ESSENTIAL CHINESE MEDICINAL MATERIALS

A Presentation of Commonly Used Chinese Herbs

by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon

The study of the Chinese medicinal materials can be a daunting task due to the very large number of items. Although there are many thousands of species of plants (as well as many hundreds of species of animals and a substantial number of minerals) that serve as sources for Chinese medicinal materials, there are only about 1,000 basic entries in the Materia Medica (guide book to medicinal materials). This is because, on average, about 6–8 different species are used as sources for the same basic herb. Most often, these different species are of the same genus and are closely related plants, with similar appearance and with similar active components; in a few cases, a diverse group of plants, botanically unrelated, may be included as sources for the same Materia Medica entry.

A collection of 1,000 medicinal materials is presented in volume 1 of the two volume set called Thousand Formulas and Thousand Herbs of Traditional Chinese Medicine (by Huang Bingshan and Wang Yuxia; 1993 Heilongjiang Press, Harbin; out of print). Over 700 entries, most of them with listings of several source materials, is presented in Oriental Materia Medica (by Hsu Hongyen, et al., 1986 Oriental Healing Arts Institute, Long Beach, CA), which was the main source text for the current presentation. A text used in most colleges of traditional Chinese medicine in the U.S. is Chinese Herbal Medicine Materia Medica (Bensky D and Gamble A, 1993 revised edition, Eastland Press, Seattle, WA), which is undergoing revision for the third edition (expected in 2002); it presents nearly 500 items.

While it is important for the competent Chinese herbalist to be familiar with a large collection of the medicinal materials to be able to maximize flexibility in formulating prescriptions useful for all kinds of health problems, the fact is that only about 180 medicinal materials are heavily relied upon: these are the essential ones. This smaller collection of items forms a more suitable basis for the study of Chinese medicinal materials, where the practitioner is quite familiar with their names, properties, and applications in traditional and modern formulas. From this relatively smaller base, which is within the realm of all students to learn, one can readily expand one’s horizons to incorporate an increasingly large number of items that are less frequently used or more recently introduced into the practice of Chinese medicine.

The names, properties, and uses of Chinese medicinal materials are generally presented for study and reference in a specific format that was developed during the 20^th century: in groupings by select therapeutic categories. There are about 20 main headings (exact number depending on the presenter’s view of the matter), and there are subdivisions for some of the main headings. This same basic format will be followed here. The concept behind these divisions is that an herb will be listed according to its main therapeutic indication, so that herbs having a similar action will be grouped together. For the most part, this procedure works quite well, but it does have drawbacks when an herb has two therapeutic properties that are of roughly equal importance, or where the use of an herb shifts (at least in emphasis) over time. However, this is a relatively minor problem in contrast to the matter of selecting, from the large number of items, which ones need to be carefully studied.

In the following presentation, for each category (or subcategory), the commonly used herbs are listed along with distinguishing features that illustrate their uniqueness within the category. There are also some comments, mainly aimed at revealing the use of the item in formulas. In general, there are only 6–12 items within each category or subcategory (the largest group is 15 blood vitalizing agents), making it quite easy to study the materials. All of this basic information is contained in convenient table format. For the herb name, a common name, the pinyin name, and one of the commonly used botanical sources (or animal or mineral sources) is given. A summary statement then follows each table, including one paragraph briefly mentioning herbs that are from other categories that frequently are combined with the herbs of the category under consideration. Finally, there is a listing comprised of commonly used traditional formulas that contain the herbs of the category (and which may contain those herbs mentioned as being frequently combined with them).

The formulas included in this presentation are those listed in the book Commonly Used Chinese Herb Formulas, Companion Handbook (Hsu Hong-yen and Hsu Chau-shin, Oriental Healing Arts Institute, 2^nd revised edition, 1997.), relying only on those formulas listed in well-known Chinese texts. For purposes of this presentation, the entire formulation is not given (the details can be pursued by looking in a book of formulas, such as the mentioned source book), but only the ingredients of immediate concern in relation to the subject just outlined are listed. This information helps illustrate the patterns of herb combining in relation to the therapeutic principle being addressed by the herb category: it helps reveal which herbs go together in traditional formulas. An attempt has been made to include as many formulas as possible so that the patterns of combining become more evident. To further make the study of the medicinal materials easy and convenient, the categories of herb therapy have been laid out so as to have just two pages devoted to each subject: one page has a table of the herbs and one page has a summary and listing of formulas.

The selected formulas rely somewhat heavily on those that are preferred by Kampo style practitioners (influenced by the Japanese system). The authors of the formula reference book used here had training in Japan and worked in Taiwan, where the Japanese system has been widely adopted. In particular, many of the formulas come from just a handful of traditional texts mainly:

Shang Han Lun and Jin Gui Yao Lue by Zhang Zhongjing;

Tai Ping Hui Min He Ji Ju Fang by Chen Shiwen; and

Wan Bing Hui Chun (and to a much lesser extent, Shou Shi Bao Yua) by Gong Tingxian.

The formulas of Gong Tingxian are used far more in Kampo medicine than in Chinese medicine as practice in mainland China; the other sources are relied on in China. Secondary sources are:

Zheng Zhi Zhun Sheng by Wang Kentang; and

Yi Fang Ji Jie and Tang Tou Ge Jue by Ang Wang.

There are also some contributions from Qian Jin Yao Fang by Sun Simiao; Nei Wai Shang Bian Huo Lun and Lan Shi Mi Cang by Li Dongyuan (Li Gao); Dan Xi Xin Fa by Zhu Danxi, and Wen Bing Tiao Bian by Tang Wu. The last three authors are frequently referenced in mainland China guides. Another author, Wang Qingren, contributed some formulas mentioned under the heading of blood vitalizing herbs in the current presentation; these were added to the 2^nd revised edition of the reference text due to their importance to practitioners who study the Chinese, rather than Japanese, system of herb prescribing.

By relying on the formulas relayed by these few authors, one finds that certain patterns of herb combining are conserved, and the variety of herbs used frequently is also limited.

CONTENTS

Relieve Surface, Dispel Wind-Chill.......................................................................................................

Relieve Surface Dispel Wind-Heat.......................................................................................................

Purgatives (attacking and moisturizing)............................................................................................

Clear Heat, Purge Fire (and purge fire, clarify vision)......................................................................

Clear Heat, Cool Blood..........................................................................................................................

Clear Heat, Dry Dampness...................................................................................................................

Clear Heat, Relieve Toxin......................................................................................................................

Dispel Moisture......................................................................................................................................

Dispel Wind-Damp................................................................................................................................

Dispel Chill, Warm Interior...................................................................................................................

Aromatic Moisture Resolvers..............................................................................................................

Blood Vitalizers......................................................................................................................................

Relieve Surface; Dispel Wind-Chill

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Allium congbai Allium fistulosum	invigorates yang	The chive bulb (allium) is a common ingredient in food therapy for wind-cold disorders.
Angelica baizhi Angelica dahurica	analgesic, resolves pustules, dries dampness, controls leukorrhea	A major ingredient for treatment of pain and treatment of skin eruptions.
Asarum xixin Asarum sieboldii	dispel chill, resolve phlegm accumulation, alleviate coughing, analgesic	Mainly used in cold syndromes where there is a respiratory system disorder or arthralgia.
Cinnamon twig guizhi Cinnamomum cassia	warms the meridians, reinforces yang, aids blood circulation	Especially used when there is a combination of deficiency syndrome and obstructive condition (e.g., surface congestion, blood stasis).
Ma-huang mahuang Ephedra sinica	strong diaphoretic, opens sinuses and lungs, regulates fluids	Especially used when there is a combination of excess syndrome, lack of perspiration, and fluid obstructive condition (e.g., sinus congestion, edema)
Siler fangfeng Ledebouriella seseloides	removes dampness, nourishes spleen, analgesic	Often used for surface pain syndromes and skin disorders, including rashes and eruptions.
Magnolia flower xinyi Magnolia liliflora	opens blocked sinuses	Primarily used for sinus disorders; sometimes used for headaches.
Chiang-huo jianghuo Notopterygium incisium	Analgesic	Mainly used in treatment of pain syndromes such as headache and arthralgia; sometimes used for skin eruptions.
Perilla zisuye Perilla frutescens	strengthens stomach, alleviates intestinal gas, antitussive	Mainly used in treating respiratory system disorders.
Schizonepeta jingjie Schizonepeta tenuifolia	analgesic, resolves pustules	Frequently used in treatment of skin disorders, including rashes and eruptions; also for ear, nose, and throat disorders.
Fresh ginger shengjiang Zingiberis officinalis	warms the stomach and spleen	Used in diaphoretic formulas and in treatments for deficiency cases, with weak stomach/spleen function; also an aid to resolving phlegm accumulation.

