ma Huang, Ge Gen.

Accompanying with Exogenous attack of wind and

cold marked by both heavy fever and chill, pain of
body, absence of sweat, fidgets, floating tight
pulse. Da Qing Long Tang (38, )
 Major Blue Dragon Decoction (da qing long tang)
 Ma Huang(Ephedra) 12g,
 Gui Zhi(cassia twig) 4g,
 Gan Cao(Roasted licorice) 5g,
 Xing Ren (bitter apricot kernel) 6g ,
 Shi Gao(gypsum) 12g,
 Sheng Jiang(fresh ginger )9g,
 Da Zhao(Chinese date) 3 pcs.

da qing long tang points

+ PC6, St36 for clearing interior heat.
 Function:
 It induces perspiration to relieve the exterior
and clears away heat to relieve fidgets.
 Indications :
 Exogenous attack of wind and cold marked by
both heavy fever and chill, pain of body ,absence
of sweat, fidgets, floating tight pulse.
 
Accompanying with attack of wind and cold
on the exterior with internal fluid-retention
manifested by chill, fever, absence of sweat,
asthma and cough with abundant thin
expectoration; or cough due fluid retention
accompanied by difficulty in lying position;
or heaviness and pain of body with edema of
face and limbs,white and slippery coating,
floating pulse. Xiao Qing Long Tang. (40,41)
 Xiao qing long tang(Minor Blue Green Dragon)
INGREDIENTS :
 Ma Huang(Ephedra) 9g Cassia twig(Gui Zhi) 6g
 Bai Shao(White peony root) 9g Asarum herb 3g (xi xin)
 Gan Jiang(Dry ginger) 3g Roasted licorice(Gan Cao) 6g
 Pinellia tuber(Ban Xia(Rhizoma Pinelliae Ternae) 9g Schizandra
fruit (wu wei zi) 3g

 DIRECTIONS: Decoct ephedra first. After getting rid of the

floating foam. put in the other herbs.

Xiao qing long tang points formula

Du 14, SI 3, LU 7 similar to Gui Zhi, Ma Huang Gan Cao
Lu7, Ding Chuan, UB13 to Xi Xin, Gan jiang, Bai Shao, Wu Wei Zi
Ren 12 to Ban Xia
EFFECTS: Relieving the exterior and resolve fluid-
retention to alleviate cough and asthma.

ANALYSIS OF FORMULA: This is a common formula for

expelling cold to relieve the exterior and warming lung to
resolve fluid-retention.
1.As the main herb, ephedra is to induce perspiration for relieving
the exterior, to disperse the lung for relieving asthma ,and to
excretes water for alleviating edema.
2.Being pungent and sweet flavors and warm nature ,cassia twig acts
as the assistant herb to help ephedra relieve the exterior as well
as to warm yang to promote the transformative function of qi.
According to the principle that "diseases pertaining to fluid-
retention should be treated with warm-natured herbs " Dry
ginger warms the spleen and lung; Ban Xia(Rhizoma Pinelliae
Ternae) dries dampness, resolves phlegm and lowers the
turbidness; both Xi Xin and Wu Wei Zi strengthen the effect of
warming the lung and resolving fluid-retention and can prevent
consuming the lung-qi for relieving cough and asthma; white
peony root cooperates cassia twig to harmonize the nutrient and
defensive qi and cooperates schizandra fruit to prevent over-
dispersing of ephedra and cassia twig. All the five herbs act as
adjuvans.
3.As the dispatcher herb, Roasted licorice harmonizes all the
components.
 In the present clinic, this formula is commonly applied
to bronchial asthma, chronic bronchitis, senile
emphysema ,and acute attack of chronic bronchitis due
to external cold with internal fluid-retention.
1.3 The transformed syndrome of Tai Yang syndrome
1.3.1 The heat syndrome
Zhi Zi Duo Chi Tang(76)
Du14, LI11, SJ5 similar to Zhi Zi
PC6, Ren12 similar to Du Chi

If abdominal fullness, Zhi Zi Huo Po Tang(79)

