Damp Syndrome. Yuxing Liu. Academy of Oriental Medicine at Austin

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1 Damp Syndrome Yuxing Liu Academy of Oriental Medicine at Austin

2 General Introduction Concept Key Symptoms Related Organs

3 Promote urination, leach out dampness Fu ling Zhu ling Ze xie Yi yi ren Dong gua pi Promote urination, relieve PUD Bian xu Qu mai Cheqianzi Mu tong Tong cao Hua shi Di fu zi Shi wei Bei (bi) xie Hai jin sha Deng xin cao Dong kui zi Damp heat Promote urination, relieve jaundice Jin qian cao Yin chen hao Hu zhang relieve cold Du huo Wei ling xian Mu gua Hai feng teng Bai hua she Wu shao she Dispel wind-damp Relieve heat Qin jiao (Han) fang ji Sang zhi Xi xian cao Si gua luo Ren dong teng Hai tong pi Strength tendon and bone Wu jia pi Ci wu jia Sang ji sheng Gou ji Qian nian jian

4 Herbs that resolve dampness Aromatic herbs dry / drain dampness Dry dampness Transform damp Cang zhu Huo xiang Bai Zhu Hou po Cao dou kou Cao guo Pei lan Bai dou kou Sha ren Tonify SP and dry dampness Zi su ye Shi chang pu

5 Ping Wei San 平胃散 (calm the ST powder) Tai ping hui min he ji ju fang Chen pi 9g Cang zhu 15g Hou po 9g Gan cao 6g Sheng jiang 2 slices Da zao 2 pcs Functions: dries dampness, strengthens SP; moves Qi, harmonizes ST Indications: dampness obstructing Qi in the SP and ST distension and fullness in the abdomen, loss of taste and appetite, sweet taste in the mouth, heavy limbs, loose stool or diarrhea, fatigued, desire to sleep lots, nausea and vomiting, belching, acid regurgitation, T: swollen tongue with thick white and greasy coat, P: moderate or slippery Contraindicated in cases of red tongue with scanty coat due to Yin deficiency or a bitter taste in the mouth, thirst, and rapid pulse due to excess heat. Modern applications: acute and chronic gastroenteritis, catarrhal gastritis, gastrointestinal neurosis, indigestion, hepatitis Modification: Dampheat: huang lian, huang qin Dampcold: gan jiang, cao dou kou Diarrhea due to damp retention: fu ling, Ze xie

6 Damp in middle jiao (Ping Wei San) Damp in middle jiao External wind-cold with internal dampness obstructing Qi in the MJ Phlegm-fluid retention affecting the upper or middle jiao with SP Yang deficiency

7 Huo Xiang Zheng Qi San 藿香正气散 Agastache Qi Rectifying Powder Tai ping hui min he ji ju fang (powder dosages) Huo xiang 90g Da fu pi 30g Ban xia 60g Bai zhu 60g Bai zhi 30g Chen pi 60g Hou po 60g Zi su ye 30g Fu ling 30g Jie geng 60g Da zao 1pc Zhi gan cao 75g Sheng jiang 3 slices Functions: aromatically transform Damp, moves Qi, harmonize middle jiao; expel wind-cold, release the exterior Indications: external wind-cold with internal dampness obstructing Qi in the middle jiao fever and chills, headache, sensation of fullness and oppression in the chest, abdominal pain, nausea and vomiting, borborygmus, diarrhea, loss of taste, T: white greasy tongue coat, P: moderate soft pulse or superficial tight Contraindicated in case of Yin deficiency with empty fire; caution for patients with thirst and yellow tongue coat Modern applications: influenza, common cold of gastraintestinal type, acute gastoenteritis, peptic ulcer, colitis, food poisoning

8 Ling Gui Zhu Gan Tang 苓桂术甘汤 <jin gui yao lue> poria, cinnamon, atractylodes, and licorice decoction Fu ling 12g (sclerotium poriae cocos) Gui zhi 9g (ramulus cinnamomi cassiae) Bai zhu 9g (rhizoma atracylodis macrocephalae) Zhi gan cao 6g (honey fried radix glycyrrhizae uralensis) Functions: warms Yang, transforms Phlegm-fluids; strengthen Spleen Qi, clear Damp Indications: phlegm-fluid retention affecting the upper or middle jiao with SP Yang deficiency fullness in the chest and hypochondria, palpitations, shortness of breath, coughing up clear and watery sputum, difficult in breathing, dizziness, vertigo, or nausea T: pale tongue and swollen with white slippery or greasy coat, P: slippery and either wiry or soft pulse, or deep weak pulse. Contraindicated in cases of Yin deficiency Modern applications: chronic bronchitis, bronchial asthma, pulmonary emphysema, Meniere s syndrome, vegetative (autonomic) nerve dysfunction, tinnitus, cardiac or nephritis edema, chronic gastritis, chronic nephritis