Summary

The herbs that dispel wind and chill to resolve the surface are primarily employed when symptoms involve the skin, muscles, joints, and head (ear, eye, nose, throat, mouth). In general, the herbs have a diaphoretic action (dilating the peripheral blood vessels, warming the skin, opening the pores, and allowing increased perspiration), interpreted in ancient times as opening the pores to let wind (and evil influences it carries) exit the body surface. Some of the herbs are particularly useful as analgesics (e.g., angelica, asarum, chiang-huo, siler, schizonepeta), while others are particularly useful for clearing mucus congestion (e.g., ma-huang, magnolia flower, perilla). Some are used for treating skin rashes and eruptions (e.g., angelica, siler, schizonepeta), while others are used for treating lack of perspiration (ma-huang, cinnamon, ginger). Some of the herbs benefit the spleen/stomach (e.g., ginger, siler, perilla) and others benefit the yang (e.g., allium, cinnamon twig), so these herbs are particularly used in persons with deficiency syndromes.

Two of the herbs have safety concerns raised in modern times that limit their use: ma-huang and asarum. Ma-huang contains the alkaloid ephedrine, which has been provided in high doses as an energy tonic (stimulates the central nervous system) and weight loss aid (increases metabolism). Adults relying on ephedrine for these purposes have sometimes experienced adverse cardiac consequences. Asarum contains ingredients that may harm the kidneys if it is used regularly and in large doses. Because the safe level for use of asarum is not established and since some individuals may be more sensitive to the herb constituents then others, its use has become limited. These two herbs are included in numerous ancient formulas (they were common in Shang Han Lun formulas for example); now other herbs in this category have become more dominant. In particular, there is heavier reliance on angelica, siler, and chiang-huo (all from the same plant family, Umbelliferae) and on schizonepeta and perilla (both from the Mint family, Labiatae). Cinnamon twig and fresh ginger, among the most commonly used herbs in the Shang Han Lun formulations, remain key herbs in the practice of Chinese medicine.

There are some herbs listed in other materia medica categories that are often incorporated into formulas along with the herbs of the wind-chill dispelling category. The main ones are cnidium (chuanxiong, listed with the blood vitalizers; it is a relative of angelica, siler, and chiang-huo that also dispels wind); cyperus (xiangfuzi; listed with the qi regulators; it also dispels wind); and ingredients of the accompanying category of herbs that dispel wind-heat, particularly pueraria (gegen) and mentha (bohe).

Sample Traditional Formulas

The following are samples of ancient formulas that include at least three ingredients from this Materia Medica section. Many short formulas, such as Guizhi Tang (Cinnamon Combination), contain only one or two of the ingredients (e.g., Cinnamon Combination has cinnamon and fresh ginger).

· Shishen Tang (Ma-huang and Cimicifuga Combination) with ma-huang, angelica, perilla, fresh ginger, and allium; also: cnidium, cyperus, and pueraria.

· Xiao Qinglong Tang (Minor Blue Dragon Combination) with ma-huang, cinnamon, and asarum.

· Chuanxiong Chatiao San (Cnidium and Tea Formula) with chiang-huo, siler, schizonepeta, and angelica; also: cnidium, cyperus, and mentha.

· Gegen Tang (Pueraria Combination) with cinnamon, ma-huang, and fresh ginger; also: pueraria.

· Wuji San (Tang-kuei and Magnolia Formula) with ma-huang, cinnamon, fresh ginger, and angelica; also: cnidium.

· Fangfeng Tongshen San (Siler and Platycodon Formula): ma-huang, schizonepeta, siler, and fresh ginger; also: cnidium and mentha.

· Qianjin Neituo San (Astragalus and Platycodon Formula): cinnamon, angelica, and siler; also: cnidium and mentha.

· Jing Fang Baidu San (Schizonepeta and Siler Formula): siler, schizonepeta, chiang-huo; also: cnidium.

· Jingjie Lianqiao Tang (Schizonepeta and Forsythia Combination): siler, schizonepeta, angelica; also: cnidium and mentha.

Relieve Surface; Dispel Wind-Heat

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Arctium niubangzi Arctium lappa	soothes the throat, ventilates the lungs, resolves eruptions	Frequently used in formulas for sore throat and for skin eruptions
Bupleurum chaihu Bupleurum chinense	regulates liver qi, raises yang qi	Used in treating disorders that combine internal syndromes with external syndromes
Chrysanthemum juhua Chrysanthemum morifolium	clarifies vision, soothes liver yang	Used for headaches, eye inflammation, and skin eruptions. Wild chrysanthemum (yejuhua) is preferred for headaches.
Cicada chantui Cryptotympana atrata	alleviates spasms, resolves pruritis	Frequently used in childhood disorders marked by convulsions or pruritis.
Cimicifuga shengma Cimicifuga heracleifolia	alleviates skin eruptions, soothes the throat, raises yang qi	Often used in treating sore throat.
Mentha bohe Mentha arvensis	alleviates skin eruptions, soothes the throat	General use in treating wind-heat; has mild action
Morus leaf sangye Morus alba	soothes liver	Used for headaches and eye disorders in which there is an underlying liver heat disorder
Pueraria gegen Pueraria lobata	regulates muscles, alleviates thirst	Commonly used in treatment of muscle tension affecting neck and shoulders; also used for disorders accompanied by thirst
Soja dandouchi Glycine max	alleviates fidgets and sense of fullness in the chest, soothes throat	Used mainly in disorders that affect the throat.
Vitex manjingzi Vitex rotundifolia	clears the eyes, analgesic	Primarily used for eye disorders with pain and headaches

Summary

The herbs that dispel wind and heat to resolve the surface are primarily employed when there are symptoms affecting the head (ear, eye, nose, throat, oral cavity) and for skin disorders. In general, the herbs alleviate infections and are thus used in treating skin eruptions, sore throat, and infected eyes, ears, and sinuses; several also alleviate pain and are used in treatment of headaches. Some of the herbs soothe the throat and are mainly used in throat disorders (e.g., cimicifuga, arctium, soja); some cool the liver and are therefore used for cases of mixed internal and external wind-heat, as occurs with hypertensive headaches (e.g., chrysanthemum, morus leaf); some herbs are particularly useful for eye disorders (e.g., vitex and chrysanthemum), and some are used for relieving muscle tension (e.g., bupleurum and pueraria).

There are a few herbs listed in other materia medica categories that are often incorporated into formulas along with the herbs of the wind-heat dispelling category. The main ones are peony (baishao, listed with the blood tonics; it nourishes the liver and calms rising heat from the liver); forsythia (lianqiao; listed with the herbs for removing toxic heat; it helps treat infections); platycodon (jiegeng; listed with the phlegm resolvers; it also resolves skin eruptions and soothes the throat); and ingredients of the accompanying category of herbs that dispel wind-chill, particularly schizonepeta (jingjie) and fresh ginger (shengjiang).

Sample Traditional Formulas

The following are samples of ancient formulas that include at least two ingredients from this Materia Medica section (few formulas contain more than 2-3 herbs from this category).

· Shishen Tang (Ma-huang and Cimicifuga Combination) with pueraria, cimicifuga; also: peony, fresh ginger.

· Renshen Baidu San (Ginseng and Mentha Formula) with mentha and bupleurum; also: fresh ginger and platycodon.

· Chai Ge Jieji Tang (Bupleurum and Pueraria Combination) with bupleurum and pueraria; also, peony, platycodon and fresh ginger.

· Yin Qiao San (Lonicera and Forsythia Formula) with mentha, soja, and arctium; also: schizonepeta, forsythia, and platycodon.

· Sang Ju Yin (Morus and Chrysanthemum Combination) with morus leaves, chrysanthemum, and mentha; also: forsythia and platycodon

· Xiao Yao San (Bupleurum and Tang-kuei Formula) with bupleurum and mentha; also: peony and fresh ginger.

· Qingyan Lige Tang (Arctium Combination) with arctium and mentha; also: schizonepeta, forsythia, and platycodon.

· Baidu San (Rehmannia and Lonicera Formula) with arctium, bupleurum, and mentha; also: peony, forsythia, and platycodon.

· Puji Xiaodu Tang (Scute and Cimicifuga Combination): with cimicifuga, mentha, arctium, and bupleurum; also: forsythia and platycodon.