Ma xing gan shi tang (63)
After the adoption of a diaphoretic, Gui zhi Tang can
not be served again. Asthma with sweating, without
high fever. Using Ma Huang Xin Ren Gan Cao Shi
Gao tang(63).
 Ephedra, Apricot, Licorice and Gypsum Decoction
 (ma xing shi gan tang)
INGREDIENTS :
 Ephedra 6g
 Bitter apricot kernel 9g
 Roasted licorice 6g
 Gypsum 18g
 DIRECTIONS: Decoct ephedra first. After removing the
foam, put in the other herbs to decoct continuously for oral
administration.
 EFFECTS: Expelling evil by its pungent-coolness herbs
and clearing the lung for relieving asthma
 INDICA TIONS : Exogenous attack of wind
evil manifested by persistent fever,cough with
dyspnea or nares flaring, thirst, sweating or
absence of sweat, thin and white or yellow
coating ,slippery rapid pulse.
 ANAL YSIS OF FORMULA: This is a heavy
pungent-cool formula for clearing away the
lung-heat.
Monarch:Being pungent and sweet flavors and
extremely cold nature, gypsum as the main
herb acts on the Lung and Stomach Meridians
to clear heat and promote production of body
fluid.
Minister: Ephedra is the assistant herb to disperse the lung
for relieving asthma and expel the exterior evil. In
clinic, for asthma with sweating, gypsum should be
five times the dosage of ephedra ;for asthma without
sweating, gypsum should be three times the dosage of
ephedra. In a word, dosage of pungent cold herb must
be larger than that of pungent-warm herb, then it is
possible to form the pungent-cool formula.
Assistant: bitter apricot kernel is to assist ephedra for
strengthening power of lowering qi to relieve asthma.
Gan cao: acts as the dispatcher herb to harmonize all
components of the formula.
This formula is commonly applied to acute bronchitis and
pneumonia due to exuberance of the lung-heat.
Bai Hu Jia Ren Shen Tang (26)

After taking Gui Zhi Tang, and having heavy sweating, the
patient still has thirsty, and full pulse, using Bai Hu Jia Ren
Shen Tang (26)

 Ginseng plus White Tiger Decoction (bai hu jia ren shen

tang): bai hu tang +ren shen
 Effects: clearing heat and reinforcing qi to promote
 generation of body fluid.
 Indications: syndrome of both injury of qi and body fluid
due to exuberant heat in the qi stage or summer-heat
disease manif. by profuse sweating with slight chill of the
back, fever, thirst, large but feeble pulse.
Ge Gen Huang qin Huang Lian Tang(34) (Ge Gen Qin Lian Tang. Kudzu,
coptis, and scutellaria decoction)

Tai Yang syndrome with manifestations of Gui Zhi Tang, a doctor treats the
patient with draining incorrectly, which causes severe diarrhea. If the
patient has rapid pulse, indicating he still has exterior syndrome, and he
has asthma with sweating, using Ge Gen Huang qin Huang Lian Tang(34)

Ge gen(Kudzu) 15g
 Huang qin(coptis root) 9g
 Scutellaria root(Huang Lian) 9g
 Zhi gan cao 6g

 Used for: incompletely resolved exterior with ex. Heat

 in interior.
 Action: release the exterior & clear heat
 Indication: fever with foul diarrhea, burning sensation in
 the anus, irritable feverish sensation of chest &
 epigastrium, dry mouth & thirst, and yellow
 coating and rapid pulse.
1.3.2 The cold syndrome
Yang deficiency of heart:
Gui Zhi Gan Cao Tang(64)
Gui Zhi jia Long Gu Mu Li Tang(118)
Used for anxiety due to Yang deficiency of heart.

Yang deficiency with water retention: Ling Gui

Zhu Gan Tang(67)
 Cause and Pathology: Shang Han is treated incorrectly, spleen
Yang deficiency causing water retention.
Ling fullness in epigastric
Gui qi moving up, hit the heart
syndromes dizziness after standing up
Zhu
deep, tight pulse
Gan
Tang treatment: warm spleen Yang, promote water

formular:

Du20,Du14,St36 similar to Gui Zhi,Gan Chao

PC6, Ren12,Sp4 similar to Fu Ling, Bai Zhu
Spleen deficiency: Xiao Jian Zhong Tang(102)
Cause and Pathology: heart and spleen deficiency and suffer
Shang Han, qi & blood deficiency
Xiao palpitation
Jian deficient pain in abdomen
Zhong
Tang( syndromes pale face
102) deep, weak pulse
treatment: warm spleen, harmonize qi & blood
formular: Yi Tang, Bai Shao, Gui Zhi, Shen Jiang, Da Zhao
Gan Cao

