Chinese Herbal Medicine CMHB211

Chinese Herbal Medicine CMHB211 Session Two Release exterior Chinese herbal medicine Warm pungent and Cool pungent Chinese Medicine Department Endeavour College of Natural Health endeavour.edu.au 1

Session Aims o Discuss the Chinese herbs that release exterior by identifying the name, investigating medicinal properties, medicinal efficacies and main clinical applications, usage/ dosage, and contraindications: Exterior warming; Exterior cooling; o Identify and group the major common differentiating actions of these herbs into further sub-classes; and o Discuss some of the pharmacological research that relates to each Chinese herb discussed. Endeavour College of Natural Health endeavour.edu.au 2

Exterior Releasing Herb Properties o Chinese herbal medicinals that mainly disperse exterior pathogen and treat exterior pattern are called herbs that release the exterior. o Most medicinals in this chapter are acrid in flavour and dispersing in nature. Most of them act on the lung and bladder channels. o They mainly act on the fleshy exterior and can promote sweating to let the exterior pathogen out for curing the exterior patterns to avoid the pathological transmission. o Some herbs that release the exterior also can promote urination to alleviate edema, relieve cough and panting, promote eruption of papules, relieve pain, and remove sores. o Xi, Shengyan, and Yuewen Gong. Essentials of Chinese Materia Medica and Medical Formulas : New Century Traditional Chinese Medicine, Elsevier Science, 2017. ProQuest Ebook Central, o http://ebookcentral.proquest.com/lib/endeavour/detail.action?docid=4853140.created from endeavour on 2018-02-13 22:40:25.. Endeavour College of Natural Health endeavour.edu.au 3

Therapeutic Goals and Primary Symptoms Therapeutic Goals: o The goal of the treatment is to expel the external pathogen, strengthen the wei qi (Hempen and Fischer 2009). o Depending on the symptoms the clinician should aim primarily to expel windcold or wind-heat first before proceeding with further treatment of deficiencies, etc. o Improving qi and blood circulation in the tai-yang channel is also useful. Primary Symptoms and Relating Dysfunctions: o Chills, fever, aversion to cold; these symptoms correspond to the struggle between the external pathogens and the wei qi (Hempen and Fischer 2009). o Headache, body pain, thirst, blocked nose, cough, dry throat; these symptoms correspond to a disturbance in the circulation of qi and blood in the taiyang channel and a dysfunction of wei qi. Endeavour College of Natural Health endeavour.edu.au 4

Taste and Temperature (Teng jialin 2007) o Pungent in flavor, efficacy to release and disperse, promote sweat, some with efficacies to promote urination, alleviate edema, stop cough and dyspnea, promote eruption, stop cough and cure abscesses. o Classified into two main groups, pungent-warm superficies releasing and pungent-cold superficies releasing medicinal. Endeavour College of Natural Health endeavour.edu.au 5

Direction of Action o Lifts o Elevates o Disperses Combination o Combine with herbs to dispel summer-heat o Combine with herbs to resolve dampness/moisten dryness (reason??) o Combine with herbs to tonify Qi (when??) Endeavour College of Natural Health endeavour.edu.au 6

Contraindications& Precautions o Due to a dispersive nature clinicians must use this class of herbal medicine with care as pungent taste herbs are also moving in nature. o Specific conditions include: Yin and/or qi deficiency Bleeding; or Pregnancy patients o Dosage and decocting time Endeavour College of Natural Health endeavour.edu.au 7

Release the Exterior Herbs - Warming in Nature o o o o o o o o o Ma Huang Ephedra sinica herba Gui Zhi Cinnamonium cassiae ramulus Jing Jie Schizonepeta tenuifolia herba Fang Feng Saposhnikoviae divaricata radix Xi Xin Asarum sieboldii herba Zi Su Ye Perilla frutescens folium Qiang Huo Notopterygium incisum rhizoma Xiang Ru Elsholtzia splendens herba Bai Zhi Angelica dahuricae radix Endeavour College of Natural Health endeavour.edu.au 8

Release the Exterior Herbs - Cooling in Nature o o o o o o o Bo He Mentha haplocalyx herba Sang Ye Morus alba folium Chai Hu Radix Bupleuri Ju Hua Chrysanthemum morifolium flos Ge geng Radix Puerariae Chan Tui Cryptotympana atrata periostracum Sheng Ma Cimicifuga heracleifolia rhizoma Endeavour College of Natural Health endeavour.edu.au 9

