【Source】

“Treatise on Cold Damage” and “Synopsis of the Golden Chamber”

 【Composition】

Evodia fruit, Ginseng, Fresh ginger, Jujube
(4)

 【Category】

<Tonify Spleen and Middle Jiao>: Jujube

<Tonify Qi>: Ginseng

<Release Exterior with Acrid Warmth>: Fresh ginger

<Warm Interior>: Evodia fruit

【Rationale】

“Prescriptions of Medicine”: The formula contains herbs for the Liver channel of Foot Jueyin, the Kidney channel of Foot Shaoyin, and the Stomach channel of Foot Yangming. (1) For Yangming syndrome with nausea after eating, Evodia fruit and fresh ginger are acrid and warm to disperse cold from the Stomach, descend qi, and relieve nausea. (2) Ginseng and jujube are sweet and to tonify the Spleen, strengthen qi, and harmonize the Middle Jiao. (3) Yu Jiayan states: This indicates that vomiting can originate from either the Taiyang or Yangming channels. If vomiting occurs after eating, it is due to Stomach cold, which is different from the aversion to cold and vomiting in Taiyang syndrome, which are heat symptoms. Care must be taken not to treat cold vomiting with cold herbs. If taking <a href='https://whatsintcm.com/dt_articles/Wu Zhu Yu Tang’>Wu Zhu Yu Tang results in worsening symptoms, then it is still a Taiyang heat pathogen and not Stomach cold. (In this case, the treatment should follow the pattern of combined Taiyang and Yangming disease, using Kudzu root plus Pinellia decoction). (4) For Shaoyin syndrome with vomiting, diarrhea, cold extremities, and severe irritability, the Yin qi of the Kidney ascends, leading to a critical condition (Kidney Yin is excessively abundant, rising to obstruct Yang, causing vomiting and nausea), hence Evodia fruit is used to disperse cold and descend counterflow. (5) Ginseng, ginger, and jujube tonify Yang and strengthen the Earth, preventing Yin cold from interfering with the upper or lower body, thus warming the meridians and the Middle Jiao. (6) Evodia fruit is the chief herb for Jueyin, therefore it also treats Liver qi rising, with frothy salivation and headache. “Compendium of Herbs”: Evodia fruit, receiving the energy of the East and Wood, is acrid, bitter, and greatly warm. It can reach Wood stagnation, directly enter the Jueyin channel, descend the turbid qi of excessive Yin, and dispel all Yin obstructions. It is used as the ruler herb. Ginseng embodies the energy of harmony and is sweet and warm, greatly tonifying. It can connect heavenly truth, restore life, raise depleted vital energy, and allow the Yang light to shine everywhere. It is used as the minister herb. Ginger and jujube assist in harmonizing the Stomach and promoting the circulation of the four limbs. Thus, Zhen (Heavenly Stem of East) and Kun (Earth) combine their virtues, Wood and Earth do not harm each other, the wondrous use of one Yang is achieved, and the three Jiao are filled with generative qi. “Han Dian”: This formula treats various symptoms arising from paroxysmal upward counterflow of turbid phlegm. Turbid phlegm refers to pathological water-phlegm that is turbid in nature. Therefore, this formula can be used for migraine, hiccups, vomiting, and acute gastroenteritis, etc. This formula is composed of four herbs: Evodia fruit, Ginseng, Jujube, and Fresh ginger. The combination of Evodia fruit and fresh ginger can invigorate blood circulation. When combined with Ginseng and jujube, it has the effect of treating upward counterflow of turbid phlegm.

 【Actions】

Warms the Middle Jiao, disperses cold, tonifies deficiency, descends counterflow, stops vomiting, warms the Liver and Stomach.

 【Indications】

(1) Deficiency cold in the Stomach with nausea after eating, fullness and oppression in the chest and epigastrium, or epigastric pain, sour regurgitation, and belching. (2) Jueyin headache, dry heaving, vomiting and diarrhea, cold extremities, and severe irritability. (3) Paroxysmal upward counterflow of turbid phlegm, accompanied by cold extremities and irritability during episodes. “Prescriptions of Medicine”: (1) Treats Yangming syndrome with nausea after eating. If symptoms worsen after taking the decoction, it indicates upper Jiao involvement (Cold Damage, Yangming Chapter). (2) Shaoyin syndrome with vomiting, diarrhea, cold extremities, and severe irritability (Cold Damage, Shaoyin Chapter). (3) Jueyin syndrome with dry heaving, vomiting of frothy saliva, and headache (Cold Damage, Jueyin Chapter). “Compendium of Herbs”: Jueyin disease with dry heaving and vomiting of saliva, and headache; Shaoyin syndrome with vomiting, diarrhea, cold extremities, and severe irritability; Yangming syndrome with nausea after eating.

 【Indications for Use】

Functional vomiting, hiccups, gastric and duodenal ulcers, enteritis, cholecystitis, hepatitis, chronic gastritis, tension headache, migraine, otogenic vertigo, and other conditions associated with deficiency cold.

 【Contraindications】

(1) This formula is acrid, bitter, sweet, and warm. It is not suitable for vomiting, headache, or abdominal pain due to heat. (2) After taking the decoction, patients may experience discomfort in the chest, worsening headache, or dizziness, which usually subsides within about half an hour. Therefore, it is advisable to rest briefly after taking the medicine to alleviate these reactions.

 【Mnemonic】

Will find me (Ginger, Jujube, Wu [Zhu Yu], Ren [Shen]).

 【Modifications】

(1) For severe vomiting, add Tangerine peel, Pinellia, and <a href='https://whatsintcm.com/dt_articles/Amomum/’>Amomum seed to warm the Stomach, descend counterflow, and stop vomiting. (2) For headache, add Ligusticum root and Angelica sinensis to regulate the Liver and stop pain. (3) For severe cold, add Sichuan pepper, Aconite root, and dried ginger to enhance the action of warming the interior and dispelling cold. (4) For sour regurgitation, add cuttlefish bone and calcined Ostrea shell to neutralize acidity.

 【Pharmacology】

It has effects of anti-emesis, anti-diarrhea, anti-ulcer, inhibition of gastric motility, cardiotonic, blood pressure elevation, anti-shock, microcirculation improvement, and immune function enhancement.