· Xigan Mingmu Tang (Gardenia and Vitex Combination) with mentha, chrysanthemum, and vitex; also: peony, forsythia, and platycodon.

· Zishen Mingmu Tang (Chrysanthemum Combination) with chrysanthemum and vitex; also: peony and platycodon.

· Jing Fang Baidu San (Schizonepeta and Siler Formula): bupleurum and mentha; also: schizonepeta, forsythia, and platycodon.

· Jingjie Lianqiao Tang (Schizonepeta and Forsythia Combination): bupleurum and mentha, also: schizonepeta, peony, forsythia, and platycodon.

· San Zhong Kui Jian Tang (Forsythia and Laminaria Combination): bupleurum, cimicifuga, and pueraria; also: peony, platycodon, forsythia, and fresh ginger.

Purgatives

Attacking Purgatives

Common, Pinyin, Sources

Additional or Dominant Properties

Comments

Mirabilitum

mangxiao

Magnesium sulfate

softens hardness, clears heat

Mirabilitum purges at the site of the small intestine; it retains moisture in the colon, treating hard constipation; is also used in formulas for abdominal masses

Rhubarb

dahuang

Rheum palmatum

cools blood, vitalizes blood

The primary stimulant laxative; it purges from the site of the colon; it is also used to treat blood stasis syndromes.

Moistening Purgatives

Common, Pinyin, Sources

Additional or Dominant Properties

Comments

Cannabis seed

maziren

Cannabis sativa

nutritive

Used for chronic constipation with dryness. Sometimes substituted by linum (flax seed).

Sesame seed

humaren

Sesamum indicum

nourishes liver and kidneys

Used for chronic constipation with dryness, especially in weakened individuals.

Summary

Purgation therapy was once one of the major treatments for diseases and was important in the Shang Han Lun, where rhubarb, with or without mirabilitum, was used to treat a disease stage characterized by contipation and dryness. Attacking purgatives, such as these, are used primarily for acute constipation. By contrast, the moisturizing purgatives are mainly used for chronic constipation (often with rhubarb in small amounts).

Rhubarb and mirabilitum differ significantly in their actions. Rhubarb has a more delayed action, affects the colon, and has a stimulant effect on the intestinal peristalsis. Mirabilitum causes the small intestine to empty, which is a more rapid action and will then affect the colon; in addition, the magnesium in mirabilitum retains water in the intestines, causing the stool to soften (in ancient times, sodium sulfate was used, and this did agent did not have the same water-retaining action for the intestinal contents). The moisturizing purgatives are rich in oils that are poorly absorbed; they lubricate the intestines to treat dry constipation, and produce a mild laxative effect due to their oiliness (which stimulates the gallbladder to purge bile and, thereby, increase intestinal peristalsis.

There are a few herbs listed in other materia medica categories that are often incorporated into formulas along with these purgative herbs. The main ones used with the attacking purgatives are magnolia bark (houpu, categorized with the fragrant herbs for resolving moisture, but which has a mild laxative action), chih-shih (zhishi, categorized with the herbs for regulating qi; it helps purge the gallbladder), and gardenia (zhizi; categorized with the fire purging herbs; it has a mild laxative action). The main ones used with the moisturizing purgatives are persica (taoren; categorized with blood-vitalizing herbs, but containing oils that serve as a moisturizing purgative) and apricot seed (xingren; categorized with the antitussive herbs, but containing oils similar to those in persica).

Sample Traditional Formulas

The following are samples of ancient formulas that include ingredients from this Materia Medica section.

· Da Chengqi Tang (Major Rhubarb Combination) with rhubarb and mirabilitum; also magnolia bark and chih-shih.

· Xiao Chengqi Tang (Minor Rhubarb Combination) with rhubarb; also magnolia bark and chih-shih.

· Tiaowei Chengqi Tang (Rhubarb and Mirabilitum Combination): with rhubarb and mirabilitum.

· Da Chaihu Tang (Major Bupleurum Combination) with rhubarb; also, chih-shih.

· Fangfeng Tongshen San (Siler and Platycodon Formula): rhubarb and mirabilitum; also: gardenia.

· Houpu Qiwu Tang (Magnolia Seven Combination): rhubarb; also: magnolia bark and chih-shih.

· Liangge San (Forsythia and Rhubarb Formula) with rhubarb and mirabilitum; also: gardenia

· Qingshang Yin (Bupleurum and Gardenia Combination) with rhubarb and mirabilitum; also: magnolia bark, chih-shih, and gardenia.

· Tongdao San (Tang-kuei and Carthamus Formula) with rhubarb and mirabilitum; also: magnolia bark and chih-shih.

· Maziren Wan (Apricot Seed and Linum Formula) with rhubarb, cannabis seed (linum); also: magnolia bark, chih-shih, and apricot seed.

· Runchang Tang (Linum and Rhubarb Combination) with rhubarb, cannabis seed (linum); also: magnolia bark, chih-shih, apricot seed, and persica.

Clear Heat, Purge Fire

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Anemarrhena zhimu Anemarrhena asphodeloides	Nourishes kidney yin, moistens dryness	Especially used in cases of yin deficiency fire
Gardenia shanzhizi (or zhizi) Gardenia jasminoides	cools blood; mild purgative	Commonly used in treatment of bleeding due to blood heat syndrome; an ingredient in formulas for oral ulceration and insomnia.
Gypsum shigao Gypsum (calcium sulfate)	alleviates thirst	Used in treatment of high fevers and for heat disorders accompanied by thirst.
Lophatherum danzhuye Lophatherum gracile	resolves phlegm	Sometimes substituted by bamboo leaves (Phyllostachys nigra); mainly used to treat upper respiratory disorders.
Phragmites lugen Phragmites communis	alleviates thirst and dryness	Mainly used in cases of upper respiratory diseases accompanied by thirst.
Prunella xiakucao Prunella vulgaris	resolves phlegm-masses	A common ingredient in formulas for thyroid swellings (goiter) and lumps beneath the skin (scrofula, breast lumps).

Purge Fire, Clarify Vision

Buddleia mimenghua Buddleeia officinalis	clears vision, dispels wind-heat	Used almost exclusively for treating eye disorders, especially those with swelling and pain, but also for retinal disorders and cataracts.
Cassia seed juemingzi Cassia tora	clears vision; mild laxative	In addition to being included in formulas for eye disorders, this herb is currently used to reduce absorption of dietary fats.
Celosia qingxiangzi Celosia argentea	clears vision, dispels wind-heat	Used almost exclusively for treating eye disorders, especially with swelling and pain, but also for retinal disorders.
Chien-li-kuang (or Senecio) qianliguang Senecio scandens	reduces inflammation due to infections, dispels wind-heat, clears vision	Used as a treatment for serious bacterial infections and also for eye diseases, especially cataracts.

Summary

The herbs that purge fire mainly treat infectious diseases that cause fever, but they may be used also for chronic diseases which manifest fire category symptoms, such as sweating, thirst, feverish feeling (without elevated body temperature), fidgets, and swellings. The main fire purging herbs are anemarrhena, gardenia, and gypsum. There is a subcategory of herbs that are mainly used in the treatment of eye disorders due to fire syndrome, which usually involves an acute infectious or allergic disorder that produces swelling, hyperemia, and pain; these same herbs may be used for chronic eye diseases, such as retinal degeneration and cataracts.

There are some herbs listed in other materia medica categories that are often incorporated into formulas along with the herbs of the fire-purging category. The main ones are phellodendron (huangbai) and scute (huangqin), both listed in the category of herbs that clear heat and dry dampness, and raw rehmannia (sheng dihuang) in the category of herbs that clear heat and cool blood. For the vision clarifying herbs, the formulas frequently include herbs for wind-heat that clarify vision, namely chrysanthemum (juhua) and vitex (manjingzi).

Sample Traditional Formulas

The following are samples of ancient formulas that include at least two ingredients from this Materia Medica section.

· Yin Qiao San (Lonicera and Forsythia Formula) with lophatherum and phragmites

· Sanhuang Shigao Tang (Gypsum, Coptis, and Scute Combination) with gardenia and gypsum; also: phellodendron and scute.

· Fangfeng Tongshen San (Siler and Platycodon Formula): gardenia and gypsum; also: scute.

· Baihu Tang (Ginseng and Gypsum Combination): anemarrhena and gypsum.

· Yu Nu Jian (Rehmannia and Gypsum Combination): anemarrhena and gypsum; also: raw rehmannia.