Release the Exterior Chinese Herbal Medicine Summary Action: Diaphoretic; Disperses cold Ma Huang Ephedra sinica herba Zi Su Ye Perilla frutescens folium Sheng Jiang Zingiber officinale rhizoma Xiang Ru Elsholtzia splendens herba Opens the lungs, stops cough, regulates the fluids, relives oedema. Gui Zhi Warm the channels, unblocks yang qi, relieves the pain in the upper Cinnamonium cassiae body. ramulus Action: Disperse wind-cold; Harmonize the middle Regulates the qi of the middle, calms the fetus, detoxifies Warms the stomach, stops vomiting, detoxifies Cools summer-heat, regulates fluids, disperses oedema Endeavour College of Natural Health endeavour.edu.au 10

Release the Exterior Chinese Herbal Medicine Summary Action: Disperse wind; Release the exterior Jing Jie Schizonepeta tenuifolia herba Fang Feng Saposhnikoviae divaricata radix Qiang Huo Notopterygium incisum rhizoma Gao Ben Ligusticum sinense radix Cong Bai Allium fistulosum bulbus Wind rashes, stops bleeding (charred) Disperse internal and external wind Disperse cold, drains damp, relieves pain in the upper body, occipital headaches Pain in the vertex Disperses cold, eliminates toxin, external sores Endeavour College of Natural Health endeavour.edu.au 11

Release the Exterior Chinese Herbal Medicine Summary Action: Disperse cold-wind; Open the nose Bai Zhi Angelica dahuricae radix Cang Er Zi Xanthium sibericum fructus Xin Yi Magnolia liliflora flos E Bu Shi Cao Centipeda minima herba Action: Clear wind-heat; Clears the throat; Expels wind rashes Bo He Mentha haplocalyx herba Frontal headaches, turbid nasal discharge Relieves runny nose, headache Anosmia (no sense of smell), clear nasal discharge Opens the nose, visual disturbance Cools and clears the head, clears wind-heat Niu Bang Zi Arctium lappa fructus Chan Tui Cryptotympana atrata periostracum Relieves throat inflammations, cold heat and draws toxins Loss of voice, relieves spasm, itching, visual disturbance Endeavour College of Natural Health endeavour.edu.au 12

Release the Exterior Chinese Herbal Medicine Summary Action: Disperse wind heat; Cools the heat in the liver; Clears the eyes Sang Ye Morus alba folium Ju Hua Chrysanthemum morifolium flos Man Jing Zi Vitex trifolia fructus Mu Zei Equisetum hyemale herba Cools the lung, stops cough, bleeding Cools the heat in the liver, draws out toxin Relieves headache Stop bleeding Action: Disperses wind heat Dan Dou Chi Glycine max. praeparatum Fu Ping Spirodela polyrrhiza herba Relieves irritability Drains damp Action: Clears wind heat; Lifts yang and qi Ge Gen Pueraria lobata radix Chai Hu Bupleurum chinese radix Sheng Ma Cimicifuga heracleifolia rhizoma Stiff neck, replenish fluids, clears wind rashes Harmonizes shaoyang, unblocks liver qi stagnation Clears wind rashes, cools heat, draws out toxin Endeavour College of Natural Health endeavour.edu.au 13

Ma Huang Ephedra sinica herba Frank Vincentz, no title, created 18. Dec. 2009, <http://commons.wikimedia.org/wiki/file:pollen%c3%a7a_-_ma-2210_-_cap_de_formentor_- _Ephedra_fragilis_05_ies.jpg> Temperature: Warm Taste: Pungent Bitter Direction of Action: Lifting, Sinks lung Qi Site of Action: Lung, Bladder Dosage: 2-9gm (suggest) Cooking time: ~10 minutes Actions: Expels cold and wind/cold; Release exterior; Moves and regulates qi; Alleviates wheeze; and Promotes urination. Clinical applications: Indicated for the treatment of common cold due to wind cold, cough and panting with an excess pattern due to lung qi obstruction, wind edema (edema caused by windpathogen), and bronchial asthma. Ephedra processed with honey (the honey-fried one) can moisten lung to arrest cough, which is always used for asthma and cough with exterior syndrome having been resolved. It can also be used for the treatment of wind cold bì syndrome, dorsal furuncle, and phlegm nodule. Endeavour College of Natural Health endeavour.edu.au 14