9 Damp in Upper/Middle jiao

10 Er Chen Tang 二陈汤 two matured ingredients decoction - Tai ping hui min he ji ju fang Chen pi 15g Ban xia 15g Fu ling 9g Zhi Gan cao 4.5g Sheng jiang 7 slc. Wu mei 1pc Functions: dry Damp, eliminate Phlegm; regulate Qi, harmonize mid Jiao Indications: phlegm-dampness obstructing Qi in the upper and middle jiao coughing copious white sputum that is easily expectorated, focal distension in chest and diaphragm, palpitations, nausea, vomiting, dizziness, lassitude T: swollen tongue with white thick greasy coat, P: slippery pulse. Contraindicated in cases of dry cough, or coughing of blood due to Yin deficiency Modern applications: chronic bronchitis, gastritis, peptic ulcer, goiter, Miniere s syndrome

11 Damp in lower jiao Damp in lower jiao Damp w/ leucorrhea Damp w/ urinary problems

12 Wu Ling San 五苓散 five ingredients powder with poria Fu ling 9g Zhu ling 9g Ze xie 15g Bai zhu 9g Gui zhi 6g Functions: Promote urination, drains water-damp; warms Yang and tonifies the SP, strengthens the transforming function of Qi; release the exterior Indications: (see next page) Contraindicated in cases of difficult scanty urination due to Yin deficiency Modern applications: acute gastroenteritis, initial stage of acute nephritis, chronic nephritis, chronic renal failure, congestive heart failure, ascites from liver cirrhosis, Meniere s syndrome, retention of urine

13 Indications: 1. lower warmer cold water accumulation (with possible external wind-cold) Difficult urination, headache, fever, irritability, thirst with vomiting immediately after drinking water; thick (greasy) white coating, floating pulse. 2. SP qi deficiency causing water-damp accumulation General edema with a general feeling of heaviness, diarrhea, difficult urination, vomiting, diarrhea thick white or greasy white coating; slippery pulse. 3. Tan Yin syndrome Throbbing or pulsing just below the umbilicus, vomiting of frothy saliva, dizziness, shortness of breath, coughing, possible expectoration of copious white sputum; thick white or thick greasy white coating; slippery pulse.

14 Wan Dai Tang 完带汤 end discharge decoction Bai zhu 30g (chao) Ren shen 6g Che qian zi 9g (chao) Cang zhu 9g (zhi) Gan cao 3g Chen pi 1.5g Shan yao 30g (chao) Bai shao 15g (chao) Chai hu 1.8g Jing jie sui 1.5g Functions: stabilize the Dai channel to stop vaginal discharge, strengths the SP, soothes the LIV, resolve dampness Indications: Sp qi def. w/ LIV qi stagnation, damp retention: Profuse white, clear vaginal discharge, fatigue, weakness of limbs, T: Pale tongue, white coating. P: Slow or soggy weak pulse. Contraindicated in cases of leukorrhea due to damp-heat Modern applications: leukorrhea, inflammation of the genital system, vaginitis

15 Bi (Bei) Xie Fen Qing Yin <yi xue xin wu> Bei xie 9g Bai zhu 6g Cheqianzi9g Huang bai 3g Lian zi xin 4g Fu ling 6g Shi changpu3g Dan shen 9g Bi (Bei) Xie Fen Qing Yin <dan xi xin fa> Yi zhi ren 9g Shi changpu9g Fu ling Bei xie 9-12g Wu yao 9g Gan cao Bei Xie Fen Qing Yin - Dan Xi Xin Fa Functions: warms Kidney Yang, remove turbid Damp; purifies the turbidity Indications: damp-cold in the lower jiao with KI Qi and Yang deficiency frequent cloudy, dense, milky, or greasy urine; soreness of lower back T: pale with white coat P: deep, slow and weak Contraindicated in cases of the KI yin deficiency or milky urine due to damp-heat in the lower jiao Modern applications: chronic prostatitis, gonorrhea, chronic pyelonephritis, nephronic syndrome, chronic pelvic inflammatory disease, trichomoniasis