Du14,Gb20, St36
UB20, UB21

Modification: + Huang qi—Huang Qi Jian Zhong Tang

+ Dang Gui—Dang Gui Jian Zhong Tang
Kidney Yang deficiency: Zhen Wu tang(82)
Cause and Pathology: promote sweating after TaiYang incorrectly,
water retention due to yang deficiency.
still fever
palpitation under heart
dizziness
syndromes spasm of muscles,
deep, weak pulse
Zen
treatment: warm Yang, steam qi, promote water
Wu formular:
Tang Fu Zi, sheng jiang—warm yang
Bai Shao—nourish yin
Bai Zhu, Fu ling—tonify spleen, transform water

Ren12, St36, Lu7—similar to Fu ling, bai zhu, baishao

UB23, UB52—to Fu Zi, Sheng jiang
Both deficiency of Yin and yang:
Shao Yao Gan Cao Tang (29)
For spasm of leg muscles due to Yin & Yang deficiency

Zhi Gan Cao Tang (177)

Shang Han, Jie & Dai pulse, palpitation, Zhi Gan Cao
Tang(177)
Tonify qi, nourish blood, warm yang, regulate heart beat.
Used for Yin & Yang deficiency of heart.
Heart yin & yang deficiency: Zhi Gan Cao
Tang(102)
Zhi Cause and Pathology: heart Yinyang,qi & blood deficiency
gan
Cao palpitation-Ht qi weak.
Tang syndromes Knotted, intermittent pulse

treatment: warm and nourish Ht yang & yin, blood, regulate pulse
formular: Zhi Gan Cao, Gui Zhi, Shen Jiang, Da Zhao, Huo Ma
Ren , Sheng Di Huang, E Jiao, Mai Meng Dong, Ren
Shen.

Water retention: Wu Ling San (71,72, 74)

Water Retention of Taiyang Disease
Cause and Pathology: evil with water stagnation in urination,
dysfunction of urine bladder.
anxiety, insomnia, thirsty-stomach yin deficiency due
Wu to promote sweating
ling syndromes floating pulse, slight fever-evils in Taiyang.
San difficulty in urine-water in UB, qi disorder.
Thirsty-water fails to be ascent.
treatment: warm yang, promote urine.
formular: Wu Ling San
Zhu Ling, Fu Ling
Ze Xie
Bai Zhu
Gui Zhi

Du14 Lu7 similar to Gui Zhi

St36 similar tobai Zhu
Lu7 similar to Zhu Ling, Fu Ling, Ze Xie.
 Blood stasis(Xu Xue Zheng):
Tao He Cheng Qi Tang(106),
Cause and Pathology: Evil in Taiyang, heat with
blood stagnation in UB.
person is as if manic, normal urine
Xue
Xu

symptoms bleeding
tense abdomen
treatment: clear heat and remove blood stasis.
formulae: Tao He Cheng Qi Tang

Du14 similar to Gui Zhi

St40, Ht7 similar to Xiao, Huang
UB40 similar to Tao Ren, Da Huang
Di Dang Tang (124, 125, 126).
 Chapter2 Yang Ming Syndrome
Yang Ming Syndrome:
 Yang Ming channel syndrome__ clearing
 Yang Ming Fu-organ syndrome___ purging
  
 2. 1 Principle of the Yang Ming syndrome
 The cause of Yang Ming syndrome is stomach excess.(180)
Excess—Evils Excess Yangming channel syndrome__ heat in all body
Yangming Fu syndrome__ heat in St with waste(feces)
in LI
 2.1.1 The manifestations of Yang Ming
syndrome
 Question: What are the manifestations of
Yang Ming syndrome?
 Answer: fever, sweating, no aversion to cold
but aversion to heat.(182)

fever, sweating—heat in interior, heat force sweat out.

no aversion to cold—no exterior
but aversion to heat—interior
2.2. Primary syndromes of Yang Ming
2.2.1 Yang Ming Channel syndromes
Zhi Zi Chi Tang(221): for heat in chest.
 Du14, LI11, SJ5 similar to Zhi Zi
 PC6, Ren12 similar to Dan Dou Chi

Bai Hu tang(176):
 EFFECTS: Clearing heat and promoting generation of
body fluid.
 INDICATIONS: Exuberant heat in the qi stage of Yangming
manif. By ex. fever, flushed face, irritable thirst with desire
for drinking, profuse sweating , aversion to heat, surging,
large and forceful pulse or slippery rapid pulse.
Du14, PC6, Shi Xuan—similar to Shi Gao
Ki6, LI11, St44—Zhi MU
St36, --Gan Cao, Geng Mi

Bai Hu Jia Ren Shen Tang(170):

  Shan Han by sweating, vomiting—body fluid injured.
symptom

having symptoms for 7 to 8 days—disease goes deep, heat in interior.

both hot in exterior and interior—severe heat interior.
thirsty, dry tongue and anxiety, drink a lot water—heat interior, injures
fluid

Formula—Bai Fu Jia Ren Shen Tang—clear interior heat, generate fluid.