Ma Huang /Schedule 4 under SUSMP https://www.tga.gov.au/publication/poisons-standard-susmp Pharmacology: Ephedrine alkaloids have demonstrated antiinflammatory and sympathomimetic activities (dilating bronchi, localised vasoconstrictive effects and stimulating CNS function); strong diaphoretic, hypertensive. Cautions: cautious in patients with spontaneous sweating due to exterior deficiency, night sweating due to yin deficiency, or dyspnea of lung and kidney deficiency; pregnancy Bio-medicine cautions: Pregnancy, hypertensive pharmaceutical agents (Diuretic, Adrenergic Receptor Agonist, Angiotensin 2 Receptor Antagonists (A2RA), Angiotensin Converting Enzyme Inhibitor (ACE), Calcium Channel Blocker, Aldosterone Antagonist). Pin Yin Name Simplified Chinese Characters Simplified Character Keystrokes Traditional Chinese Characters Traditional Character Keystrokes Ma huang 麻黄 11 麻黃 11 Scientific Name 1. Ephedra sinica Stapf 2. Ephedra equisetina Bge. 3. Ephedra intermedia Schrenk et Pharmaceutical Name Ephedrae Herba Chinese Species Name 1. 草麻黄 2. 木贼麻黄 3. 中麻黄 Common English Name Type of Ingredient Ephedra Plant S4 Restriction/ Warning 1 (SUSMP) Endeavour College of Natural Health endeavour.edu.au 15

* Every medicine has its side effect * For Chinese herbs practice, Improper use of is the major reason cause toxicity Some research information about Ma Huang and toxicity : http://www.fcma.org.au/file.php?fid=121 16 Endeavour College of Natural Health endeavour.edu.au 16

Gui Zhi Cinnamomi cassiae ramulus Franz Eugen Köhler, Köhler's Medizinal-Pflanzen, creatd 1897, no title, <http://commons.wikimedia.org/wiki/file:cinnamomum_aromaticum_- _K%C3%B6hler%E2%80%93s_Medizinal-Pflanzen-039_cropped.jpg> Thiry, no title, created 1996, < http://commons.wikimedia.org/wiki/file:baton_de_cannelle.jpg> Temperature: Warm Taste: Pungent Sweet Direction of Action: Superficial Site of Action: Heart/ Lung/Bladder Dosage: 3-10gm Cooking time: ~20 minutes Actions: Induce sweating & Release the exterior Warm the channels Disperse swelling Move and regulate the qi Reinforce Yang Moves the blood Clinical applications: External syndrome of wind-cold Wind-cold-damp arthralgia, shoulder and back pain Chest impediment, heart pain, amenorrhea, dysmenorrhea Phlegm-fluid retention Palpitation and up-rushing of qi Pharmacology: Promotes urination (diuretic like activity) and anti-pyretic; antibiotic, anti-fungal and sedative in vitro Cautions: Heat due to yin xu, blood heat, wind heat; Pregnancy Endeavour College of Natural Health endeavour.edu.au 17

Jing Jie Schizonepeta tenuifolia herba Epibase, n.d., no title, viewed 7 January, < http://commons.wikimedia.org/wiki/file:nepeta_manchurensis1b.ume.jpg> Shen, Y 2015, JingJie Temperature: Warm Tendency Taste: Pungent Aromatic Direction of Action: Superficial Site of Action: Lung/Liver Dosage: 4.5-9gm Cooking time: ~20 minutes Actions: Expels cold and wind/cold Release superificies/exterior Alleviates itching/vents rashes Promote eruption Stops bleeding Eczema, burns and sores Clinical applications: External contraction of exterior syndrome Rubella and itching Early stage of sores and ulcers Pharmacology: Stops bleeding by decreasing coagulation time, antipyretic, diaphoretic, antibiotic, analgesic. Cautions: Internal wind, open sores, full blown measles. Bi-medicine Caution: Anticoagulant pharmaceutical agents Endeavour College of Natural Health endeavour.edu.au 18

