Ge Gen Formula Family With Dr Huang Huang

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1 Ge Gen Formula Family With Dr Huang Huang Ge Gen Recorded in the Shen Nong Ben Cao Jing (Divine Husbandman s Classic of Materia Medica) as being indicated for xiao ke (wasting-thirst disease), great fever, vomiting and various type of Bi syndrome. Included in 4 formulas in the Shang Lan and 3 formulas in the Jin Gui Yao Lue. Ge Gen Herb Pattern Head & neck issues e.g. headache, pain and stiffness of the nape of the neck, blood supply issues to the brain Loose stools Absence of sweating Thirst Ge Gen back Ge Gen Tang Traditionally used as a sobering up formula after alcohol intoxication. Used in Shang Han Lun to treat Taiyang Cold Damage with stiff neck; or for Taiyang Yangming combined disease with diarrhoea; also used in the Jin Gui Yao Lue to treat Jing disease It is a gentle diaphoretic formula that can dispel cold and relax tendons; and is suitable for patients with symptoms of aversion to cold with no sweating, headache, body ache, neck and back pain, sleepiness, easily fatigued, and loose stools. Dr Huang s modifications of the formula: Ge Gen g Sheng Ma Huang 10-15g Gui Zhi 15g Bai Shao 15g Sheng Gan Cao 5g Sheng Jiang 15g Da Zao 20g Decoct herbs in 900ml of water until water reduced to 300ml. Divide into 2-3 portions to drink. Drink the formula warm. 1

2 If the amount of Ge Gen used exceeds 60g, decoct the Ge Gen first separately, then use the decocted water to cook the other herbs. Applicable to patients with the following characteristics: o Thick waist and strong broad back strong muscular build with big, firm muscles, especially the neck and back muscles; may have bulging muscles on the back of the neck or on the back; strong pulse; often seen in young fit adults or labourers o Dry and rough skin dark yellow or dark red facial complexion; acne on the face or back; not prone to sweating o Easily tired and have lots of head related conditions sense of fatigue, sleepiness, delayed reaction times; easy to get dizzy, tinnitus, deafness, acne, dry mouth o Menstrual dysfunction irregular periods, oligomenorrhoea, lengthening of cycle, amenorrhoea, dysmenorrhoea, etc. Applicable to conditions and diseases that present with: o Fever and absence of sweating e.g. common colds and flus, initial stage of mastitis, initial stage of boils o Pain in the back of the neck, back and leg e.g. cervical spondylosis, wry neck, frozen shoulder, lumbar vertebral disc protrusion, acute/chronic lumbago o Chronic inflammatory conditions of the face and head e.g. acne, folliculitis, gingivitis, sinusitis, allergic rhinitis, etc. o Dysfunction of the 5 senses organs e.g. sudden deafness, facial paralysis, TMJ dysfunction, Bell s palsy, trigeminal neuralgia, macular degeneration o Dizziness and heaviness of the head e.g. cerebrovascular infarction, hypertension, atherosclerosis, alcohol intoxication o Menstrual dysfunction e.g. PCOS, amenorrhoea, dysmenorrhoea, etc. Dr Huang s clinical experience using this formula: o Common cold: Accompanied by fatigue, neck and back pain, aches and heaviness all over the body, absence of sweating, nasal congestion, blocked ears, non-injected pharynx The objective is to promote diaphoresis. If accompanied by sore throat or phlegm that is difficult to expectorate, or tonsillitis, add Jie Geng. If accompanied by fever, headache, sore throat, irritability and thirst, add Shi Gao. If accompanied by runny nose or rhinitis, add Chuan Xiong and Xin Yi Hua. o Viral induced diarrhoea: Suitable only for strong and healthy children with viral induced diarrhoea, gastroenteritis, etc. Can also be used for shingles or herpes simplex infection. Most are accompanied by absence of sweating, nasal congestion and runny nose, and frothy diarrhoea. o Acne: Suitable for cold type acne acne is dark in colour, with deep and sunken acne head; acne distributed on the face and back but predominantly on the back; acne is worse in winter and better in summer and relieved by sweating 2

