【Source】

Shang Han Lun (Treatise on Cold Damage Diseases)

 【Composition】

Roasted Licorice, Fresh Ginger, Cinnamon Twig, Ginseng, Raw Rehmannia, Ejiao (Donkey-hide Gelatin), Ophiopogon Japonicus, Semen Cannabis, Chinese Red Date
(9)

 【Categorization】

<Blood Tonic>: Ejiao

<Nourish Yin>: Ophiopogon Japonicus

<Clear Heat and Cool Blood>: Raw Rehmannia

<Tonify Qi>: Ginseng

<Dispel Exterior with Pungent Warmth>: Cinnamon Twig, Fresh Ginger

<Tonify Spleen and Harmonize Middle Jiao>: Chinese Red Date, Licorice

<Lubricate and Purge Downward>: Three assistants (Licorice, Ginger, Jujube), Semen Cannabis

【Formula Rationale】

From “Yi Fang” (Medical Formulas): Hand and Foot Tai Yin herbs. (1) Ginseng, Ophiopogon Japonicus, Licorice, Chinese Red Date: Tonify the Middle Jiao Qi and restore the pulse. (2) Raw Rehmannia, Ejiao: Assist the Ying blood and calm the Heart. (3) Cannabis Seed: Lubricate and ease the Spleen and Stomach. (4) Ginger and Cinnamon: Dispel residual pathogens with pungent warmth. (5) Adding clear wine to assist the medicinal efficacy. (6) “Sheng Ji Jing” states: When bodily fluids scatter and cause dryness, and the Five Wei (flaccidity) are weak, the Ying and Wei flow are depleted, therefore, moistening agents are used. (7) The sweet and moist properties of Cannabis Seed, Ophiopogon Japonicus, Ejiao, and Rehmannia nourish the blood, restore the pulse, and open the Heart. From “Shan Bu” (Supplemented and Revised): Ke Qin states: Master Zhang Zhongjing, for Yin deficiency with weak and intermittent pulse, used White Peony to nourish Yin. For Yang deficiency, he used Cinnamon Twig to unblock Yang. In severe cases, he added Ginseng to restore the pulse. He did not use Rehmannia or Ophiopogon Japonicus. Was this because the emphasis in the treatment of Shang Han (Cold Damage) was on supporting Yang? Or is it that there is no method for abrupt tonification of Yin? This formula uses Raw Rehmannia as the sovereign herb for Heart deficiency with knotted and intermittent pulse, Ophiopogon Japonicus as the minister herb, to vigorously tonify true Yin and open the path for later generations to nourish Yin. Although Rehmannia and Ophiopogon Japonicus are sweet in taste, their Qi is cold. They are not herbs for expelling stagnation. They must be combined with Ginseng and Cinnamon Twig to unblock the Yang pulse, and with Fresh Ginger and Chinese Red Date to harmonize the Wei and Ying. Ejiao tonifies blood, Sour Jujube calms the spirit, and the緩 (slowing) effect of Licorice prevents rapid downward movement. The potency of clear wine facilitates upward movement. Internal and external harmony can then calm palpitations and restore the pulse. Seven Sheng of wine and eight Sheng of water, taking only three Sheng, indicates prolonged simmering to prevent the Qi from being too harsh, which is the method of using wine for deficiency. It is also known that Rehmannia and Ophiopogon Japonicus are best with wine. For deficiency patterns, Sour Jujube Seed should be used. For lung flaccidity, Cannabis Seed can be used. If genuine Ejiao is unavailable, Turtle Shell Gelatin can be substituted. From “Han Dian” (Chinese Dictionary): The combination of Licorice and Cinnamon Twig in the formula treats palpitations. Rehmannia, Ophiopogon Japonicus, Ginseng, Cannabis Seed, and Ejiao have nourishing, calming, and strengthening effects. Cannabis Seed has a moistening and mildly laxative effect. Ginseng has a stomach-strengthening effect. Chinese Red Date and Fresh Ginger harmonize the herbs and promote absorption.

 【Functions】

Tonify Qi, nourish Yin, enrich blood, restore pulse, generate fluids, and moisten dryness.

 【Indications】

(1) Patterns of deficiency of Qi and blood, consumptive diseases, lung flaccidity, palpitations, and knotted and intermittent pulse. (2) Patients using this formula exhibit signs of nutritional deficiency, dry skin, easy fatigue, as well as vexation and heat in the hands and feet, and dry mouth. From “Yi Fang”: (1) Shang Han (Cold Damage) with knotted and intermittent pulse, and palpitations (Shang Han, Tai Yang Chapter). (2) And lung flaccidity with frequent coughing and expectoration, and a feeling of warmth in the chest (Jin Gui, Lung Flaccidity). (3) “Bao Jian” uses it to treat hiccups (Bao Jian).

 【Clinical Applications】

(1) Heart disease, arrhythmia, disorders, weakness, coronary heart disease, angina pectoris, viral myocarditis, rheumatic heart disease, cor pulmonale. (2) Gastric ulcers, atrophic gastritis, aphthous ulcers, hiccups, post-concussion syndrome, Bi syndrome (painful obstruction), puerperal fever, etc.

 【Contraindications】

This formula can moisten dryness and promote bowel movements. It is not suitable for individuals with weak gastrointestinal function or diarrhea.

 【Mnemonic】

Just dare to argue — Noble person sells hemp in the cellar (Cinnamon, Ginseng, Rehmannia, Ejiao, Ophiopogon, Cannabis) + Three assistants (Licorice, Ginger, Jujube).

 【Modifications】

(1) Adding Sour Jujube Seed and Biota Seed to this formula enhances the action of nourishing the Heart, calming the spirit, and relieving palpitations. (2) Removing Ginseng, Cinnamon Twig, Fresh Ginger, and Chinese Red Date from this formula and adding White Peony results in “Jia Jian Fu Mai Tang” (Modified Pulse Restoration Decoction). Its function is to nourish blood, astringe Yin, generate fluids, and moisten dryness. It is primarily used for patterns of Yang Ming fu-syndrome where the excess heat has been cleared by the above methods, but Yin fluid remains deficient, presenting with a weak and large pulse, and more heat in the palms and soles than on the back of the hands and feet.

 【Pharmacology】

Possesses anti-arrhythmic effects, influences the physiological characteristics of the myocardium, affects the action potential of the myocardium, protects against myocardial ischemia-reperfusion injury, and has shown efficacy in experimental models of Yin deficiency rats.