Zhu Ling Tang(223):
 Ze xie (Rhizoma Alismatis Orientalis) 9g
 Fu ling (Sclerotium Poriae) 9g
 Zhu ling (Sclerotium Polipori Umbellati) 9g
 Hua Shi(Talcum) 9g
 E Jiao(Gelatinum Corii Asini) 9g
Actions: diuresis, clear away heat and nourish yin.
Indications:
Retention of water and heat with yin deficiency.
Accumulation of water and heat with impairment of
yin-fluid marked by disturbance in micturition, fever
and thirst with a desire to drink.

Du14, PC6, Ki6—nourish yin, clear heat

Lu7, Ren3, Sp6, Sp9—clear dam-heat
2.2.2 Yang Ming Fu syndromes
Tiao Wei Cheng Qi Tang(248)
Used for: Yangming disease manifested by constipation, thirst,
fever, abdominal distending with tenderness, yellow coating and
slippery rapid pulse. Fullness of abdomen is not severe.

St25, UB25—similar to Da Huang

SJ6, GB34—to Mang Xiao
Ren12, St36 

Xiao Cheng Qi Tang(213):

 The Minor Purgative Decoction is a moderate purgative formula
to treating the light syndrome of heat accumulation of Yangming
only including the stuffiness, fullness and excessiveness.

UB25, St25, St39—Da Huang

SJ6, GB34—Zhi Shi, Hou Po 
Da Cheng Qi Tang(220, 212,241, 253,254,
255,256, 215,217, 238).
 Da Huang(Radix et Rhizoma Rhei,rhubarb) 12g
 Mang Xiao(Mirabilite)9g
 Hou Po(magnolia) 12g
 Zhi Shi(Fructus Immaturus Citri Aurantii, unripened
bitter orange) 9g

Ren13, Ren12, Ren10, St25, St36—similar to Da Huang

Ren6, PC6—to Zhi Shi, Hou Po
SJ6, BG34,UB25—to Mang Xiao

 Used for:
 Yang Ming organ disorder with dry stool in the
intestines.
 Actions: Vigorously purges heat accumulation.
 Indications:
 (1)severe constipation and flatulence, focal
distention and abdominal fullness, abdominal
pain which increases up pressure, a tense and
form abdomen, a dry, yellow or dry, black
tongue coating with prickles and a submerged,
excessive pulse.[hardness(Pi), fullness(Man),
dryness(Zao) and excessiveness(shi)]

 (2) In severe cases, there may be tidal fever,

delirious speech, and profuse sweating from the
palms and soles.
 2.2.2.1 The contraindications of the Purging
treatment
 vomiting(204):
 Yang Ming channel syndrome (206)
 Deficient cold of Sp and St (194)
 
 2.2.3 The accompanying with symptoms of Yang
Ming
 Accompanying with Jaundice:
 Yin Chen Hao Tang (236):

 sweat upper of neck—heat in interior couldn’t move out.
symptoms

difficulty in urine—damp heat is in the body.

thirsty like drink—heat worse in body
jaundice—damp heat force bile out.

Yin Chen Hao Tang—clear heat and expel dampness, treat

formula

jaundice.

Yin Chen—
Zhi Zi—
Da Huang—

UB19, Ren16, Sp6—Yin Chen

PC6—Zhi Zi
St25, Ren6, St37—Da Huang
 Zhi Zi Bai Pi Tang(261):
Zhi Zi
Huang Bai
Gan Cao

Function: clear heat, expel Jaundice.