· Xinyi Qingfei Tang (Magnolia and Gypsum Combination): anemarrhena, gardenia, and gypsum; also: scute.

· Xie Huang San (Siler and Licorice Formula): gardenia and gypsum.

· Xigan Mingmu Tang (Gardenia and Vitex Combination): gardenia, gypsum, cassia seed; also: scute, raw rehmannia, chrysanthemum, and vitex.

Clear Heat, Cool Blood

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Lithospermum zicao Lithospermum euchroma	alleviates rashes and resolves swellings	Especially used in cases of reddened skin.
Moutan mudanpi Paeonia moutan	invigorates blood stagnation	Used for heat in the liver; a common ingredient in formulas for regulating menstruation
Hu-chang huzhang Polygonum cuspidatum	dries dampness	Of renewed interest due to finding antiviral properties and increased use in treatment of microcirculation disorders.
Raw rehmannia sheng dihuang Rehmannia glutinosa	nourishes yin, controls bleeding	The yin-nourishing effects are commonly mentioned as a basis for selecting this herb.
Ox horn shuiniu jiao Bos taurus	alleviates high fevers, relieves convulsions	This is the main substitute for the formerly used item rhino horn (xijiao) and is often included in aromatic formulas that open the orifices and clear heat.
Scrophularia xuanshen Scrophularia ningpoensis	nourishes yin, resolves swellings (scrofula)	A relative of raw rehmannia, this has similar applications but is often relied upon for treating swellings beneath the skin.

Summary

The herbs that clear heat and cool blood treat febrile diseases that enter the blood level, agitate the blood, and cause symptoms of bleeding, spontaneous bruising, or disturbance of mental function (agitation due to heat). This kind of pattern is considered quite dangerous and is usually treated for a short period of time with a small formulation, typically with six or fewer ingredients (exception: prepared pills, such as Zixue Dan). However, several of the herbs are used individually in formulas for other diseases which involve larger formulas and a variety of symptoms: lithospermum for skin disorders; scrophularia for lumps under the skin; moutan for yin nourishing formulas with deficiency heat (example: Rehmannia Six Formula), and raw rehmannia in formulas for bleeding.

Sample Traditional Formulas

The following are samples of ancient formulas that include at least two ingredients from this Materia Medica section. Because many of the famous formulas of this type contained rhino horn, which is no longer used, and because many of the formulas treat diseases that are now considered mainly in the realm of Western medical therapies (e.g. meningitis), the number of formulas presented here is quite limited.

· Qingwei San (Coptis and Rehmannia Formula) with raw rehmannia and moutan

· Baidu San (Rehmannia and Lonicera Formula) with raw rehmannia and scrophularia

· Xijiao Dihuang Tang (Rhino and Rehmannia Combination): raw rehmannia, moutan, ox horn (rhino horn).

· Qinghao Biejie Tang (Ching-hao and Turtle Shell Combination): raw rehmannia and moutan

· Zixue Dan (Rhino and Antelope Horn Formula): ox horn (rhino horn) and scrophularia

Clear Heat, Dry Dampness

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Coptis huanglian Coptis chinensis	alleviates fidgets and mental distress due to heat	Used for intestinal disorders and for agitation due to fire syndrome.
Gentiana longdancao Gentiana scabra	purges gallbladder; alleviates lower warmer damp heat	Used for heat in the liver and gallbladder; especially used with symptoms of red eyes, fire-type headache, and genital itching.
Phellodendron huangbai (or huangbo) Phellodendron amurense	clears deficiency heat	Used with coptis to dry damp-heat and with anemarrhena to clear deficiency heat.
Picrorrhiza huhuanglian Picrorrhiza kurrooa	kills intestinal parasites and microorganisms	Used in the treatment of dysentery and for high fever with sweating.
Scute huangqin Scutellaria baicalensis	stops bleeding due to heat; calms agitation	This is one of the safest and most widely used herbs for clearing heat and drying dampness.
Sophora kushen Sophora angustifolia	alleviates skin damp-heat	Sophora is often used in the treatment of intestinal infections and skin inflammation.

Summary

The herbs that clear heat and dry dampness mainly treat diarrhea due to infection (as opposed to spleen deficiency as cause), skin inflammation, and mental agitation. Modern applications include treatment of hypertension and viral hepatitis. While these herbs are used in short-term treatment of diarrhea, prolonged usage or high doses can cause diarrhea. This is interpreted as being the result of cooling the spleen; from the modern viewpoint, this reaction may be understood in terms of inhibition of normal intestinal flora (preventing the bacteria from maintaining the volume of the feces) and stimulation of the gallbladder (causing intestinal peristalsis).

A few herbs from other materia medica categories are combined with these herbs in producing formulas. In particular, gardenia (classified with the fire-purging herbs) also dries dampness; forsythia (classified with the herbs that clean toxin) is sometimes added to treat infections (particularly for skin) and swellings; and peony (classified with the blood tonics) is sometimes added to clear heat from the liver and blood, and to astringe the intestines.

Sample Traditional Formulas

The following are samples of ancient formulas that include at least two ingredients from this Materia Medica section.

· Banxia Xiexin Tang (Pinellia Combination) with coptis and scute.

· Huangqin Tang (Coptis and Gelatin Formula) with coptis and scute; also peony.

· Sanhuang Shigao Tang (Gypsum, Coptis, and Scute Combination): coptis, scute, phellodendron; also: gardenia.

· Gegen Huanglian Huangqin Tang (Pueraria, Coptis, and Scute Combination): coptis and scute

· Sanhuang Xiexin Tang (Coptis and Rhubarb Combination): coptis and scute.

· Sanwu Huangqin Tang (Scute Three Herb Combination): scute and sophora.

· Chaihu Qinggan Tang (Bupleurum and Rehmannia Combination): coptis, scute, phellodendron; also: gardenia, peony, and forsythia.

· Qingyan Lige Tang (Arctium Combination): coptis, scute; also: gardenia and forsythia.

· Huanglian Jiedu Tang (Coptis and Scute Combination): coptis, scute, phellodendron; also: gardenia.

· Longdan Xiegan Tang (Gentiana Combination): scute and gentiana; also: gardenia

· Jingfu Tang (Bupleurum and Pinellia Combination): coptis and scute.

· Qingliang Yin (Gardenia and Mentha Combination): coptis and scute; also: gardenia and forsythia

· Qingshang Yin (Bupleurum and Gardenia Combination): coptis, scute; also: gardenia and peony

· Wenqing Yin (Tang-kuei and Gardenia Combination): coptis, scute, phellodendron; also: gardenia and peony.

· Danggui Niantong Tang (Tang-kuei and Anemarrhena Combination): scute and sophora root.

· Xigan Mingmu Tang (Gardenia and Vitex Combination): coptis and scute; also: gardenia and forsythia

· Jingjie Lianqiao Tang (Schizonepeta and Forsythia Combination): coptis, scute, phellodendron; also: gardenia, forsythia, and peony.

· Sanzhong Kuijian Tang (Forsythia and Laminaria Combination): coptis, scute, phellodendron, and gentiana; also: forsythia

Clear Heat, Clean Toxin

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Andrographis chuanxinlian Andrographis paniculata	dries dampness	Especially used in cases of dysentery and sore throat.
Isatis leaf daqingye Baphicacanthis cusia	cools blood	Mainly used for epidemic infections that produce erythema or sore throat
Isatis root banlangen Baphicacanthis cusia	soothes the throat	Especially used for treatment of feverish disease accompanied by sore throat.
Dictamnus baixianpi Dictamnus dasycarpus	dispels wind-damp	In modern practice, it is mainly used for skin diseases; also used for rheumatism.
Forsythia lianqiao Forsythia suspensa	disperses accumulations and swellings	The most widely used herb in this category; it is safe and has the added benefit of resolving swellings.
Houttuynia yuxingcao Houttuynia cordata	dries dampness, eliminates abscesses	Particularly used for treatment of lung diseases with colored mucus (discharge of pus from lung abscess).
Lonicera jinyinhua Lonicera japonica	benefits stomach	Usually combined with forsythia, this herb is very gentle to the system and even benefits the stomach functions.
Oldenlandia baihuasheshecao Oldenlandia diffusa	antitumor effects	Modern applications are mainly for cancer patients; it is an herb of low toxicity with reputation for inhibiting tumor growth.
Pulsatilla (or Anemone) baitouweng Pulsatilla chinensis	cools blood, controls diarrhea	Used primarily for dysentery.
Scutellaria banzhilian Scutellaria barbata	antitumor effects	Modern applications of this herb are as an addition to oldenlandia in the treatment of tumors; traditionally used for bleeding due to feverish disease.
Smilax tufuling Smilax glabra	dries dampness	Especially used for skin diseases.
Taraxacum pugongying Taraxacum mongolicum	disperses accumulations	Mainly used for heat toxin that produces masses, such as breast lumps; also for skin eruptions.
Viola zihuadiding (or kudiding) Viola yedoensis	resolves swellings	Especially used for skin eruptions and lumps beneath the skin.

