Chuan Lian Zi Fructus Meliae toosendan 5 g

Explanation

This formula, which has already been explained in Chapter 5, nourishes Liver-Yin.

Variations

• To enhance the Liver-Qi-moving effect of the formula add Mei Gui Hua Flos Rosae
  rugosae which moves Qi without injuring Yin.

Appendix: Gall-Bladder Stones

Gall-Bladder stones are formed when there is an excess of cholesterol in relation to bile acids.
Such changes in the relation between cholesterol and bile acids precede the formation of calculi
and are dependent on the Liver. Thus, the free flow of Liver-Qi is the most important factor in
maintaining normal bile acids and therefore stagnation of Liver-Qi is an important prerequisite
for the formation of stones. When Liver-Qi stagnates, bile is not secreted properly or is secreted
insufficiently. This leads to the accumulation of Damp-Heat in the Gall-Bladder. The steaming
action of Heat on Dampness over a long time leads to the formation of stones.

There are three types of stones:

1. Cholesterol stones are composed almost entirely of cholesterol. They more often
   correspond to the pattern of Damp-Heat in the Liver and Gall-Bladder. They are
   usually single stones.


2. Pigment stones, which are always numerous, are composed of bile pigments.
   They are less common.


3. Mixed stones are the most common type. They consist of lamellated layers of
   cholesterol, calcium and bilirubin.

Differentiation

Treatment must be differentiated according to the two main patterns appearing in gall stones, i.e.
stagnation of Liver-Qi and Damp-Heat in Liver and Gall-Bladder. The two patterns may of
course occur simultaneously and they often do.

Stagnation of Liver-Qi