Symptom—Shan Han jaundice, fever—heat in stomach, damp heat
stagnates in GB.
Zhi Zi Bai Pi Tang—clear heat, expel dampness.
Ma Huang Lian Qiao Chi Xiao Dou
Tang(262):
Ma huang
Lian Qiao
Xin Ren
Chi Xiao Duo
Sang Bai Pi
Sheng Jiang
Gan Cao
Da Zao
Function: expel exterior, clear heat and Jaundice
SI3, St36, Ding Chuan—Ma huang, Xin Ren, Gan Cao.
Ren12, UB19—Sheng Jiang, Da Zao.
PC6, Sp6, Sp9--Lian Qiao, Chi Xiao Dou, Sang Bai Pi.
 Yin Jaundice
Cold dampness in Tai Yin
e
Jaundic

Yang Jaundice

Damp heat in Fu—fullness of abdomen

Yin Chen Hao Tang
Damp heat in San Jiao
Zhi Zi Bai Pi Tang
Damp heat—accompanying exterior syndrome
Ma Huang Liang Qiao Chi Xiao Duo Tang
 Chapter 3 Shao Yang Syndrome
 
Shao yang syndrome is due to Shao Yang is attacked by
pathogens, flaming of the heat of gallbladder, qi stagnation,
affecting spleen and stomach, as a result, manifested by
alternate chill and fever, chest distress and hypochondriac
fullness, depression with poor appetite, vexation with liability of
vomiting, oral bitter taste, dryness of throat, vertigo, thin and
white coating, and wiry pulse.
 
The treatment for Shao Yang syndrome is harmonizing. All of the
promoting sweating, purging, and vomiting are contraindication.
3.1 Principle of the Shao Yang syndrome
Shao Yang syndrome, oral bitter taste, dryness of throat, vertigo(263,
264, 265)

Principle of Shaoyang disease—pathogen in both half exterior & interior

oral bitter taste—flam of GB fire
dryness of throat—heat injure yin pathogen in hyperchondric,
vertigo—flaming of Liver yang head is disturbed by pathogen

3.2 Primary syndromes of Shao Yang

3.2.1 Xiao Chai Hu Tang (96, 97,266, 99,
100, 101,229, 230, 148).
When in Shan Han five or six days, or wind strike, alternating chills and fever, suffers
fullness in the chest & rib side, taciturnity with no desire for food or drink, heart
vexation and frequent retching, or possible vexation in chest and no retching, or thirst
or pain in the abdomen, or a hard glomus under the rib side, or palpitation below the
heart with inhibited urination, or absence of thirst with mild generalized heat, or cough.
Xiao Chai Hu Tang (96)
 Shan Han five or six days—evil into Shao yang
wind strike—into Shao yang
alternating chills and fever—evil in both half exterior & interior
suffers fullness in the chest & rib side—Shao yang channel is blocked
taciturnity with no desire for food or drink—evil affects stomach
Shao yang

heart vexation and frequent retching—heat disturbs heart & stomach

possible vexation in chest
Thirst—evil injure fluid
pain in the abdomen, a hard glomus under the rib side—shao yang qi
stagnation
palpitation below the heart with inhibited urination—water under heart.
absence of thirst with mild generalized heat—evil still in exterior
Cough—lung qi affected.
 Xiao Chai Hu Tang(Minor Bupleurum Decoction )
Chai Hu(Radix Bupleuri) 12g
Huang Qin (scutellaria root)9g
Ginseng(Ren Shen) 6g
Banxia (pinellia tuber) 9g
Zhi Gan cao(Fired Roasted licorice) 9g
Sheng jiang(Fresh ginger) 9g
Da Zhao (Chinese date) 4pcs

SJ 6 GB 34 Ren 12
Liv 13 St 36 PC 6
 Modification
 1.exterior severe+Gui Zhi, Jing Jie, Bai Zhi, Qiang huo,
Fang Feng(Radix Ledebouriellae Divaricatae).
 2.heat severe+Gypsum, Zhi Mu, Zhi Zi, Xia Ku Cao(heat in
Yangming meridian). If heat in Yangming Fu-organ:+
 3. chest distress and hypochondriac fullness+ Zhi Ke, Hou
Po
 4.depression with poor appetite, vexation with liability of
vomiting, Vertigo +Huo Xiang, Su Ye, Fu Ling(Slerotium
Poria Cocos)
 5.oral bitter taste: Xia Ku cao, Long Dan Cao
 6. dryness of throat: Pi Pa Ye, Niu Bang Zi, She Gan.
 7. Headache:+
 8. Qi deficiency+ Si Jun Zi Tang
 9. Blood deficiency+ Si Wu Tang
 3.3 The transition syndrome of Shao Yang syndrome
 Cha Hu Gui Zhi Tang (146).
 When Shan Han for six or seven days, this is heat effeusion, mild aversion
to cold, vexing pain of the limb joints, mild retching, propping bind below
the heart, and the exterior syndrome is still present, Cha Hu Gui Zhi
Tang(Xiao Chai Hu Tang add Gui Zhi) Zhi .