Fang Feng Saposhnikoviae divaricata radix Le.Loup.Gris, 5 June 2011, no title, viewed 7 January 2015, < http://commons.wikimedia.org/wiki/file:laser_trilobium_flowers_2.jpg> Radix Saposhnikoviae, viewed 7 January 2015, <http://tool.zyy123.com/zybbg/jb/fhff.htm> Temperature: Warm Taste: Pungent Sweet Direction of Action: Superficial Site of Action: Bladder/Liver/Spleen Dosage: 4.5-9gm Cooking time: ~20 minutes Actions: Release superficies Expels wind and wind/cold Dispels dampness Relieves pain Stop spasm Clinical applications: External contraction of exterior syndrome Rubella and itching Wind-dampness and arthralgic pain Tetanus Pharmacology: Weak antipyretic and antimicrobial. Noted as an antidote for arsenic. Toxicology: Nil Cautions: Yin-blood deficiency or generation of wind in warm disease. Bi-medicine Caution: Diuretic pharmaceutical agents Endeavour College of Natural Health endeavour.edu.au 19

Qiang Huo Notopterygium incisum rhizoma Chinese Herbal Treasures, 2012, Notopterygium Rhizome (Qiang Huo), viewed 7 January 2015, < http://www.chineseherbaltreasures.com/herbs_english_na_oy.html> Temperature: Warm Taste: Pungent Bitter Aromatic Direction of Action: Lifting Site of Action: Bladder/Kidney Dosage: 3-10gm Cooking time: 20 minutes Actions: Release the exterior Dispels cold Relieves pain Expels wind-damp Drains damp Clinical applications: External contraction of wind-cold Althralgia(joint pain) due to wind-cold-damp Pharmacology: Active ingredients have an analgesic, antipyretic, antiarrhythmic effect; Increase coronary artery perfusion also indicated. Toxicology: Overdose generates nausea and vomiting Contraindications/Cautions: Blood deficiency (xu), yin deficiency (xu); deficiencies (xu) of the exterior (eg. wei qi xu). Endeavour College of Natural Health endeavour.edu.au 20

Sheng Jiang Zingiber officinale rhizoma Luc Viatour, 2008, no title, viewed 7 January 2015, < http://commons.wikimedia.org/wiki/file:lesser_galangal_kencur_luc_viatour.jpg> Temperature: Warm Tendency Taste: Pungent Direction of Action: Descending Site of Action: Lung/Spleen/Stomach Dosage: 2-6 slices (standard 3 slices) Cooking time: 20 minutes Actions: Release the exterior Dispels cold Transforms phelgm Calms vomiting Stops cough Detoxifies and disinfects Pharmacology: Induces gastric juices and saliva secretion, stimulate intestinal peristalsis, bile production and anti-emetic. Toxicology: Nil Cautions: Heat in the lungs, heat in the stomach with nausea and vomiting Caution: Nil Endeavour College of Natural Health endeavour.edu.au 21

Zi Su Ye Perillae folium SB_Johnny, n.d., no title, viewed 7 January 2015, <http://commons.wikimedia.org/wiki/file:purple_perilla_foliage.jpg> Shen, Y 2015, Zi Su Temperature: Warm Taste: Pungent Aromatic Direction of Action: Sinking Site of Action: Lung/Spleen Dosage: 5-9gm Cooking time: 3 minutes(avoid long time decocting) Actions: Release the exterior Dispels cold Moves and regulates qi Tonifies and harmonizes spleen Calms the fetus Detoxifies(fish and crab) and disinfects Clinical applications: External contraction of wind-cold Qi stagnation in Sp and St Intoxication by fish and crab Pharmacology: Antibiotic, antipyretic, bronchodilating and deacreases bronchial spasm and secretions; Perilla aldehydes have a noted sedative and antibacterial effects; Cytotoxic and anti-neoplastic have also been noted. Cautions: Deficient exterior with excessive sweating, damp-heat. Endeavour College of Natural Health endeavour.edu.au 22