Summary

The herbs that clean toxin mainly treat skin eruptions, sore throat, and swellings (including abscesses and tumors). While there are several toxic herbs that have been used traditionally for such purposes, the ones listed here are all deemed non-toxic. Although the herbs all have general applications for treating infection, inflammation, and swellings, there is some specificity when designing formulas. Thus, for example, houttuynia is usually used for lung and throat disorders; viola and taraxacum are usually used for skin eruptions and lumps beneath the skin; pulsatilla is mainly used for intestinal infections; and oldenlandia and scutellaria are primarily used for treatment of tumors. The herbs used most generally are forsythia and lonicera which have a very mild nature and a broad spectrum of activities. In fact, among the traditional formulas (see below), these two are the only ones frequently mentioned. Many traditional formulas are described as toxin clearing formulas (e.g., in the name are the terms jiedu, baidu, or xiaodu; where du is toxin), but their ingredients are generally from the other heat clearing sections of the materia medica, with the possible addition of forsythia and/or lonicera.

Aside from the herbs of the other heat-clearing sections that are combined with the toxin-cleansing herbs, there are some herbs listed in other materia medica categories that are often incorporated into these formulas. The main ones are mentha (bohe) and arctium (niubangzi), both from the wind-heat dispelling section; schizonepeta (jingjie) from the wind-chill dispelling section; and platycodon (jiegeng), in the category of herbs that resolve phlegm. This group of herbs is relied on for treatment of skin eruptions and abscesses.

Sample Traditional Formulas

The following are samples of ancient formulas that include at least two ingredients from this Materia Medica section.

· Yin Qiao San (Lonicera and Forsythia Formula) with forsythia and lonicera; also: mentha, schizonepeta, arctium, and platycodon.

· Qingyan Lige Tang (Arctium Combination) with forsythia and lonicera; also: mentha, schizonepeta, arctium, and platycodon.

· Baidu San (Rehmannia and Lonicera Formula): forsythia and lonicera; also: mentha, arctium, and platycodon.

· Buji Xiaodu Tang (Scute and Cimicifuga Combination): forsythia and isatis root; also: mentha, arctium, and platycodon.

· Jingfang Baidu San (Schizonepeta and Siler Formula): forsythia and lonicera; also: mentha, schizonepeta, and platycodon.

Dispel Moisture

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Akebia mutong Akebia quinata	clears urinary heat, vitalizes blood	Mainly used in treatment of urinary tract infections; guangmutong, from Aristolochia manschuriensis, used as a source of this herb, is considered toxic.
Alisma zexie Alisma plantago-aquatica	clears heat	Especially used in cases of yin deficiency with dark, scanty urine.
Stephania hanfangji Stephania tetrandra	resolves fluid swellings	Mainly used for knee and ankle swelling; guangfangji, from Aristolochia plants, used as a source of this herb, is considered toxic.
Capillaris yinchenhao Artemisia capillaris	clears damp-heat of the liver-gallbladder	Especially used for treatment of hepatitis causing jaundice (blockage of bile flow).
Coix Yiyiren Coix lachryma-jobi	strengthens the spleen; controls diarrhea; nourishes the skin.	Widely used for damp syndromes including arthralgia (wind-damp), diarrhea (spleen damp), and skin eruptions (damp-heat).
Dianthus qumai Dianthus chinensis	clears urinary heat	Particularly used for treatment of urinary tract infections.
Kochia difuzi Kochia scoparia	dispels wind-heat	Mainly used in treatment of skin diseases with itching.
Plantago seed cheqianzi Plantago asiatica	disperses phlegm damp, clears vision	It is used for fluid-type accumulations, such as prostate swelling, and for eye disorders with swelling or pressure, such as glaucoma.
Polygonum bianxu Polygonum avicularis	clears urinary heat	Primarily used for urinary tract infections. Many species of Polygonum are used, some with notably different properties.
Polyporus zhuling Polyporus umbellatus	clears turbidity	This mushroom is mainly used for urinary disorders with turbid urine; also for edema.
Hoelen (or Poria) fuling Poria cocos	strengthens spleen, calms spirit	The most widely used herb in this category, it is very mild. The outer portion of the mushroom, fulingpi, is especially diuretic.
Pyrrosia shiwei Pyrrosia lingua	clears urinary heat	Mainly used for urinary tract infections.
Talc huashi Talcum	relieves irritation	Used for urinary disorders and intestinal orders with burning sensation.

Summary

The herbs that dispel moisture mainly treat edema, urinary tract infections, and swellings. Most of the herbs have a cool or cold nature, and are appropriate for inflammatory and infectious diseases. Although the this group of herbs is often described as having a diuretic property, some of the herbs have very mild diuretic effects and the main diuretic action involves overcoming urinary retention due to kidney and bladder diseases. Some of the herbs are specifically used for urinary tract infections (e.g., akebia, dianthus, polygonum, pyrrosia), while others are used mainly for localized swelling or accumulation (e.g., stephania, lysimachia, plantago seed).

Two of these herbs, akebia and stephania, are derived from several plant sources including species of Aristolochia. During the 1990’s, evidence accumulated to indicate that a component of Aristolochia plants, aristolochic acid, could cause renal damage in some individuals. Therefore, these have been removed from the Western market even though they remain widely used in China.

Some herbs listed in other materia medica categories are often incorporated into moisture resolving formulas. The main one is atractylodes (baizhu, in the category of qi tonic herbs; it promotes the spleen function of distributing moisture). Others that are sometimes used include gardenia (for clearing heat in treatment of urinary infections), magnolia bark and areca peel (for regulating qi to disperse moisture stagnancy in the abdomen), and citrus (for resolving phlegm-damp accumulation, usually combined with fresh ginger for this purpose).

Sample Traditional Formulas

The following are samples of ancient formulas that include at least three ingredients from this Materia Medica section.

· Bazheng San (Dianthus Formula) with dianthus, akebia, polygonum, plantago seed, and talc; also: gardenia.

· Wuling San (Hoelen Five Herb Formula) with hoelen, polyporus, and alisma; also: atractylodes.

· Wei Ling Tang (Magnolia and Hoelen Formula): with hoelen, polyporus, and alisma; also: atractylodes, citrus, and magnolia bark.

· Chai Ling Tang (Bupleurum and Hoelen Formula): with hoelen, polyporus, and alisma; also: atractylodes and fresh ginger.

· Yinchen Wuling San (Capillaris and Hoelen Formula): with hoelen, polyporus, alisma, and capillaris; also: atractylodes.

· Danggui Niantong Tang (Tang-kuei and Anemarrhena Combination): with polyporus, alisma, and capillaris; also: atractylodes

· Zhuling Tang (Polyporus Combination) with hoelen, polyporus, alisma, and talc.

Dispel Wind-damp

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Acanthopanax wujiapi Acanthopanax gracilistylus	nourishes liver and kidneys, invigorates blood circulation	Used for deficiency syndromes that produce tendon spasms and numbness.
Agkistrodon baihuashe Agkistrodon acutus	alleviates spasms, reduces itching	Used in cases of tonic paralysis and for itching.
Tu-huo duhuo Angelica pubescens	analgesic	Commonly used for pain syndromes including headache, arthritis, and painful swellings.
Chaenomeles mugua Chaenomeles lagenaria	relaxes tension of muscles and tendons; drains excess moisture	Especially used for stiffness due to tight muscles and ligaments, and for fluid swelling in the legs.
Clematis weilingxian Clematis chinensis	analgesic	Mainly used for pain syndromes affecting the lower body.
Chin-chiu qinjiao Gentiana macrophylla	nourishes liver to relax spasms	Mainly used in deficiency cases, with spasms and contraction of the ligaments.
Morus twig sangzhi Morus alba	drains excess moisture	Mainly used for rheumatic disorders with stiffness and swelling.
Tiger bone hugu Panthera tigris	nourishes and strengthens tendons and bones	Various substitutes are now used, bones from other animals, to treat stiffness, pain, and weakness of the legs and lower back.
Xanthium cangerzi Xanthium strumarium	anti-allergy effects	Mainly used in treatment of allergic rhinitis and skin rashes with itching.
Zaocys wushaoshe Zaocys dhumnades	alleviates itchings	Used for arthralgia and for itching; commonly combined with agkistrodon.