16 Damp in superficial channels

17 Qiang Huo Sheng Shi Tang 羌活胜湿汤 Notopterygium Decocotion to Overcome Dampness Qiang huo Du huo Gao ben Fang feng Chuan xiong Man jing zi Zhi gan cao Functions: Expels Wind-dampness, releases the exterior, alleviates pain Indications: Wind-dampness invading the superficial channels Heaviness and pain in the head, neck, shoulder, and back, difficulty in turning to sideway, or general aching, slight chills and fever, lack of sweating, thin white tongue coat, a superficial, slow pulse. Caution for patients with Yin deficiency. Contraindicated for patients with windheat. Modern applications: fibromyolgia, common cold, influenza, rheumatic arthritis, sciatica

18 Yin Fluid Retention

19 Cold accumulation with yang deficiency and blood deficiency

20 Dang gui si ni tang 当归四逆汤 Angelica frigid extremities decoction Shang Han Lun Dang gui 12g Gui zhi 9g Bai shao 9g Xi xin 3g Zhi gan cao 6g Tong cao 6g (Mu Tong) Da zao 8pc 1. guides herbs to the upper limbs and opens the blood vessels 2. warms the meridians and expels Cold, and harmonizes the Ying and Wei levels thus regulating Yin and Yang strengthens the effects by encouraging the flow in the meridians and blood vessels Functions: warms meridians, expel Cold, nourish blood, moves Blood Stasis (unblocks blood vessels) Indications: chronic cold hands and feet (to the touch and patient) due to a lack of Yang warming action. It is said that this is Cold in the meridians in people who are Blood deficient. T- pale with white coat, P- deep weak thin. This formula can also be used in cases of joint pain, irregular menses, abdominal cold pain, and lower back cold pain.

21 yin fluid deficiency lack of liquid Qi and Yin deficiency

22 Zeng Ye Tang 增液汤 increase the fluids decoction - Wen Bing Tiao Bian Sheng Di 24g Mai dong 24g Xuan Shen 30g Functions: nourishes Yin, clears heat; increases fluids, moisten dryness; promote bowel movement Indications: constipation (due to injury of fluids usually from a warm febrile disease, or a patient with chronic Yin deficient constitution), thirst, dry mouth or throat, T- dry red tongue with scanty yellow coat P- slightly rapid or weak forceless. If more purgative is required Zeng Ye Cheng Qi Tang should be used. Modern applications: habitual constipation, hemorrhoids, irritable bowel syndrome, hyperthyroidism, chronic pancreatitis

23 Sheng Mai San 生脉散 activate the pulse powder Nei Wai Shang Bian Huo Lun Ren shen 10g (9g chinese text) Mai dong 15g (9g chinese text) Wu wei zi 6g Functions: Tonifies Qi, stops excess sweating, and alleviates fatigue; Nourishes Yin and Fluids and moistens dryness. Indications: Qi and Yin deficiency of the HT and LU Chronic cough with scanty sputum that is difficult to expectorate, spontaneous sweating, shortness of breath, and a dry tongue and mouth; or palpitations, insomnia, and fatigue. T: Pale red or red tongue with thin dry coat P: Empty, thin, possibly weak and rapid pulse Contraindicated in cases of exterior patterns, acute cough, or summer heat without damage of Qi and Yin fluids. Applications: Chronic Bronchitis, Pulmonary Tuberculosis, Supraventricular Arrhythmias, Rheumatic Heart Disease, Angina Pectoris, Coronary Artery Disease, Post-Bypass Debility

24 Yin excess lack of liquid damp retention damp retention damp in middle jiao damp in upper jiao damp in lower jiao cold accumulation yin fluid deficiency Qi and Yin deficiency damp in middle jiao external wind-cold with internal dampness obstructing Qi in the middle jiao phlegm-fluid retention affecting the upper or middle jiao with SP Yang deficiency damp in lower jiao damp w/ leucorrhea damp w/ urinary problems cold accumulation with yang deficiency and blood deficiency