Zhou Y 24 May 2005, Asarum sieboldii, viewed 7 January 2015, http://www.plantphoto.cn/tu/349701 Temperature: Warm Taste: Pungent Aromatic Direction of Action: Lifting Site of Action: Heart/Lung/Kidney Dosage: 1-3gm Cooking time: 20 minutes Actions: Xi Xin Asarum sieboldii herba Open the exterior(nose) Expels cold and wind/cold Dispels damp and wind/damp Transforms cold phelgm Relieves pain Blockages due to damp Clinical applications: Wind-cold of exterior type Headache, toothache, wind-damp, and arthralgia pain Sinusitis Lung cold, cough and dyspnea Pharmacology: Antibiotic; Contains asarone which has a expectorant, analgesic, broncholytic and antibacterial activity; local anaesthetic. Toxicology: Nephrotoxic, hepatotoxic and carcinogenic due to safrol content and aristolochic acid content. Contraindications/Cautions: Yin xu and dryness due to wind heat; Pregnancy Bio-medicine Caution: Kidney and Liver dysfunction if unsure of appropriate screening; Oncology management Endeavour College of Natural Health endeavour.edu.au 23

Xi Xin / S10 under SUSMP Pin Yin Name Simplified Chinese Characters Simplified Character Keystrokes Traditional Chinese Characters Traditional Character Keystrokes Xi xin 细辛 8 細辛 11 Scientific Name 1. Asarum heterotropoides Fr. Schmidt var. mandshuricum (Maxim) Kitag. 2. Asarum sieboldii Miq. var. seoulense Nakai 3. Asarum sieboldii Miq. Pharmaceutical Name Asari Radix et Rhizoma Chinese Species Name 1. 北细辛 2. 汉城细辛 3. 华细辛 Common English Name Type of Ingredient Manchurian Wildginger Root Plant S10 Restriction/ Warning 1 (SUSMP) The research link about Xi Xin http://eds.a.ebscohost.com.ezproxy.endeavour.edu.au/eds/pdfviewer/pdfviewer?vid=3&sid=37d9c4c1-abc5-48c7-9fc4- f9f069cee140%40sessionmgr4007 In your practice, you will find one classic TCM patent herbal formula Du Huo Ji Sheng Wan(Tang) in Australia removed Xi Xin from product due to toxicity concerns *******Any alternative method in your practice for treatment then? 24 Endeavour College of Natural Health endeavour.edu.au 24

Herbs differentiation 25 Endeavour College of Natural Health endeavour.edu.au 25

Xiang Ru Elsholtzia splendens herba Actions: Release the exterior Cools summer heat Resolve dampness Promotes urination and alleviate edema Expels wind/cold Harmonizes the spleen TCM Wiki n.d., Herba Moslae, viewed 7 January 2015, < http://www.tcmwiki.com/wiki/herba-moslae> Temperature: Warm Tendency Taste: Pungent Aromatic Direction of Action: Ascending, Lung Qi Descending Site of Action: Spleen/Stomach Dosage: 3-6gm Cooking time: 20 minutes Pharmacology: Antipyretic, diuretic, promotes sweating, stimulates gastric juice production and peristalsis, broad spectrum antibiotic, antiviral. Toxicology: If taken hot then can induce vomiting. Cautions: Strong sweating with yang deficiency (xu) Endeavour College of Natural Health endeavour.edu.au 26

Xin Yi Magnolia liliflora flos Derek R 9 June 2007, no title, viewed 7 January 2015, <http://commons.wikimedia.org/wiki/file:sweetbay_magnolia_magnolia_virginiana_comparison_4400px.jpg> Temperature: Warm Taste: Pungent Aromatic Direction of Action: Lifting Site of Action: Lung/Stomach Dosage: 3-9gm Cooking time: Boil the blossoms wrapped in a musclin cloth (the blossoms may irritate the throat). Actions: Expels wind Dispels cold Moves and regulates the qi Dislodges phelgm Opens nose Pharmacology: Antimucolytic, antibiotic (streptococcus, staphylococcus), stimulates uterine contraction; Topically can be used as an anti-inflammatory and open nasal passages. Toxicology: Allergic reactions that may include pruritis, nausea, anxiety, chest discomfort; overdose may lead to dizziness and redness of the eyes. Contraindications/Cautions: Yin deficiency (xu) with heat or fire. Pregnancy. Endeavour College of Natural Health endeavour.edu.au 27