Summary

The herbs that dispel wind-damp are often used to treat pain of the joints, ligaments, and muscles. In some cases, they also treat pruritis (e.g., agkistrodon, xanthium, zaocys). Certain herbs are deemed more suited to patients with deficiency syndromes (e.g., acanthopanax, chin-chiu, tiger bone) and some are deemed especially potent for promptly relieving pain (e.g., clematis, tu-huo).

Three items are from animal sources: snakes (agkistrodon and zaocys) and tiger. The snakes were originally collected from the wild but are now raised on ranches to supply the high demand (other snakes are also used as sources of medicinal materials and some snakes are eaten as food in southern China). Tiger bones were used in making Chinese medicines until about the 1970’s, at which point they became so rare that substitute items were used instead. Initially, the substitutes were from other wild cats (e.g., mountain lions), but eventually they were substituted by bones from domestic animals. Nonetheless, products made in China still describe the ingredient as “tiger bone”. Western research has suggested that the gelatins from bones may inhibit the immune attack of rheumatoid arthritis (one study relied on chicken bones).

Some herbs listed in other materia medica categories are often incorporated into formulas for dispelling wind-damp. The main ones are herbs from the category of herbs for dispelling wind-chill to relieve the surface; in particular, angelica (baizhi), asarum (xixin), cinnamon (guizhi), chiang-huo (jianghuo), ma-huang (mahuang), and siler (fangfeng) are used in these formulas. The reason for the large contribution from this group of herbs is that the Chinese theory of causation for most rheumatic disorders is that there is a combination of wind, cold, and dampness entering the body; the herbs for dispelling wind-chill affect at least two of these conditions. Many formulas for treating rheumatism are comprised mainly of these herbs and only one or two of the herbs specific for dispelling wind-damp. Other herbs that are commonly included in the formulas are blood tonics (particularly tang-kuei, peony, and rehmannia), since weak blood circulating in the vessels is believed to be one reason why wind can easily penetrate and remain in the body. An herb that both dispels wind and nourishes blood, cnidium (chuanxiong), is classified with the herbs that vitalize blood circulation; it is also included in many formulas for wind-damp syndrome; this herb additionally provides strong analgesic action. An herb classed with those that dispel moisture and which relieves wind-damp syndromes, stephania (fangji), is often included in the prescriptions. Finally, aconite (fuzi), classed with the chill-dispelling herbs, appears in many of the formulas due to its strong analgesic action.

Sample Traditional Formulas

The following are samples of ancient formulas that include at least one ingredient from this Materia Medica section.

· Canger San (Xanthium Formula) with xanthium; also: angelica.

· Shang Zhong Xia Tongyong Tongfeng Wan (Cinnamon and Angelica Formula) with clematis; also: cinnamon, chiang-huo, angelica, cnidium, and stephania.

· Qingshang Juantong Tang (Ophiopogon and Asarum Combination) with tu-huo; also: siler, asarum, chiang-huo, angelica, tang-kuei, and cnidium.

· Shujin Lian San (Clematis and Carthamus Formula): with clematis, tu-huo, and chaenomeles; also: angelica, siler, chiang-huo, stephania, rehmannia, cnidium, and aconite.

· Shufeng Huoxue Tang (Stephania and Carthamus Combination): with clematis; also: angelica, chiang-huo, cnidium, and stephania.

· Duhuo Jisheng Tang (Tu-huo and Loranthus Combination): with tu-huo and chin-chiu; also: asarum, siler, tang-kuei, peony, rehmannia, and cnidium.

· Da Qinjiao Tang (Major Chin-chiu Combination): with tu-huo and chin-chiu; also: angelica, chiang-huo, asarum, siler, tang-kuei, peony, rehmannia, and cnidium.

· Jiawei Baxian Tang (Siler and Chiang-huo Combination) with chin-chiu; also: chiang-huo, siler, cinnamon, tang-kuei, peony, rehmannia, and cnidium.

Dispel Chill, Warm Interior

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Aconite fuzi Aconitum carmichaelii	restores yang, warms spleen, controls pain	Used mainly for arthralgia due to cold and for diarrhea and abdominal pain due to spleen cold.
Clove dingxiang Eugenia caryophyllata	promotes digestion, alleviates intestinal gas	Used for digestive disturbance due to cold spleen and for abdominal and chest pains.
Cinnamon bark rougui Cinnamomum cassia	restores yang, warms vessels	Commonly used for chilliness of feet, legs, and back and for accompanying deficiency heat affecting the upper body.
Evodia wuzhuyu Evodia rutaecarpa	lowers uprising qi from the stomach	Especially used for hiccough, vomiting, and acid regurgitation associated with cold in the stomach (which can also cause diarrhea).
Zanthoxylum shanjiao Zanthoxylum schinifolium	analgesic, controls intestinal parasites	Mostly used for abdominal pain and diarrhea associated with intestinal worms.
Dry ginger ganjiang Zingiberis officinale	warms spleen and lungs, resolves phlegm	The safest and most widely used chill-dispelling herb, dry ginger is particularly used when there is excess moisture or phlegm.

Summary

The herbs that dispel chill and warm the interior mainly treat kidney and spleen yang deficiency (aconite, cinnamon bark), diarrhea due to cold stomach and spleen (aconite, dry ginger), and abdominal pain (clove, zanthoxylum).

Aconite, when raw, is a highly toxic herb; it is always processed to yield an herb of low toxicity that is used by Western practitioners and used most of the time by Chinese practitioners. The processing changes the alkaloids, mainly aconitine, into a hydrolized form that has low toxicity. Evodia is slightly toxic and usually used in small quantities. Zanthoxylum is extremely spicy (it is also known as Sichuan hot pepper, used in several of the firey hot Sichuan dishes) and can irritate the oral mucosa when taken in decoction form.

Some herbs listed in other materia medica categories are often incorporated into formulas for dispelling chill and warming the interior. The main ones are herbs from the qi tonic category: ginseng (renshen), atractylodes (baizhu), and licorice (gancao); these herbs benefit the spleen functions. Sometimes, cinnamon twig (guizhi, in the section of herbs for dispelling wind-chill) is used in place of cinnamon bark; this is because guizhi was the original item used in the Shang Han Lun, the primary text on diseases associated with cold syndromes. When the chill-dispelling herbs are used to treat spleen cold or abdominal pain, it is common to add blood tonic herbs, usually tang-kuei (danggui) or peony (baishao), to protect the body from a potential overly warming action that dries the blood. When the chill-dispelling herbs are used specifically to benefit the kidney yang (usually cinnamon bark and/or aconite are relied on for this purpose), rehmannia (shu dihuang, listed with the blood tonics, but also an herb that nourishes kidney yin) is usually included so as to prevent damage to kidney yin as a potential result of using strong warming herbs for the kidney yang. In such formulas, a variety of yang tonic herbs might also be included, such as deer antler (lurong) and cuscuta (tusizi), and it is common practice to add an astringent to help prevent further loss of essence (the combined yin and yang components) from the kidney: for that purpose, cornus (shanzhuyu) is the herb selected.

Sample Traditional Formulas

The following are samples of ancient formulas that include at least two ingredients from this Materia Medica section, allowing for cinnamon twig to be used in place of cinnamon bark, as mentioned above.

· Da Jianzhong Tang (Major Zanthoxylum Combination) with zanthoxylum and dry ginger; also: ginseng.

· Qianjin Dangui Tang (Tang-kuei Combination) with zanthoxylum, dry ginger, and cinnamon (twig); also: ginseng, licorice, tang-kuei, and peony.

· Sini Tang (Aconite and Ginger, Licorice Combination): with aconite and dry ginger; also: licorice.

· Gancao Fuzi Tang (Licorice and Aconite Combination): with aconite and cinnamon (twig); also: atractylodes and licorice.

· Fuzi Lizhong Tang (Aconite, Ginseng, and Ginger Combination): with aconite and dry ginger; also: ginseng, atractylodes, and licorice.

· Guizhi Renshen Tang (Cinnamon and Ginseng Combination): with cinnamon (twig) and dry ginger; also: ginseng, atractylodes, and licorice.

· Guizhi Jia Fuzi Tang (Cinnamon and Aconite Combination): with cinnamon (twig), dry ginger, and aconite; also: licorice and peony.

