[Synonyms]

Dan Zhi Xiao Yao San, Ba Wei Xiao Yao San.

[Source]

Vol. 2, under Internal Medicine Synopsis.

Angelica, Poria cocos, Gardenia, White Peony Root, Bupleurum, Atractylodes Macrocephala Rhizome, Paeonia suffruticosa Root Bark, Honey-fried Licorice Root, Parched Ginger, Mint.(10)

[Classification Group]

<Nourishing Blood>: Peony Root, Angelica Sinensis

<Tonifying Spleen and Middle Jiao>: Licorice Root, Atractylodes Macrocephala Rhizome

<Tonifying Spleen and Promoting Urination>: Poria Cocos

<Dispersing Exterior with Acrid Warmth>: Parched Ginger

<Dispersing Exterior with Acrid Coolness>: Bupleurum, Mint

<Clearing Heat and Purging Fire>: Gardenia

<Clearing Heat and Cooling Blood>: Paeonia suffruticosa Root Bark.

[Analysis]

Xiao Yao San plus Paeonia suffruticosa Root Bark and Gardenia. <Clearing Heat and Purging Fire>: Gardenia; <Clearing Heat and Cooling Blood>: Paeonia suffruticosa Root Bark.

[Mnemonic]

Xiao Yao San + Dan Zhi.

[Functions]

Soothes the Liver and clears heat, resolves depression and harmonizes the营 (Ying), soothes the Liver and resolves depression, clears heat and cools blood, harmonizes blood and regulates menstruation.

[Indications]

(1) Blood and Spleen deficiency, leading to generation of heat, internal heat from depression, tidal fever, alternating fever and chills. Or irritability and anger, or spontaneous and night sweats, abdominal and flank pain, dizziness and headache, blurred vision, palpitations and restlessness, or red cheeks and dry mouth.

(2) This formula is for deficiency patterns of Shaoyang disease, with the pathology in the Liver. Indicated for conditions similar to 柴胡湯/’>Minor Bupleurum Decoction but in a deficiency state, where chest and hypochondriac fullness is not severe, with easy fatigue, and accompanied by various neurological symptoms. Chief complaints include feeling of fatigue in the limbs, heavy head, dizziness, insomnia, increased anger, intermittent (irregular) burning sensation, menstrual irregularities, upward sensation in the afternoon and facial flushing, chills or steaming sensation in the back, and sweating.

(3) Women with irregular menstruation, fever and cough, lower abdominal pain, or bloating and distension in the lower abdomen, or pain in the vulva, or vulvar swelling, and painful urination with astringent sensation, characterized by red tongue and white coat, and wiry and rapid pulse. It is particularly effective for menstrual disorders caused by Liver Qi stagnation transforming into fire, such as early menstruation and dysmenorrhea. Used for symptoms of Liver dysfunction in deficient constitutions, especially in gynecological conditions accompanied by neurological symptoms.

(4) Postpartum women with vulvar swelling, or redness and pain without closure; blood deficiency with fire dryness, postpartum constipation.

(5) Women with internal heat damaging the Liver and Spleen due to depression, leading to damp-heat descending to cause pain in the vulva, where the pain is so severe that the limbs cannot be extended; and for blood wind sores caused by wind-dampness and blood dryness, with itching or pain, which develops into sores upon scratching.

(6) Depression, with excessive Liver Fire, characterized by feverishness, bitter taste, tinnitus, and dizziness.

(7) Children with Liver and Spleen blood deficiency and internal heat, experiencing flank and abdominal pain, dark eyes and heavy head, or poor appetite and insomnia, or mouth and tongue sores, or distension of the chest and breasts.

(8) External symptoms of generalized itching all over the body, or sores due to deficient heat.

[Indications]

(1) Menopausal disorders, menopausal syndrome, irregular menstruation, breast hyperplasia during menopause, premenstrual tension syndrome, infertility, irregular menstruation, postpartum stomatitis, leucorrhea, chronic endometritis, various neuroses caused by abortion or tubal ligation.

(2) Hepatitis, chronic gastritis, gastric and duodenal ulcers, chronic hepatitis, cirrhosis, chronic cholecystitis, biliary tract infections, puberty, lactation.

(3) Urethritis, cystitis, constipation, eczema, palmar keratosis, vitiligo.

[Contraindications]

Avoid anger and overwork.

[Rationale of Formula]

From “Convenient Reading”: This formula uses Paeonia suffruticosa Root Bark which enters the Liver and Blood of the Gallbladder to clear fire evil; Black Gardenia also enters the Ying and can guide heat from the upper Jiao (Heart and Lungs) downwards. Combined with Xiao Yao San, it can resolve depression and scatter fire. When fire recedes, all ailments are cured.

From “Chinese Medicine Dictionary”: The principal herbs in this formula are Angelica Sinensis, White Peony Root, and Bupleurum. Angelica Sinensis nourishes blood, moistens dryness, disperses internal stagnation, acting as a warm agent to remove blood stasis and also as a blood tonic. White Peony Root harmonizes the blood, soothes the middle, and acts as a mild antispasmodic and analgesic. Together with Angelica Sinensis, it treats blood disorders. Bupleurum is the chief herb for treating hypochondriac pain, alternating chills and fever, abdominal pain, etc., acting as an antipyretic and stomachic, and is indicated for Liver diseases in the Shaoyang level (implying neurological symptoms). Paeonia suffruticosa Root Bark is an anti-inflammatory agent that harmonizes blood and removes stasis. Gardenia is an anti-inflammatory, analgesic, and hemostatic herb used for irritability, fever, burning sensations, and jaundice, and also treats nervousness and insomnia. Furthermore, Atractylodes Macrocephala Rhizome, Poria Cocos, and Licorice Root have stomachic and diuretic effects; Mint, with its cooling property, opens the chest and stimulates the appetite, and together with Ginger, enhances the absorption of the herbs.