Kham T 10 November 2007, no title, viewed 7 January 2015, http://commons.wikimedia.org/wiki/file:mintleaves-2007.jpg Shen, Y 2015, BoHe Temperature: Cold Taste: Pungent Aromatic Direction of Action: Lifting Site of Action: Lung/Liver Dosage: 3-6gm Cooking time: Add at the end of the cooking process and steep for 10 minutes Bo He Mentha haplocalyx herba Actions: Expels wind heat Clear heat and eyes Opens the orifices and channels Soothe throat Moves and regulates the qi Promote eruption and alleviates itch Clinical applications: External contraction of wind-heat,early stage of warm disease Headache, dizziness, red eyes and tearing Sore throat Stagnation of liver qi Rubella, itching and measles failing to erupt Pharmacology: Increases bile secretion, antiseptic, spasmolytic, secretolytic; Topically used to manage myalgias and neuralgias. Toxicology: Long term use may lead to stomach irritation; Can inhibit lactation, chronic use may reduce qi and yang reserves. Cautions: Exterior deficiency, spontaneous sweating, yin deficiency (xu) with heat. Endeavour College of Natural Health endeavour.edu.au 28

Chai Hu bupleurum chinense radix Shen, Y 2015, ChaiHu Temperature: Cold Tendency Taste: Bitter Pungent Aromatic Direction of Action: Lifts the liver qi Site of Action: Liver/Gallbladder Dosage: 3-10gm Cooking time: 20 minutes Actions: Release the exterior Harmonize the exterior and interior Soothe liver /relieve depression Raise yang qi Clinical applications: Exterior syndrome, fever, and Shaoyang syndrome Liver qi depression with qi stagnation Qi deficiency with sinking and visceral prolapse Pharmacology: Saponins have anti-pyretic, Relieve oedema and anti-inflammatory actions; induces corticosterone production; Hepatoprotective; Sedative; Analgesic; Anti-tussive; Anti-ulcerative; Hypotensive. Cautions: Cough due to yin xu; ascendant liver yang; Liver yang fire Bio-medicine Caution: Pregnancy; Interferon Endeavour College of Natural Health endeavour.edu.au 29

Chai Hu is the major herb in Xiao Chai Hu Tang from Shang Han Lun, which is one of the most famous Chinese herbal formulas in history to harmonize Shao Yang. ***Some research resources link with Chai Hu and Xiao Chai Hu Tang http://www.wjtcm.net/article.asp?issn=2311-8571;year=2017;volume=3;issue=3;spage=46;epage=50;aulast=wang http://www.worldscientific.com/doi/abs/10.1142/s0192415x05003296?journalcode=ajcm http://www.worldscientific.com/doi/abs/10.1142/s0192415x07004862 https://www.sciencedirect.com/science/article/pii/0378874189900202 http://eds.b.ebscohost.com.ezproxy.endeavour.edu.au/eds/pdfviewer/pdfviewer?vid=8&sid=134f6482-e590-43fe-8919-509649421e81%40sessionmgr103 30 Endeavour College of Natural Health endeavour.edu.au 30

Chan Tui Cryptotympana atrata periostracum) Shen, Y 2015, ChanTui Temperature: Cold Taste: Sweet Salty Direction of Action: Ascending Site of Action: Lung/Liver Dosage: 3-10gm (standard 6gm) Cooking time: 20 minutes Actions: Release the exterior Expels wind heat Vents rashes Settles tremors and convulsions Clears the head and eyes Expels wind Alleviates itching Cools heat and moistens dryness Pharmacology: CNS sedative / relaxant. Toxicology: Reduced the stimulating effects of caffeine. Cautions: Exterior deficiency; Pregnancy Bio medicine Caution: Barbiturate and CNS depressant pharmaceutical agents; Driving and/or operating heavy machinery. Endeavour College of Natural Health endeavour.edu.au 31

Ge Gen Pueraria lobata radix Alpsdake 16 August 2002, no title, viewed 7 January 2015, http://commons.wikimedia.org/wiki/file:pueraria_lobata_in_mount_ibuki_2002-08-16.jpg Shen, Y 2015, GeGen Temperature: Neutral Taste: Sweet Pungent Direction of Action: Lifting Site of Action: Spleen/Stomach Dosage: 3-15gm (standard 5gm) Cooking time: 20 minutes Actions: Release the muscles Subdue fever Vents rashes Generates fluids Stops diarrhoea Raises qi Expels wind Clinical applications: Exterior syndrome, fever, and pain of nape and back Warm disease, thirst and Xiaoke Measles failing to erupt Diarrhea Pharmacology: Vasodilator (Coronary and cerebral arteries); Spasmolytic (CVS and GIT); Lower myocardial oxygen requirements; Improves perfusion; Antihypertensive; Mild antipyretic; hypoglycemic; Anti-PAF and reduces alcohol cravings. Cautions: Yin xu with heat or fire Bio medicine Caution: Pregnancy; Anti-coagulant and antidiabetic pharmaceutical medications. Endeavour College of Natural Health endeavour.edu.au 32

