Herb selection syndromes

This book mainly considers individual syndromes, such as the syndrome of Spleen-Qi deficiency, and it discusses the composition of individualized formulas, such as a formula to tonify the Spleen-Qi. In practice, a syndrome can be much more complicated. The sections on Common accompanying symptoms and treatment offer more possibilities for herb selection in complicated situations. To treat a syndrome with different kinds of secondary syndromes, such as Spleen-Qi deficiency with dampness accumulation or food accumulation, a practitioner should consult different chapters to compose an effective formula. 

When the herbs fulfill these conditions, the wind calms down and the bleeding in the intestines stops. Although there are only four herbs in the formula, each has more than two functions or properties to suit the syndrome. It is a perfect example of herb selection. 

For students and junior practitioners, this book offers a method of learning formula composition in a clear and concise fashion. For experienced practitioners, this book offers a comprehensive discussion of various syndromes and their differential diagnoses, as well as treatment methods and strategies that may bring a deeper understanding of the theories of traditional Chinese medicine and help to improve their diagnostic skills and their knowledge of appropriate herb selection, as well as their... 

In the sections Structure of the formula and selection of herbs, a herb may sometimes be assigned a different position in the formula structure (e.g. it may serve as a chief or as a deputy) according to the nature of the presenting syndrome and the understanding of the herb s function. 

Composing a formula is a process where several conditions must be fulfilled. First, one must make a clear syndrome differentiation, establish the treatment principles, select treatment methods and figure out the most suitable strategies. One should then follow the model of formula structure, selecting appropriate herbs to play specific roles in the formula and ensuring that treatment strategies are fully expressed. 

In order to compose effective formulas, the principles, methods and strategies of selecting herbs are very important. They enable a practitioner to compose formulas to treat a variety of syndromes. The principles, methods and strategies introduced in each chapter of this book are abstracted from a large number of formulas, integrating the knowledge... 

As soon as a treatment principle is established, the composition plan and treatment strategies can be arranged. For instance, to treat the syndrome of excess heat in the Lung and Stomach, one would first prescribe herbs that have sweet-cold, bitter-cold or salty-cold properties, and which have the functions of clearing heat and reducing fire in the Lung and Stomach. Second, herbs that are sweet and cold and that can nourish body fluids and protect the Yin, which has been severely consumed by the excess heat, should be selected. Herbs that can tonify the Qi should be selected if the Qi is weakened severely by the heat. Herbs that moderate the actions of the harsh herbs in the formula, and reduce their side effects, should also be added. 

When patients suffer from chronic liver or kidney disease, the selection of the herbs and their dosages should be determined carefully to avoid placing an unnecessary workload on these weakened organs. At the same time, herbs that protect these organs and promote their function should also be included. For instance, acute or chronic liver diseases are mainly differentiated into a syndrome consisting of Spleen-Qi deficiency, damp-heat and heat-toxin accumulation, and herbs that treat this syndrome can be used. Chronic kidney diseases are mainly differentiated as Kidney-Yang and Spleen-Yang deficiency, dampness accumulation and heat-toxin in the blood. Herbs that treat this syndrome should be used in appropriate doses to help restore kidney function. 

These three herbs are able to expel wind, cold and dampness from the skin, subcutaneous region and muscles. They can be selected as chief in a formula to treat a severe excess condition of wind-cold syndrome. 

Xi Xin is a very pungent and hot herb with an aromatic smell. It does not enter the Bladder meridian, but does enter the Kidney meridian. It can be selected as deputy in the formula to enhance the action of the chief herbs in treating an excess condition of wind-cold syndrome and can release pain. 

Sang Ye and Ju Hua are bitter, sweet and cold, and enter the Lung and Liver meridians. They are often selected as chief herbs in the formula to treat a mild wind-heat syndrome when the wind-heat mainly affects the Lung. 

These two herbs are often selected as chief herbs in a formula to treat a common case of wind-heat syndrome. 

In this formula, two groups of herbs are selected to treat two aspects of the syndrome - Yin deficiency and constipation. Furthermore, the side effects of the purgative herbs have to be considered as the Yin and fluid in the intestines may be further injured and constipation can get worse. 

Ji Xue Teng is bitter, slightly sweet and warm, and enters the Kidney and Liver meridians. It is a special herb for tonifying the blood as it is also able to promote the blood circulation and relax the tendons. It is therefore selected in formulas to relieve stiffness, tingling, numbness, pain and an uneasy feeling in the body, such as in Bi syndrome and in restless leg disorder due to blood deficiency with Qi and blood stagnation. 

Gui Zhi is sweet, pungent and warm, and enters the Heart meridian. Since the twigs enter the meridians according to the concepts of traditional Chinese medicine, this herb is able to stimulate the Yang and the Qi of the Heart. Together with herbs that tonify the blood, it can accelerate the speed of the bloodgenerating process. It is mainly used as assistant in the formula to tonify the blood so as to warm the blood, promote blood circulation and open up the obstruction. It is particularly selected in the syndrome where there is numbness and tingling of the limbs, cold and pain of the extremities. 

Generally speaking, blood, Yin and essence all belong to the Yin because of their substantial form. In a syndrome of Liver-Yin deficiency, liver-blood deficiency is often the initial stage of Liver-Yin deficiency liquid-Yin deficiency is the second stage, and essence deficiency of the Liver and Kidney is the last stage. Thus, to tonify the Liver-Yin, herbs that tonify the blood and nourish the liquid-Yin and the essence are all selected. 

Along with these, it is equally important to select herbs that tonify and stabilize the Qi, blood, Yin and Yang in order to treat the cause of the syndrome and enhance the ability of the stabilizing and binding herbs. 

In this formula, herbs are selected with pungent, bitter and cold properties to treat Bi syndrome. 

Second, for treating damp-phlegm syndrome, bitter and warm herbs that can dry dampness, or sweet and bland herbs that can leach out dampness, are selected for treating phlegm-heat syndrome, cold and moistening herbs that can dilute phlegm are selected. 

These herbs are the most commonly used herbs to treat phlegm-heat. They are selected as chief in formulas to treat phlegm-heat syndrome. 

The other three herbs are able to leach out dampness and promote urination. They can be selected in the formula to assist the chief and deputy herbs to remove damp-phlegm. Among these herbs, Fu Ling is neutral and can gently tonify the Spleen-Qi Ze Xie and Yi Yi Ren are cold and are more suitable for treating phlegm-heat syndrome. 

Bai Zhu is warmer than Dang Shen but is bitter. The strong point of this herb is that it can either tonify the Qi or dry dampness. It can also treat the cause and manifestations of phlegm. It is often selected to treat damp-phlegm syndrome. 

Chuan Lian Zi is very bitter and cold. It can intensively drain the Liver-fire and direct the Liver-Qi downwards. It is selected in formulas for treating syndromes where Liver-fire flares up and Liver-Qi movement is disturbed. The disorder is manifested as irritability, distension in the hypochondria, insomnia, quick temper, red eyes, headache, red tongue with a yellow coating and a forceful, wiry and rapid pulse. Because Chuan Lian Zi is very bitter and cold, it easily injures the Stomach. This herb should not be used for a long period of time or in large dosage, because it is a toxic herb. Overdose may cause nausea, vomiting, diarrhea, dyspnea and arrhythmia. 

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