3 If accompanied by constipation or dysmenorrhoea, together with rough skin in the lower limbs, add Gui Zhi Fu Ling Wan. If the acne is pustular, add Chuan Huang San (Zhi Da Huang 10g and Chuan Xiong 10g). o Sudden deafness: Suitable for acute onset deafness or common cold induced sudden deafness, or low pitched tinnitus If accompanied by dark yellow facial complexion or cerebrovascular infarction or high blood viscosity, add Chuan Xiong. o Facial paralysis o Cerebrovascular infarction: Add Chuan Xiong, Dan Shen, Huang Qi. o Dysmenorrhoea accompanied by acne o Polycystic ovarian syndrome: This formula can promote menstruation. If the patient is of a sturdy build, has hirsutism, red face, purplish black facial acne, a firm and protruded lower abdomen, add Gui Zhi Fu Ling Wan, Da Huang and Huai Niu Xi. If the patient has a yellow facial complexion and dry skin, not a lot of body hair, soft waist, abdomen and hips, prone to loose stools and oedema, and/or also has infertility, add Dang Gui Shao Yao San. If the patient is medium build, has small volume of pale coloured menses or amenorrhoea or thin endometrium, add Wen Jing Tang. If the patient is of sturdy build, has rough and dark skin, is easily fatigued, add Ma Huang Fu Zi Xi Xin Tang. o Fatigue (sleepiness, tiredness, low motivation) o Others: TMJ dysfunction, haemafaecia, mastitis, low libido in women, vaginal wall laxity, ADHD Dr Huang s Modifications: o Cold and heavy sensation at the waist with fatigue, add Gan Jiang Ling Zhu Tang o Abdominal pain (especially near left iliac fossa) and back and leg pain, dry skin in both lower legs, dark coloured tongue, add Gui Zhi Fu Ling Wan o Heaviness and pain in the back and lower limb joints, add Bai Zhu, Fu Zi o Fit and sturdy men with hypertension, diabetes, cervical spine disease, or wry neck, add Huang Lian, Huang Qin Additional Notes: o Caution when patient has constipation use a small quantity of the formula or add Da Huang o A stiff and hard neck and back can also be a symptom in other formulas such as Ge Gen Qin Lian Tang, Tao He Cheng Qi Tang, Ma Huang Tang, Da Chai Hu Tang etc. Further differentiation is required. Ge Gen Qin Lian Tang Traditionally used for hangovers and dysentery. 3

4 Functions include clears heat, antibacterial, antiviral, anti-hypoxic, hypoglycaemic, antispasmodic, anti-peristaltic, and anti-arrhythmic. Used to treat diarrhoea, vexation, chest stuffiness, palpitations, glomus under the heart, neck and back stiffness, body heaviness, sweating, thirst, red tongue, slippery rapid pulse. Dr Huang s modifications of the formula: Ge Gen 40g Huang Lian 10g Huang Qin 10g Sheng Gan Cao 10g Cook in 800ml of water until 200ml of water left. Divide into 2 portions to drink separately. Drink the formula warm. Applicable to patients with the following characteristics: o Strong and sturdy build with well-developed and firm muscles, thick waist and broad back, dark red lips and tongue, injected conjunctiva, oily facial complexion o Prone to loose stools unformed stools, loose stools, sticky smelly stools, or diarrhoea after drinking alcohol o Neck and back stiffness body feels heavy all over, neck and nape discomfort/pain; has thick and firm neck and back muscles o Often have high blood sugar, hypertension and hyperlipidaemia often seen in middle aged male executives with stressful work, who drinks heavily and eats out often; the elderly often presents with dizziness, headaches, aversion to heat, sweating and rapid heart rate. Applicable to conditions and diseases that present with: o Loose stools or diarrhoea e.g. dysentery, acute gastrointestinal inflammation, paediatric viral enteritis, alcohol intoxication, etc. o Headache and fever e.g. measles, encephalitis B, seasonal influenza, aphthous ulcers, gingivitis, etc. o Dizziness and heaviness in the waist and back e.g. diabetes, hypertension, coronary artery disease, fatty liver, stroke, arrhythmia, cervical spondylosis Dr Huang s clinical experience using this formula: o Heat type diarrhoea: Abdominal pain and diarrhoea with hot, smelly, explosive type stools causing redness and burning sensation in the anus; has thirst and dry mouth; has rapid slippery pulse Add Chai Hu for fever; add Bai Shao for abdominal pain or cramps; add E Jiao for blood in the stools. o Diabetes: Suitable for patients with a strong and sturdy physique presenting with dizziness, stiff neck and back, loose stools, dry mouth, excessive sweating, dark red tongue, rapid and slippery pulse, persistent hyperglycaemia 10g and Rou Gui 10g. 4