· Danggui Sini Jia Wuzhuyu Shengjiang Tang (Tang-kuei, Evodia, and Ginger Combination) with evodia and cinnamon (twig); also: licorice, tang-kuei, and peony.

· Jieji Zhujiao Tang (Zanthloxylum Combination) with zanthoxylum, aconite, and dry ginger; also: ginseng and licorice.

· Bawei Dihuang Wan (Rehmannia Eight Formula) with cinnamon (twig) and aconite; also: rehmannia and cornus.

· Yougui Wan (Eucommia and Rehmannia Formula) with cinnamon bark and aconite; also: tang-kuei, rehmannia, cuscuta, deer antler (gelatin), and cornus.

Aromatic Moisture Resolvers

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Cluster baidoukou Amomum cardamomum	alleviates intestinal gas	Used for nausea, vomiting, and stomach pain; also for intestinal gas and abdominal distention.
Cardamom sharen Amomum villosum	alleviates stagnation of food	Alleviates stomach pain, loss of appetite, nausea, diarrhea, and fullness after eating.
Tsao-ko caoguo Amomum tsao-ko	resolves phlegm	Mainly used for abdominal or chest pain associated with retention of phlegm, sensation of fullness, or regurgitation of food or stomach acid.
Red (or black) atractylodes cangzhu Atractylodes lancea	dispels wind-damp	Used for aching of the limbs associated with dampness accumulation; also used with magnolia bark to resolve gastro-intestinal disorders.
Eupatorium peilan Eupatorium fortunei	alleviates summer heat syndrome, tonifies stomach and spleen.	Mainly used for persons of weak constitution who suffer from a summer-heat syndrome.
Magnolia bark houpu Magnolia officinalis	alleviates fullness	Typically used in cases of abdominal distention or sense of fullness in the chest; relieves diarrhea associated with overeating.
Pogostemon (or Agastache) huoxiang Pogostemon cablin	relieves summer heat syndrome	The primary herb for summer heat syndrome, it alleviates digestive disturbances accompanied by headache.

Summary

The aromatic herbs that dispel moisture have a combination of therapeutic actions: they regulate qi, dispel chilliness in the center (stomach/spleen) and promote digestion. Their functions are similar to that of the qi regulating herbs, but they have a greater impact on stagnated food, moisture, and phlegm. Most of these herbs are used in the treatment of summer heat syndrome: this is an acute ailment marked by a combination of digestive symptoms (mainly nausea, vomiting, diarrhea) and surface symptoms (mainly headache, feverish feeling or fever and chills, muscle aches). The herbs may be used in treatment of some cases of asthma, namely those marked by tightness in the chest, some phlegm, and weakness of the digestion, and in some cases of edema, particularly ascites (as opposed, for example, to leg edema).

Three items are varieties of cardamom (that is, they are species of Amomum); they contain the aromatic borneol (and related monoterpenes) that has an analgesic and stimulant action. They have similar functions and are sometimes combined together. The atractylodes listed in this category has been called red atractylodes (the rhizomes have a distinct reddish color) or black atractylodes (cang in the Chinese name cangzhu, refers to black); the atractylodes listed in the qi tonic section is called white atractylodes (or simply atractylodes), and is derived from a different species. Pogostemon refers to the current source of huoxiang, while the older source is Agastache; most herbalists consider Pogostemon to be superior.

Some herbs listed in other materia medica categories are often incorporated into formulas for using aromatics to dispel accumulated moisture. The main ones are herbs from the category of qi-regulators, especially the materials derived from citrus fruits (citrus, chih-shih, and chih-ko), saussurea, cyperus, and areca peel (or the related areca seed, which is categorized with the anthelmentics); the herbs that are qi tonics, mainly ginseng, atractylodes, licorice, jujube) and the herbs that dispel dampness (mainly hoelen).

Sample Traditional Formulas

The following are samples of ancient formulas that include at least two ingredients from this Materia Medica section.

· Liuhe Tang (Cardamon Combination) with pogostemon (agastache) and cardamon; also: ginseng, atractylodes, licorice, and hoelen.

· Huoxiang Zhengqi San (Agastache Formula) with pogostemon (agastache) and magnolia bark; also: hoelen, citrus, licorice, and areca peel.

· Renshen Yangwei Tang (Ginseng Stomach Combination) with pogostemon (agastache), magnolia bark, and tsao-ko; also: ginseng, licorice, atractylodes, and hoelen.

· Fenxiao Tang (Hoelen and Alisma Combination) with magnolia bark and cardamon; also: atractylodes, hoelen, citrus, chih-shih, cyperus, saussurea, and areca peel.

· Gehua Jiexing Tang (Pueraria Flower Combination) with cardamon, cluster, and red atractylodes; also: ginseng, hoelen, citrus, and saussurea.

· Xiang Sha Yangwei Tang (Cyperus and Cluster Combination) with magnolia bark, red atractylodes, cardamon, and cluster: also: ginseng, atractylodes, licorice, hoelen, saussurea, and cyperus.

· Buzi Jianzhong Tang (Magnolia and Alisma Combination) with magnolia bark, red atractylodes; also: ginseng, atractylodes, hoelen, and citrus.

· Shipi Yin (Magnolia and Atractylodes Combination) with magnolia bark and tsao-ko; also: atractylodes, saussurea, areca peel, licorice, and hoelen.

· Buhuanjin Zhenqi Tang (Pinellia, Atractylodes, and Agastache Formula) with magnolia bark, red atractylodes, and pogostemon (agastache); also: licorice and citrus..

Qi Regulators

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Aquilaria chenxiang Aquilaria sinensis	supplements yang, disperses chill	Used for nausea, vomiting, hiccoughs, and stomach pain due to cold and stagnation in the center (stomach/spleen).
Areca peel dafupi Areca catechu	dispels moisture accumulation	Primarily used for abdominal swelling associated with water accumulation. Areca seed is sometimes used instead.
Chih-ko zhiqiao Citrus aurantium	resolves phlegm, disperses accumulations	Used for food stagnancy, epigastric aching, and lung congestion.
Chih-shih zhishi Citrus aurantium	purges gallbladder to produce laxative effect; clears heat and phlegm	Used for abdominal stagnation with constipation and for lung congestion.
Blue citrus qingpi Citrus reticulata	resolves phlegm	Mainly used for lung disorders with phlegm accumulation or for dispersing soft swellings.
Citrus chenpi Citrus noblis	strengthens spleen, dries moisture and phlegm	The most widely used qi regulating herb; it is also used in treatment of most phlegm disorders, combined with pinellia.
Aurantium jupi Citrus reticulata	lowers qi, relieves stagnation in the chest.	Used for nausea, vomiting, hiccough, and coughing.
Fu-shou fushougan Citrus medica	alleviates pain, controls vomiting	Used for digestive distress with abdominal pain and distention.
Cyperus xiangfuzi Cyperus rotundus	alleviates pain, regulates menstruation	Used for headaches and abdominal pains and for menstrual irregularities.
Lindera wuyao Lindera strychnifolia	alleviates pain, warms the kidney	Mainly used for lower abdominal pain associated with cold kidney; has properties similar to cinnamon twig.
Melia chuanlianzi Melia toosendan	alleviates pain, eliminates intestinal parasites.	Mainly used for pain in the chest and upper abdomen (liver area); the antiparasitic action of the root bark is stronger.
Saussurea muxiang Saussurea lappa	alleviates pain, controls diarrhea, sedative	Used for mainly for abdominal disorders that include diarrhea.

Summary

The qi regulating herbs disperse stagnant qi, lower uprising qi (this is qi flushing up from the stomach to cause nausea, vomiting, hiccoughing, and asthmatic breathing), promote digestive functions, and alleviate pain in the chest and abdomen. Several of the herbs also resolve phlegm accumulation. The qi stagnation syndrome is thought to arise most often from excessive anxiety, which weakens the stomach and spleen and thus impairs circulation of fluids, and which inhibits the liver’s qi regulating functions. In turn, the stagnation of circulation (often accompanied by accumulation of fluids) can cause depression and worsening anxiety.

Six of the items are varieties of citrus, and there are several more citrus materials that are also in this category but less commonly used. Chih-shih (zhishi) is the immature fruit, while chih-ko (zhiqiao) is the mature fruit of the same plant; similarly, blue citrus qingpi is the immature whole fruit, while aurantium (zhupi) is the mature fruit peel of another, similar citrus plant. The citrus materials have slightly different indications, but are often combined together, two or three in one formula. The most commonly used of the qi regulators is the one simply called citrus (chenpi), which is the dried peel (usually aged or fried before use) of the fruit from numerous citrus plants.