[Modifications]

From “Chinese Medicine Dictionary”: For palmar keratosis or tinea pedis, add 20g each of Root Bark of Wolfberry and Schizonepeta.For stubborn skin diseases in women or dry eczema, it can be used in combination with Si Wu Tang (Four Substances Decoction). From “Wan Bing Hui Chun”, Vol. 5.

[Composition]

White Peony Root, Angelica Sinensis, Raw Rehmannia Root, Atractylodes Lancea Rhizome, Peach Kernel, Achyranthes Root, Achyranthes Bidentata, Tangerine Peel, Gentiana, Poria Cocos, Sichuan Lovage Rhizome, Han Fang Ji, Notopterygium Root, Saposhnikovia Root, Angelica Dahurica, Ginger, Licorice Root.(17)

[Classification Group]

 <Nourishing Blood>: White Peony Root, Angelica Sinensis

<Tonifying Spleen and Middle Jiao>: Licorice Root

<Tonifying Spleen and Promoting Urination>: Poria Cocos

<Dispersing Exterior with Acrid Warmth>: Ginger, Angelica Dahurica, Saposhnikovia Root, Notopterygium Root

<Clearing Heat and Drying Dampness>: Gentiana

<Clearing Heat and Cooling Blood>: Raw Rehmannia Root; <Expelling Wind-Dampness>: Fang Ji, Achyranthes Bidentata

<Aromatizing and Transforming Dampness>: Atractylodes Lancea Rhizome

<Regulating Qi>: Tangerine Peel

<Invigorating Blood and Removing Stasis>: Sichuan Lovage Rhizome, Achyranthes Root, Peach Kernel.

[Analysis]

Si Wu Tang(Cooked Rehmannia Root,Angelica Sinensis,White Peony Root,Sichuan Lovage Rhizome) + Atractylodes Lancea Rhizome, Peach Kernel, Achyranthes Root, Achyranthes Bidentata, Tangerine Peel, Gentiana, Poria Cocos, Han Fang Ji, Notopterygium Root, Saposhnikovia Root, Angelica Dahurica, Ginger, Licorice Root, Fang Ji, Ginger.

[Mnemonic]

 <Nourishing and Invigorating Blood>: Peony, Angelica, Lovage Rhizome, Achyranthes, Peach Kernel → Sister Angelica Fierce Achyranthes Escapes

<Expelling Wind-Dampness, Transforming Dampness, Regulating Qi>: Fang Ji, Achyranthes Bidentata, Atractylodes Lancea, Tangerine Peel → Fake Immortal Stir-fried Pig Skin

<Dispersing Exterior, Clearing Heat>: Saposhnikovia, Angelica Dahurica, Ginger, Notopterygium, Gentiana.

[Functions]

Soothes channels and invigorates blood, expels wind and removes dampness.

[Indications]

(1) Generalized pain like stabbing throughout the body, especially severe in the left leg. The left side is related to blood. Often caused by damage from alcohol and sex, leading to empty channels and sinews, attacked by wind, cold, dampness, and heat. Internal heat encasing external cold causes pain that damages the channels and sinews, leading to milder pain during the day and more severe pain at night. Indications include soothing channels, invigorating blood, and removing dampness. This is not arthritic wind. Recommended for women with blood wind and consumption.

(2) Indicated for pain in muscles, joints, and the lower back, especially below the waist, due to blood stasis and water toxin, exacerbated by exposure to wind and cold.

[Indications]

Gout, rheumatism, arthritis, lower back pain, sciatica, leg paralysis, beriberi, edema, purpura, hemiplegia, hypertension, postpartum thrombotic pain.

[Rationale of Formula] 

From “Chinese Medicine Dictionary”: This formula is named “Soothes Channels and Invigorates Blood” formula, implying the meaning of opening up stagnant blood in the channels and removing wind-dampness. It is indicated for pain in muscles, joints, and the lower back, especially below the waist, due to blood stasis and water toxin, exacerbated by exposure to wind and cold. This is originally a modified formula of Si Wu Tang. Angelica Sinensis, White Peony Root, Sichuan Lovage Rhizome, Rehmannia Root, and Peach Kernel are the components of Si Wu Tang, with the addition of Peach Kernel to open stagnant blood in the lower abdomen. Poria Cocos, Atractylodes Lancea Rhizome, Tangerine Peel, Notopterygium Root, Angelica Dahurica, and others, combined with Achyranthes Bidentata, Fang Ji, and Gentiana, work together to expel wind and dampness from the waist and legs. Achyranthes Root is particularly effective in removing dampness and has the effect of treating pain in the waist and legs.

[Modifications] 

(1) For phlegm, add 1 qian each of Pinellia ternata and Pinellia Ternata.

(2) For pain in the upper body and arms, add 3 fen of Cinnamon Bark.

(3) For pain in the lower body and legs, add 1 qian each of Papaya, Akebia, salt-fried Amur Cork Tree Bark, and Job’s Tears.

(4) For Qi deficiency, add 7 fen each of Ginseng, Atractylodes Macrocephala Rhizome, and Turtle Plastron.

(5) For blood deficiency, double the amount of Si Wu Tang, stir-fry with ginger juice and wine, and add 1 qian of Safflower.