[Source]

“Tong Su Shang Han Lun”

 [Composition]

Unicorn Horn, Mulberry Leaf, Sichuan Fritillary Bulb, Fresh Rehmannia Root, Cat Tail Herb, Chrysanthemum Flower, Poria Cocos, White Peony Root, Raw Licorice Root, Fresh Bamboo Shavings
(10)

 [Category]

<Nourishing Blood>: Peony Root

<Clearing Heat and Cooling Blood>: Fresh Rehmannia Root

<Tonifying Spleen and Middle Jiao>: Raw Licorice Root

<Dispersing Exterior with Acridity and Coolness>: Mulberry Leaf, Chrysanthemum Flower

<Tonifying Spleen and Promoting Water Metabolism>: Poria Cocos

<Resolving Phlegm>: Sichuan Fritillary Bulb, Fresh Bamboo Shavings

<Calming the Liver and Extinguishing Wind>: Cat Tail Herb, Unicorn Horn

[Formula Rationale]

Commentary by He Xiushan in “Revised Tong Su Shang Han Lun”: Unicorn horn, cat tail herb, mulberry leaf, and chrysanthemum are the sovereign herbs for extinguishing wind and calming convulsions. The minister herbs are Sichuan Fritillary Bulb, which excels in treating wind-convulsions, and Poria Cocos, which specifically calms liver wind. However, excessive fire generates wind, and wind exacerbates fire, easily injuring blood. Therefore, it must be supplemented with Peony Root, Licorice Root, and fresh Rehmannia Root to transform yin with sourness and sweetness, nourish blood to alleviate liver urgency. The envoy is Bamboo Shavings, which merely allows the network of bamboo to communicate with the network of the human body. “Qian Zhai Medical Lectures”: This formula was originally designed for the condition where pathogenic heat invades the Jue Yin channel, causing coma and spasms. This is due to extreme heat damaging yin, wind arising, phlegm generating, the heart and spirit being unsettled, and the tendons and meridians being stiff. Therefore, Unicorn Horn, Cat Tail Herb, Mulberry Leaf, and Chrysanthemum Flower are used as the main herbs to cool the liver and extinguish wind. They are assisted by Rehmannia Root, White Peony Root, and Licorice Root, which are sweet and sour, nourish yin, relieve spasms, and transform phlegm, unblock collaterals, clear the heart, and calm the spirit. Since liver diseases often involve liver heat and upward-reversing liver yang, which shares the same pathogenesis, this formula is also commonly used for severe cases of liver yang rising. Haliotis Shell etc. may be added to calm and anchor. “Formulas of Chinese Medicine – Tang Dynasty”: Unicorn Horn enters the liver channel, cooling the liver and extinguishing wind; Cat Tail Herb clears heat, calms the liver, extinguishes wind, and resolves spasms, serving as the main herbs in the formula. Mulberry Leaf and Chrysanthemum Flower are acrid, cool, and dispersing, clearing heat, calming the liver, and extinguishing wind, thereby strengthening the effect of cooling the liver and extinguishing wind. They are the secondary herbs. Due to extreme heat agitating wind and wind-fire fanning each other, yin and body fluids are easily consumed. Therefore, Rehmannia Root, White Peony Root, and raw Licorice Root are combined to achieve the transformation of yin with sourness and sweetness, nourish yin, increase fluids, soften the liver, and relax tendons. Simultaneously, they are combined with Unicorn Horn and Cat Tail Herb to enhance the effect of extinguishing wind and resolving spasms. Pathogenic heat is exuberant and easily burns body fluids into phlegm, so Fritillary Bulb and Bamboo Shavings are used to clear heat and resolve phlegm. Because heat disturbs the heart and spirit, Poria Cocos is used to calm the liver, soothe the heart, and calm the spirit, serving as the assistant herbs. Raw Licorice Root harmonizes all the herbs and serves as the envoy herb.

 [Functions]

Calms the liver, extinguishes wind, clears heat, and stops convulsions.

 [Indications]

Excessive heat in the liver channel, leading to extreme heat generating wind, resulting in persistent high fever, dizziness and distending pain in the head, tinnitus and palpitations, vexation and restlessness, hand and foot tremors, and even coma, manifesting as convulsions and seizures. Symptoms include a red and dry tongue, and a wiry and rapid pulse. Also used for eclampsia in pregnant women and infantile convulsions after childbirth.

 [Mnemonic]

Grandma at the funeral, walks the dog to calm the liver and extinguish wind, few quarrels trouble the spirit (Sang Ju Di Zhu Mu, Ling Gou, Shao Cao Shen).

 [Modifications]

(1) If the liver channel has severe heat and toxicity, add Isatis Leaf and Isatis Root to enhance heat-clearing and detoxifying effects. (2) If pathogenic heat is internally occluded, causing coma and blocked orifices, it is advisable to take Calculus Bovis pills or Zi Xue Dan concurrently to clear heat, open the orifices, and awaken the spirit. (3) If body fluids are depleted and heat does not subside, add Scrophularia Root, Ophiopogon Tuber, Dendrobium Stem, Donkey-hide Gelatin, and other Yin-nourishing and fluid-generating herbs to soften the liver and clear heat, and extinguish wind. (4) If there is coma due to phlegm obstruction, add bamboo sap, Gastrodia Tuber, ginger juice, etc., to resolve phlegm and open the orifices. (5) If heat toxin and blood stasis are severe, add Salvia Root, Red Peony Root, and Moutan Bark to invigorate blood and resolve stasis. (6) If convulsions are continuous, add Scorpion, Centipede, and Cicada Slough to enhance the effect of extinguishing wind and stopping convulsions. (7) If Mulberry Leaf, Sichuan Fritillary Bulb, Rehmannia Root, White Peony Root, Chrysanthemum Flower, Poria Cocos, and Bamboo Shavings are removed from this formula, and Ginseng, Scorpion, and Gastrodia Rhizome are added, it becomes Cat Tail Herb Decoction (Gou Teng Yin) from “Yi Zong Jin Jian”. It is primarily used for infantile “heavenly fishing” (a type of convulsion), fright, high fever, trismus, and limb spasms, characterized by upward gaze of the head and eyes.