Chapter 14 Warming interior [7. Herbs That Warm the Interior, 9] Fu Zi 附子 Gan Jiang 乾薑 Rou Gui 肉桂 Wu Zhu Yu 吳茱萸 Xiao Hui Xiang 小茴香 9 herbs Ding Xiang 丁香 Gao Liang Jiang 高良薑 Hua Jiao 花椒 Hu Jiao 胡椒 : Pungent, hot Indications: Interior cold excess def Ext cold SP/ST Abd pain, vomiting, diarrhea Yang def (KI, SP) Cold limbs, profuse/clear urination Collapse of yang Profuse sweating, (KI) extremely cold limb, faint pulse Combinations: Warming int herbs Exterior PF Qi stagnation Yang def Other herbs + relieving Ext PF + moving qi + tonifying yang Contraindication: heat synd yin deficiency pregnancy 1
1. Fuzi taste Pungent toxic HT, KI, SP 1. restore yang, rescue life 2. reinforce fire to assist KI yang 3. disperse cold, stop pain Yang collapse syndrome (Key herb) + gang jiang, or + ren shen Yang insufficiency (KI, SP, HT) Defensive (yang) qi weakness Bi-syndrome (cold-damp-wind) Dosage/usage: 3-15 g; boil 30 60 minutes prior to other herbs Cautions & Contraindications: pregnancy Comment: Fu zi fire yang (whole body: int/ext, upper/lower, int organs/collaterials) 2. Ganjiang (dried ginger) taste Pungent SP, ST, HT, LU 1. warm the middle jiao 2. restore yang SP/ST def cold syndr (eg, abd pain, vomiting, diarrhea) + ren shen, bai zhu, gan cao Yang collapse syndr + fu zi 3. warm LU and resolve Fluid retention in LU (cough, asthma, profuse sputum) retained fluid + ma huang, xi xin Dosage: 3-10 g Cautions & Contraindications: pregnancy. Compare: Sheng jiang -- gan jiang 2
Sheng jiang: moving, not staying gan jiang: staying, not moving 3. Rou gui taste Pungent, sweet KI, SP, HT, LV 1. reinforce fire to assist yang 2. disperse cold, stop pain 3. warm channels KI yang insufficiency (cold limbs, frequent urination) SP/KI yang def (eg, diarrhea) Cold blood stasis in lower abd (eg, amenorrhea) Yin type of boil/abscess Dosage: 2-5 g Cautions & Contraindications: pregnancy; yin def and heat; excess heat Comment: rou gui == ming men fire (KI yang) invigorate 3
4. Wu Zhu Yu taste Pungent, bitter Mild toxic LV, SP, ST 1. dispel cold and stop pain; cold abd pain + Gan Jiang, Mu Xiang. Cold LV m hernia + Xiao Hui Xiang, Wu Yao Def (SP/KI) cold diarrhea 2. pacify LV and direct rebellious qi downward; (stop vomiting) Vomiting/ acid regurgitation + sheng jiang + huang liang 3. dry dampness Cold damp flaccidity of lower limbs + Mugua Dosage: 1.5-5 g Comment: very dry/pungent, easily produce side effects Formula: huang lian 6 g + wu zhu yu 1g ----- zuo jin wan Vomiting due to ST heat ( LV heat LV qi stg) 4
5. Hua Jiao taste Pungent Mild toxic SP, ST, KI 1. warm the middle jiao 2. kill chong, stop pain Def cold of SP/ST (eg, abd pain, vomiting, diarrhea) Round worm (eg, abd pain, vomiting) Dosage: 2-5 g 5. Dingxiang Nature taste warm Pungent SP, ST, KI 1. warm the middle jiao, bring down qi 2. warm KI, assist yang ST cold (eg, vomiting, belching, hiccup) Key herb + Ban Xia, Sheng Jiang. KI yang def (eg, impotence) Dosage: 2-5 g Cautions & Contraindications: 5
6. Gao Liang Jiang Nature taste hot Pungent SP, ST Warm the middle jiao, stop pain SP/ST cold (eg, abd pain, vomiting, diarrhea) Dosage: 3-10 g 7. Xiaohuixiang Nature taste warm Pungent LV, KI, SP, ST 1. disperse cold, stop pain 2. regulate qi, harmonize ST Hernia Cold ST (eg, vomiting, appetite loss) Dosage: 3-8 g 6
Xixin Nature taste Warm Pungent LU, KI 1. disperse wind cold 2. disperse cold, stop pain 3. warm LU, resolve retained fluid 4. opening nose Exterior synd Headache, toothache, bi-pain Fluid retention in LU rhinitis Dosage: 1-3 g Cautions & Contraindications: deficient yin Exercise Case study: 25 years old; winter; cause: out door activities, shower of cold water Abd pain (severe) 3 days, worsen by the cold, relieve a little by the warm nausea, acid reg-, diarrhea (3 times a day, very loose), poor appetite white thick wet coating, tight pulse. No history of any other illness A. Multiple choice (only one answer) 1. Fu zi should be boiled ( ) a. before other herbs b. after other herbs c. Separately d. at same time with other herbs 7
?2. ( ) can warm HT yang (in the upper jiao) to unblock channels, SP yang (in the middle jiao) to invigorate TNT and KI yang (in the lower jiao) to reinforce KI fire. a. fu zi b. gang jiang c. gui zhi d. rou gui 3. ( ) can inspire/invigorate/activate the growth of qi and blood so as to reinforce the effect of herbs for tonifying qi and blood. a. gui zhi b. fu zi c. rou gui d. sheng di huang 4. ( ) is sweet and warm and is usually used to treat decline of ming men fire a. fu zi b. gang jiang c. wu zhu yu d. rou gui 5. To treat LV qi stagnation and transformation of fire, manifested as vomiting, bitter mouth, pain hypochondriac region, to stop vomiting, wu zhu yu (3g) is better to combine with ( ) a. huang qin 9g b. huang lian 18g c. huang bai 9 d. zhi zi 9 6. Among herbs for warming the interior, ( ) is good at treating pain due to cold accumulating in LV meridian. a. gao lian jiang b. wu zhu yu c. ding xiang d. gang jiang 7. Wu zhu yu is good for headache of ( ) a. shao yang b. jue yin c. blood stasis d. wind cold 8
8. Common action of gang jiang and xi xin is to warm LU to ( ) a. disperse cold b. resolve retained fluid c. stop cough d. resolve phlegm 9. Rou gui is often combined with ( ) to treat KI yang def and ming men fire decline a. fuzi, b. gang jiang c. wu zhu yu d. xi xin 10. Fu zi is usually combined with ( ) to treat yang collapse syndrome a. ren shen b. dang shen c. xi yang shen d. tai zi shen B. multiple choice (more than two answers) 1.Herbs for warming the interior are used for ( ) a. wind cold attacking the superficial b. SP and ST cold c. yang collapse d. KI yang def e. HT yang def? 2. Common actions of fu zi and rou gui are to ( ) a. warm and unblock channels b. tonify fire to assist yang c. revive the yang for resuscitation d. disperse cold to stop pain e. warm the middle jiao to bring down qi 9