Ju Hua Chrysanthemum morifolium flos Shen, Y 2015, Ju Hua Temperature: Cold Tendency Taste: Sweet Bitter Direction of Action: Sinking Site of Action: Lung/Liver Dosage: 5-10gm Cooking time: add at the end of boiling decoction, allow to steep for 3 minutes Actions: Dispel wind-heat Pacify liver Clears heat, wind/heat, head and eyes Eczema, burns and sores Relieve toxicity/vents rash Clinical applications: External contraction of wind-heat, early stage of warm disease Hyperactivity of liver yang Reddish eyes and blurred vision Abscess, swelling, sores and toxin Pharmacology: Antibiotic; Used in the management of arteriosclerosis and hypertension; Topically used to manage eye and skin disease. Toxicology: Nil Cautions: Spleen qi xu with poor appetite and diarrhoea Endeavour College of Natural Health endeavour.edu.au 33

Sheng Ma Cimicifuga heracleifolia rhizoma Prof. Dr. Otto Wilhelm ThoméA, 1885, ctaea spicata, viewed 8 January 2015, <http://commons.wikimedia.org/wiki/file:illustration_actaea_spicata0.jpg> Temperature: Cold Tendency Taste: Sweet Bitter Pungent Direction of Action: Lifting Site of Action: lung/spleen/stomach/ large intestine Dosage: 1-10gm (standard 6gm) Cooking time: 20 minutes Actions: Release the exterior Vents rash Disinfects and detoxifies Raises qi Clears heat Expels wind/heat Pharmacology: Antibiotic, antifungal, mild antiinflammatory and analgesic. Toxicology: Overdose may lead to headaches, vertigo, vomiting, tremor, gastroenteritis, delirium and dysponea. Cautions: Yin deficiency (xu) with fire, full blown measles, respiratory complaints. Pregnancy Endeavour College of Natural Health endeavour.edu.au 34

Sang Ye Morus alba folium Shen, Y 2015, SangYe Temperature: Cold Taste: Bitter Sweet Direction of Action: Sinks the liver yang Site of Action: Lung/liver Dosage: 5-15gm (standard 10gm) Cooking time: Add at the end of cooking period, cook breifly and allow to steep for 3 minutes Actions: Expels wind heat Clear lung Moisten dryness Pacify liver and subdue yang Brighten the eyes Clinical applications: External contraction of wind-heat, early stage of warm disease Cough due to lung heat or dry heat Hyperactivity of liver yang Reddish eyes and blurred vision Pharmacology: Antibiotic (Staphylococcus aureus, b- haemolytic streptococci, Bacillus dysenteriae, Escherichia coli, Pseudomonas aeruginosa, Leptospira spp.); Lowers serum glucose and cholesterol levels; Topically applied to eyes and skin diseases. Caution: Antidiabetic pharmaceutical medications or reactive hypoglycaemia. Endeavour College of Natural Health endeavour.edu.au 35

Herbs differentiation Chai Hu, Ge Gen 36 Endeavour College of Natural Health endeavour.edu.au 36

Tutorial Activity Case Study 2.1 o Patient (female 18 years) presents to your clinic with a stiff neck and aversion to cold. Pain is characterised as tight and sharp and aggravated by movement. The condition onset <1 week ago and to date has been treated with pharmaceutical agents (panadiene forte and ibuprofen). Heat improves the movement and reduces the pain in the neck. o Clinical Assessments: o Slight fever, no sweating o Pulse: Superficial and tight o Tongue: Thin white coating o What is the diagnosis, treatment principles and herbal herbs that should be used here? Endeavour College of Natural Health endeavour.edu.au 37

Tutorial Activity Case Study 2.2 o Patient (female 24 years) presents to your clinic with a sore throat and aversion to cold. Patient also reports headaches, body aches, obstructed and sluggish sweating, nasal congestion with yellow discharge o Clinical Assessments: o Pulse: Superficial and slightly rapid o Tongue: Red body with a slightly yellow coating o What is the diagnosis, treatment principles and herbal agents that should be used here? Endeavour College of Natural Health endeavour.edu.au 38