5 If the patient also has hypertension, headache, cerebrovascular infarction, tinnitus or deafness, increase the Ge Gen to g. o Arrhythmias: Suitable for patients with tachy-arrhythmias with loose stools and abdominal pain o Hypertension: Suitable for strong and fit men with hypertension presenting with dark red lips, injected conjunctiva, aversion to heat, excessive sweating, a tendency for loose stools. If the patient also has dizziness and chest stuffiness, add Chuan Xiong. o Cervical spondylosis: Suitable for patients who have a strong and sturdy physique presenting with severe neck and shoulder pain. o Diseases of the mouth & teeth: E.g. aphthous ulcers, gingivitis, tooth abscess, etc. o Acne: Accompanied by loose stools, aphthous ulcers, etc. Often seen in patients with PCOS, gastrointestinal inflammatory diseases, insomnia o Alcohol intoxication / hangover: Red face, dry mouth, thirst, diarrhoea, dizziness, headache, chest stuffiness, shortness of breath Can use the original formula or add Rou Gui and Gan Jiang Modifications: o Weakness in lower back and legs due to diabetes, discolouration of skin in lower limbs, sexual dysfunction, add Huai Niu Xi o Glomus under the heart, nausea & vomiting, add Ban Xia Xie Xin Tang o Increase Huang Lian dose (15g and above) for persistent hyperglycaemia in diabetic patients. o Can decrease Huang Lian dose to less than 5g for patients without a lot of thirst or for children. Gui Zhi Jia Ge Gen Tang A modification of the Gui Zhi Tang formula. Functions include tonifying, ability to raise the clear, ability to release the muscle layer, enhances blood circulation to the head and face, anti-spasmodic effect on the neck and back muscles Used to treat head and neck stiffness and spontaneous sweating type conditions. Dr Huang s modifications of the formula: Gui Zhi 25g Bai Shao 15g 5

6 Zhi Gan Cao 10g Sheng Jiang 40g or Gan Jiang 10g Hong Zao 20g Ge Gen 40g Decoct in 1000ml of water until 450ml of water left. Divide into 3 portions and drink the formula warm. Applicable to patients with the following characteristics: o Dark yellow or pale or dark red complexion o Dark purplish or pale red or dark red tongue o Dizziness and headache or tight neck and back with lack of strength, or has cognitive impairment or speech difficulties, or has insomnia and lots of dreams, or irritable, or has blurry vision, or has tinnitus or deafness o Cerebro/coronary vascular diseases prone to have hypertension, cerebrovascular infarction, cerivical spondylosis, diabetes, hyperlipidaemia, insomnia, lumbar spondylosis, etc. o Gui Zhi Tang pattern + nape of neck or back spasm/tightness or loose stools Gui Zhi Tang pattern: 1. Thin physique, muscles are not well developed 2. Skin is clammy or moist 3. Skin pores are fine and skin lacks lustre 4. Abdominal muscles are thin and weak but tight 5. Tongue is pale red or dull red, tongue body is soft and moist with thin white coating 6. Pulse is often deficient and slow 7. Often have cold sweats and feels uncomfortable after sweating 8. Prone to get palpitations 9. Easily fatigued, poor endurance 10. Gets abdominal pains easily 11. Often gets insomnia or dreamful sleep 12. Sensitive to cold and pain 13. Tendency to have poor cardiac function, low blood pressure, vascular diseases, digestive diseases and malnutrition. Applicable to conditions and diseases that present with: o Dizziness and headache e.g. hypertension, cerebrovascular infarction, cerebrovascular insufficiency, insomnia, etc. o Neck and back tightness/stiffness e.g. cervical spondylosis, neck and shoulder muscular tension, lumbar spondylosis, etc. Dr Huang s clinical experience using this formula: o Dizziness due to underlying cerebrovascular ischaemia: Presenting symptoms dizziness or vertigo, head distension, heaviness in the head but feels light in the feet, etc. Add Chuan Xiong and Gui Zhi Fu Ling Wan. If the patient also has lack of energy, excessive sweating, puffiness in the face, add Huang Qi. 6

7 o o o Tinnitus due to underlying cerebrovascular ischaemia: Patients presenting with this often have cerebrovascular or coronary vascular disease. If the patient has dark yellow or darkish complexion and rough skin, add Ma Huang 5g. If the patient has limb numbness, excessive sweating, and oedema, add Huang Qi. Cervical spondylosis: If accompanied by numbness in the limbs, excessive sweating and oedema, add Huang Qi. If accompanied by weakness in the lower back or legs, add Huai Niu Xi. If accompanied by headache or dizziness, add Chuan Xiong. Facial paralysis: Add Chuan Xiong, Huang Qi, etc. Additional Notes: o After taking the formula, the patient may complain about toothache, feeling weak or hungry, or a heat sensation in the head or face, or constipation. As long as the original symptoms are improving, there is no need to change the formula. You can decrease the dosage of the formula instead. o Comparison with Ge Gen Tang: Both formulas can be used to treat neck and back pain/stiffness, deafness, and tinnitus Differences lie in: 1. Presence or absence of sweating 2. Strong or weak physique 3. Acute or chronic nature of the disease 7

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