 Da Chai Hu Tang (103, 165.Major Bupleurum

Decoction)
Chai Hu (Radix Bupleuri) 9g
 Huang Qin (scutellaria root)9g
 Ban Xia (Rhizoma Pinelliae Ternae, pinellia tuber) 9g
 Fresh ginger 9g
 Chinese date 4pcs
 Shao Yao (Radix Paeoniae Lactiflorae) 9g
 Zhi Shi (Fructus Immaturus Citri Aurantii) 9g
 Da Huang (Radix et Rhizoma Rhei) 6g

 Actions:
 expelling evil in Shao Yang exteriorly and purging heat accumulation interior
 Indications: combination of Shaoynag and Yangming diseases manifested by alternate
chill and fever, chest distress and hypochondriac fullness, oral bitter taste,nausea,
continuous vomiting, hard focal distention or fullness and pain in the epigastrium,
burning diarrhea or no bowel movements, constipation, yellow coating, and wiry and
forceful pulse.
  
 SJ7, GB34, Liv13, Ren12, St36
 St25, Ren6,--Da Huang, Zhi Shi
 Sp9—Bai Shao
 Chai Hu Jia long Gu Mu Li Tang (107)
 Heat invading the blood-compartment of female (143, 144)
Chapter 4 Tai Yin syndrome

  
 4. 1 Principle of the Tai Yin syndrome
 The manifestations of Tai Yin Syndrome are
abdominal distention and vomiting, poor
 Appetite, diarrhea which is becoming more acute
with occasional abdominal pain. if a purgative is
given, hardness and fullness in the epigastrium
will result. (273)
 
Tai yin syndrome—interior, deficiency, cold. Caused by evil directly
or
transited invades, or incorrect treatment.
abdominal distention—deficient cold stagnates in abdomen.
vomiting—sp deficiency fails to descend.
poor appetite, diarrhea—sp deficiency fails to transformation
occasional abdominal pain—deficient cold with qi stagnation
a purgative given, hardness and fullness in the epigastrium will
result—
incorrect purging injures sp yang.
 4. 2 Primary syndromes of Tai Yin
 Diarrhea without a thirst is syndrome of
Tai Yin. It is caused by deficiency cold of
viscera. The treatment is warming, using
the groups formula of groups of Si Ni
Tang (277).

We often use Xiao Jiang Zhong Tang.

 4.2.1The accompanying with
symptoms of Tai Yin Syndrome
 
 Accompanying with exterior: used Gui
Zhi Tang (276)
 The Tai Yin syndrome with floating
pulse, the patient can be treated by
diaphoresis. Using Gui Zhi Tang(276).
 Accompanying with abdominal pain
 Gui Zhi Jia Shao Yao Tang(279).
 Gui Zhi Jiao Da Huang Tang(279)
 
 
 Accompanying with Yang qi deficiency
 
 
 
Chapter 5 Shao Yin
syndrome
 Shao Yin includes the heart of hand
Shao Yin and kidney of foot Shao Yin. It
is the critic stage if pathogens attacks
the Shao Yin. There are transited heat
syndromes and transited cold
syndrome, according to the constitution
of patients. The Tai Yang Syndromes
are easy to transit to Shao Yin because
they have exterior and interior relations.
 Cold syndrome of Shao Yin is Yang
deficiency of heart and kidney, and yin
cold is excess interior. The manifestations
are feeble and weak pulse, tendency to
fall asleep, chill without fever, tongue
stiffness, vomiting, diarrhea with cold,
clear and complete indigestion, cold
extremities, clear and long urinary, pale
tongue with white coating. The ,,,, patient
will have true cold and false heat that are
reddish face, no chill. Warm Yang is the
treatment, eg, Si Ni Tang.
 Heat syndrome of Shao Yin is kidney
yin deficiency in the lower and Yang
hyperactivity of heart in the upper. The
manifestations are anxiety, insomnia,
red tongue, thready and rapid pulse.
Nourishing Yin and clearing heat is
main treatment, eg, Huang Lian E jiao
Tang.
 
  5. 1 Principle of the Shao Yin syndrome
 Shao Yin Syndrome, the manifestations are feeble and weak pulse,
tendency to fall asleep(281).
Shao Yin syndrome

Causes & pathology: constitution is deficiency of heart & kidney, qi &

blood,
suffers cold
 feeble and weak pulse—deficiency of qi, blood, yin and yang
tendency to fall asleep—deficiency of yin & yang.

