【Source】

Treatise on Cold Damage (Shang Han Lun)

 【Composition】

(White) Peony Root (Shaoyao), Prepared Licorice Root (Zhi Gancao)
(2 parts each)

 【Classification】

<Blood Tonic>: Peony Root

<Tonify Spleen and Middle Jiao>: Licorice Root

【Formula Rationale】

According to Yi Fang Ji Jie: This formula targets the Foot Taiyin and Yangming channels. (1) When Qi and Blood are disharmonious, abdominal pain occurs. White Peony Root is sour and astringent, with a bitter and descending nature, capable of moving Ying Qi. (2) Prepared Licorice Root is warm and dispersing, sweet and moderating, capable of harmonizing rebellious Qi. (3) Furthermore, pain can be attributed to excessive Wood (Liver) overcoming Earth (Spleen). White Peony Root can reduce the Liver, while Licorice Root can moderate the Liver and harmonize the Spleen.

 【Functions】

Harmonizes Qi and Blood, regulates Ying Qi and disperses rebellion, moderates spasms and cramps, and relieves pain.

 【Indications】

(1) Improper diaphoresis leading to injury of Ying Blood, persistent heat, and resulting in limb cramps, cold extremities, and inability to straighten stiff legs. (2) Disharmony of Stomach Qi causing abdominal pain. (3) Pain in the four limbs, and colicky pain from kidney stones, gallstones, etc. According to Yi Fang Ji Jie: (1) Treats abdominal disharmony and pain. (2) Zhang Zhongjing used it for patients experiencing cold extremities, vomiting, and rebellious Qi after improper induction of sweating. It was used with Gan Jiang Gancao Tang to restore Yang. Once the cold extremities warmed, this formula was then used to harmonize Yin and resolve leg stiffness.

 【Clinical Applications】

Gastrointestinal pain, trigeminal neuralgia, gastrocnemius muscle spasms, gastric volvulus, epigastric and abdominal pain, elderly low back and leg pain, leg cramps in the late stage of febrile diseases with heat, dysmenorrhea, and swelling and pain of the feet.

 【Contraindications】

This formula should be used after differentiating between deficiency and excess. It is suitable for deficiency-heat patterns but not for deficiency-cold patterns.

 【Mnemonic】

The name of the formula itself.

 【Modifications】

According to Yi Fang Ji Jie: (1) For a slow pulse indicating water damage: add Cinnamon Twig (Guizhi) and Fresh Ginger (Sheng Jiang). (2) For a surging pulse indicating metal damage: add Scutellaria Root (Huang Qin) and Jujube (Da Zao). (3) For a choppy pulse indicating blood damage: add Angelica Sinensis (Dang Gui). (4) For a thready pulse indicating Qi damage: add more Peony Root (Shaoyao). (5) For a delayed pulse indicating cold damage: add Dried Ginger (Gan Jiang). According to Han Dian: Add Aconite (Fu Zi) for cases of Shaoyao Gancao Tang syndrome with symptoms such as cold extremities, aversion to cold, etc.

 【Pharmacology】

Possesses antispasmodic, analgesic, anti-inflammatory, and central nervous system depressant effects.