Some herbs listed in other materia medica categories are often incorporated into qi-regulating formulas. The main ones are herbs that have qi regulating effects, mainly perilla (zisuye, categorized with the wind-chill dispelling herbs; sometimes perilla stem or perilla seed will be used instead), cnidium (chuanxiong, categorized with the blood vitalizing herbs), and mangolia bark (houpu; categorized with the fragrant moisture dispelling herbs). Additionally, qi tonic herbs are sometimes included, particularly ginseng, atractylodes (along with hoelen, an herb for dispelling moisture, that benefits the spleen functions), and licorice. Fresh ginger (shengjiang) is also included in several formulas to benefit the function of the stomach.

Sample Traditional Formulas

The following are samples of ancient formulas that include at least three ingredients from this Materia Medica section.

· Fenxiao Tang (Hoelen and Alisma Combination) with areca peel, citrus, chih-shih, saussurea, and cyperus; also: magnolia, atrctylodes, hoelen, and fresh ginger.

· Xiang Sha Yangwei Tang (Cyperus and Cluster Combination) with citrus, cyperus, and saussurea; also: magnolia bark, ginseng, atractylodes, hoelen, licorice, and fresh ginger.

· Gehua Jiexing Tang (Pueraria Flower Combination) with citrus, blue citrus, and saussurea; also: ginseng, atractylodes, and hoelen.

· Shiliuwei Liuqi Yin (Tang-kuei Sixteen Herb Combination) with chih-ko, lindera, and saussurea; also: perilla, cnidium, magnolia bark, ginseng, and licorice.

· Sanhe San (Aquilaria and Perilla Formula) with aquilaria, citrus, areca peel, and saussurea; also: perilla, atractylodes, licorice, and fresh ginger.

· Fen Xinqi Yin (Citrus and Perilla Combination) with areca peel, citrus, and blue citrus; also: perilla, hoelen, licorice, and fresh ginger.

· Xingqi Xiang Su San (Cyperus, Perilla and Citrus Formula) with citrus, chih-ko, cyperus, and lindera; also: perilla, cnidium, fresh ginger, and licorice.

· Zhengqi Tianxiang San (Lindera and Cyperus Formula) with citrus, cyperus, and lindera; also: perilla and licorice.

· Wuyao Shunqi San (Lindera Formula) with citrus, chih-ko, and lindera; also: cnidium and licorice.

· Chuan Si Junzi Tang (Atractylodes and Cardamon Combination) with aquilaria, saussurea, and citrus; also: perilla seed, magnolia bark, ginseng, atracytlodes, hoelen, and licorice.

Vitalize Blood

Common, Pinyin, Sources	Additional or Dominant Properties	Comments
Achyranthes niuxi Achyranthes bidentata	nourishes blood, dispels wind-damp	Commonly used for rheumatic syndromes affecting the lower body; a directing herb to move blood from upper to lower body.
Cyathula chuanniuxi Cyathula capitata	regulates menstruation	Mainly used for pain associated with menstruation.
Carthamus honghua Carthamus tinctorius	regulates menstruation, alleviates pain of injuries	Combined with persica in treatments of blood stasis causing pain.
Cnidium chuanxiong Ligusticum chuanxiong	dispels wind, regulates qi, controls pain, nourishes blood	It is the main herb used for headache pain; used in most formulas for blood stasis and in many formulas for nourishing blood.
Corydalis yanhusuo Corydalis ambigua	controls pain, regulates qi	Mainly used for abdominal pain syndromes, including menstrual pain.
Curcuma yujin Curcuma aromatica	regulates qi, disperses accumulations	Mainly used in cases of stagnation with accumulation, including treatment of phlegm masses and other lumps.
Leonurus yimucao Leonurus heterophyllus	regulates menstruation, disperses water accumulation	Most often used for women’s reproductive system disorders.
Millettia jixueteng Spatholobus suberectus	nourishes blood, alleviates numbness, relaxes tedons	Modern applications are mainly for anemia; traditionally used for numbness of the legs in the elderly.
Myrrh moyao Commiphora sp.	controls pain, disperses swellings, promotes tissue regeneration	Used mainly for injuries (along with frankincense) and for swellings (such as abscesses).
Frankincense (or Mastic) ruxiang Boswellia carterii	controls pain, relaxes muscles	Mainly used in treatment of injuries, usually combined with myrrh.
Red Peony chishao Paeonia obovata	clears heat, cools blood	Especially used for blood stasis syndrome with blood heat, often combined with salvia and/or moutan.
Persica taoren Prunus persica	moistens the intestines	Often used for abdominal blood stasis accompanied by constipation; combined with carthamus for many blood stasis disorders.
Salvia danshen Salvia miltiorrhiza	cools blood, nourishes blood, sedative	Primarily used for cardiovascular disorders and for liver fibrosis; also useful as a sedative.
Sparganium (or Scirpus) sanleng Sparganium stoloniferum	regulates qi, disperses mass	Mainly used for hard masses, especially those in the abdomen, usually combined with zedoaria.
Zedoaria ezhu Curcuma zedoaria	regulates qi, disperses mass, benefits stomach functions	Mainly used for hard masses, in combination with sparganium; also for digestive disturbance with distention.

Summary

The herbs that vitalize blood treat pain, particularly sharp pain at a fixed site, resolve swellings and masses, and regulate menstruation. They also dilate the vessels, thin the blood, and promote circulation of qi and blood. Some of the herbs are more specific in their applications: corydalis is especially used for pain; sparganium and zedoaria for masses, leonurus for regulating menstruation; myrrh and frankincense treat injuries; salvia and red peony vitalize and cool blood, while persica and carthamus vitalize and warm the blood.

These herbs are often combined with others from the Materia Medica sections of blood tonics, notably tang-kuei, peony, and rehmannia, and qi regulators, mainly cyperus, lindera, and the citrus materials, especially chih-shih. Bupleurum, an herb classified with the wind-heat dispelling herbs, is also an important qi regulating herb used in these formulas. The use of blood vitalizing herbs as a specific therapy was promoted by Wang Qingren, who in the mid-18^th Century wrote several prescriptions that are still relied upon today (though not much used in Kampo medicine).

Sample Traditional Formulas

The following are samples of ancient formulas that include at least two ingredients from this Materia Medica section (these formulas may also include others from this Materia Medica section that are more rarely used in this group of traditional formulas and do not appear on this listing of blood vitalizing herbs).

· Qi Li San (Musck and Catechu Formula) with carthamus, myrrh, and frankincense.

· Shujing Huoxue Tang (Clematis and Stephania Combination) with cnidium and persica; also: tang-kuei, peony, rehmannia, and citrus.

· Shugan Tang (Bupleurum and Evodia Combination): persica and carthamus; also: tang-kuei, peony, chih-ko, citrus, and bupleurum.

· Fuyuan Huoxue Tang (Tang-kuei and Persica Combination): persica and carthamus; also: tang-kuei and bupleurum.

· Xuefu Zhuyu Tang (Persica and Achyranthes Combinatoin): cnidium, persica, carthamus, red peony, achyranthes; also: tang-kuei, chih-ko, and bupleurum.

· Buyang Huanwu Tang (Astragalus and Red Peony Combination): cnidium, persica, carthamus, and red peony; also: tang-kuei.

· Xiao Huoluo Dan (Myrrh and Aconite Formula): myrrh and frankincense.

· Tao Hong Siwu Tang (Persica, Carthamus, and Tang-kuei Combination): cnidium, persica, carthamus, and red peony; also: tang-kuei and rehmannia.

· Shaofu Zhuyu Tang (Cnidium and Bulrush Combination): cnidium, corydalis, myrrh, and red peony; also: tang-kuei

· Gexia Zhuyu Tang (Persica and Carthamus Combination): cnidium, persica, carthamus, red peony, and corydalis; also: tang-kuei, lindera, cyperus, and chih-ko.

· Tongqiao Huoxue Tang (Persica and Cnidium Combination): cnidium, persica, carthamus, and red peony.

· Shentong Zhuyu Tang (Cnidium and Chiang-huo Combination): cnidium, persica, carthamus, myrrh, and achyranthes; also: tang-kuei and cyperus.

· Shenghua Tang (Tang-kuei and Ginger Combination): cnidium and persica; also: tang-kuei.

· Xiong Gui Tiaoxue Yin (Cnidium and Rehmannia Combination): cnidium and leonurus; also: tang-kuei, rehmannia, citrus, lindera, and cyperus.