 5.2 Primary syndromes of Shao Yin

 5.2.1 Cold syndrome of Shao Yin
 Si Ni Tang
 Shao Yin Syndrome with deep pulse, warming urgently, Si
Ni Tang(323). (324)
Fu Zi—Ren12(warm), GB34
Gan Jiang—Ren8, Ren6(warm)
Gan Cao—St36, PC6

Function: Warm Yang, recuperating the depleted yang & rescuing the patient from danger.
Used for: the syndrome of depleted yang, and Shao Yin disease.  

Tong Mai Si Ni Tang(317)

 Bai Tong Tang and Bai Tong Jia Zhu Dan Zhi Tang(314,
315) 
 Zen Wu Tang(316)
 
 Fu Zi Tang(304, 305)
 Fu Zi 12g—UB21,UB23(warm),
 Fu Ling 9g—Sp9, Ren4
 Ren Shen 6g—Lu7
 Bai Zhu 12g—St36
 Bai Shao 9g—Sp6

Function: Warm yang, promote urine.

 Wu Zhu Yu Tang(309)
 Wu zhu yu—(warm)Ren12, Needing Liv13
 Ren shen, Da zao—St 36, Ren 10
 Sheng jiang—PC6, Liv3
Function: Warm & Descend Liv., & St.,For vomiting
, headache.

Tao Hua Tang(306, 307)

 Chi Shi Zhi 30g—St25, UB25(warm)
 Gan Jiang 3g—Warm St36 & Ren6
  geng mi
 Function: Warm Middle and stop diarrhea.
 Acupuncture(308, 292, 325)
 5.2.1 Heat syndrome of Shao Yin
 
 Huang Liang E Jiao Tang
 Shao Yin Syndrome, after two or three days, anxiety, insomnia,
Huang Liang E Jiao Tang(303).
 Huang Lian
 Huang Qin
 Bai Shao
 Ji Zi Huang
 E Jiao

 Ying Tang
 Ht7, Ki6
 St36, Sp6
Function: Nourish yin, descend fire, balance ht & Ki
 Zhu Ling Tang(319)
 
 
 5.3 The transition syndrome of Shao Yin
syndrome
 Ma Huang Xi Xin Fu Zi Tang(301)
 Si Ni San(318)
Chapter 5 Shao Yin
syndrome
 Shao Yin includes the heart of hand
Shao Yin and kidney of foot Shao Yin. It
is the critic stage if pathogens attacks
the Shao Yin. There are transited heat
syndromes and transited cold
syndrome, according to the constitution
of patients. The Tai Yang Syndromes
are easy to transit to Shao Yin because
they have exterior and interior relations.
 Cold syndrome of Shao Yin is Yang
deficiency of heart and kidney, and yin
cold is excess interior. The manifestations
are feeble and weak pulse, tendency to
fall asleep, chill without fever, tongue
stiffness, vomiting, diarrhea with cold,
clear and complete indigestion, cold
extremities, clear and long urinary, pale
tongue with white coating. The ,,,, patient
will have true cold and false heat that are
reddish face, no chill. Warm Yang is the
treatment, eg, Si Ni Tang.
 Heat syndrome of Shao Yin is kidney
yin deficiency in the lower and Yang
hyperactivity of heart in the upper. The
manifestations are anxiety, insomnia,
red tongue, thready and rapid pulse.
Nourishing Yin and clearing heat is
main treatment, eg, Huang Lian E jiao
Tang.
 
  5. 1 Principle of the Shao Yin syndrome
 Shao Yin Syndrome, the manifestations are feeble and weak pulse,
tendency to fall asleep(281).
Shao Yin syndrome

Causes & pathology: constitution is deficiency of heart & kidney, qi &

blood,
suffers cold
 feeble and weak pulse—deficiency of qi, blood, yin and yang
tendency to fall asleep—deficiency of yin & yang.

 5.2 Primary syndromes of Shao Yin

 5.2.1 Cold syndrome of Shao Yin
 Si Ni Tang
 Shao Yin Syndrome with deep pulse, warming urgently, Si
Ni Tang(323). (324)
Fu Zi—Ren12(warm), GB34
Gan Jiang—Ren8, Ren6(warm)
Gan Cao—St36, PC6

Function: Warm Yang, recuperating the depleted yang & rescuing the patient from danger.
Used for: the syndrome of depleted yang, and Shao Yin disease.  

Tong Mai Si Ni Tang(317)

 Bai Tong Tang and Bai Tong Jia Zhu Dan Zhi Tang(314,
315) 
 Zen Wu Tang(316)
 
 Fu Zi Tang(304, 305)
 Fu Zi 12g—UB21,UB23(warm),
 Fu Ling 9g—Sp9, Ren4
 Ren Shen 6g—Lu7
 Bai Zhu 12g—St36
 Bai Shao 9g—Sp6

Function: Warm yang, promote urine.

 Wu Zhu Yu Tang(309)
 Wu zhu yu—(warm)Ren12, Needing Liv13
 Ren shen, Da zao—St 36, Ren 10
 Sheng jiang—PC6, Liv3
Function: Warm & Descend Liv., & St.,For vomiting
, headache.

Tao Hua Tang(306, 307)

 Chi Shi Zhi 30g—St25, UB25(warm)
 Gan Jiang 3g—Warm St36 & Ren6
  geng mi
 Function: Warm Middle and stop diarrhea.
 Acupuncture(308, 292, 325)
 5.2.1 Heat syndrome of Shao Yin
 
 Huang Liang E Jiao Tang
 Shao Yin Syndrome, after two or three days, anxiety, insomnia,
Huang Liang E Jiao Tang(303).
 Huang Lian
 Huang Qin
 Bai Shao
 Ji Zi Huang
 E Jiao

 Ying Tang
 Ht7, Ki6
 St36, Sp6
Function: Nourish yin, descend fire, balance ht & Ki
 Zhu Ling Tang(319)
 
 
 5.3 The transition syndrome of Shao Yin
syndrome
 Ma Huang Xi Xin Fu Zi Tang(301)
 Si Ni San(318)
Chapter 6 Jue Yin Bing

 6. 1 Principle of the Jue Yin syndrome

 Jue Yin Syndrome, the manifestations are
great thirst, an uncomfortable feeling of
ascending air rushing up from below the
epigastrium, a hot and painful feeling in the
stomach, and hunger without being able to
take in food. Once food is taken, ascarids will
be vomiting up. If a purgative is given, there
will be continuous diarrhea(326).
 heat in upper—great thirst, an uncomfortable feeling of
Jueyin, heat & cold disorder

ascending
air rushing up from below the epigastrium, a
hot and
painful feeling in the stomach
cold in lower—hunger without being able to take in food,
Once food is taken, ascaridws will be vomiting
up
purging yang
in lower--------If a purgative is given, there will be continuous
diarrhea
The final exam will be at Dec.12th, 2008.
Please review.
If you have questions, please ask me or
classmates.
 6.2 The syndrome of Heat in the upper and
cold in the lower.
  Wu Mei Wan(338)
 Wu Mei, Xi Xin, Gan jiang, Fu Zi, Gui Zhi
 Chuan Jiao, Huang Lian, Huang Bai, Ren Shen, Dan Gui

 LI4, Liv3, PC6, UB20—clear heat in upper Jiao

 Liv13, St36, Sp6—warm cold in lower Jiao
 Bai Chong Wo—kill worms

Function: warm Yang clear heat, calm worm relieve pain

 Shang Han pulse weak, cold extremities—yang deficiency
cold skin until seven or eight days—yang weak
Zang reversal (Jue)—Zang cold extremely
Roundworm Jue—cold in stomach leading to abnormal activity.

 Wu Mei Wan
 Xi Xin, Gan jiang, Fu Zi, Gui Zhi—warm yang, expel cold.
Wu Mei, Chuan Jiao—calm stomach, expel roundworm.
Huang Lian, Huang Bai—clear heat, dry dampness, expel worm
Ren Shen, Dang Gui—tonify qi and blood.

 LI4, UB18, PC6, St20—clear heat in upper

 Liv13, Ren12, St36, Sp6—warm cold in lower
 Bai Cong Wo—expel worm
 Gan Jiang Huang Qin Huang Lian Ren Shen
Tang(359).
 
 Ma Huang Shen Ma Tang(357)
 
 6.3 The Jue (cold extremities) Syndrome

 Heat Jue syndrome(350): Bai Hu Tang

 Cold jue syndrome(353, 354, 349):
 Shang Han with running pulse(Cu Mai), severe cold
extremities, moxibustion can be practiced(349).
 Si Ni Tang
 Dang Gui Si Ni Tang(351)
Dang Gui
Gui Zhi
Bai Shao
Xi Xin
Gan Cao
Tong Cao
Da Zao

Function: tonify blood, warm & expel cold, unblock channels.

6.4 Vomiting due to liver cold

Wu Zhu Yu Tang(379)