Folio Bound VIEWS - Chinese Medicine

Diagnosis This is a condition of combined Deficiency and Excess. There is some
deficiency of Qi and Blood (tiredness, desire to lie down, poor appetite,
poor memory) whilst the Excess is characterized by Phlegm (Slippery
pulse and sticky tongue coating) and Heat (dry mouth, constipation, Red
tongue with yellow tongue coating and Rapid pulse).

Treatment principle Although the condition is one of both Deficiency and Excess, it is better
to resolve Phlegm and clear Heat before tonifying Qi and Blood.
Especially with herbal medicine, tonifying Qi and Blood in the presence
of Phlegm and Heat may aggravate the condition. This is because most
Qi and Blood tonics are "sticky" (therefore tending to aggravate
Phlegm) and warm in nature (therefore tending to aggravate Heat). After
a few weeks of treatment aimed at resolving Phlegm and clearing Heat,
attention should be diverted to tonifying Qi and Blood.

Herbal treatment In accordance with these principles the first prescription used was a
variation of Gua Lou Xie Bai Ban Xia Tang
Trichosanthes-Allium-Pinellia Decoction:

Gua Lou Fructus Trichosanthis 9 g

Xie Bai Bulbus Allii 4 g

Ban Xia Rhizoma Pinelliae ternatae 6 g

Bai Jiu Rice wine 15 ml

Huang Lian Rhizoma Coptidis 3 g

Dan Nan Xing Rhizoma Arisaematis praeparata 4 g

Zhu Ru Caulis Bambusae in Taeniis 6 g

Dan Shen Radix Salviae miltiorrhizae 4 g

Explanation Huang Lian was added to clear Stomach-Heat.

Dan Nan Xing and Zhu Ru resolve Phlegm.

Dan Shen moves Blood in the chest and stops pain.

After the patient had taken this formula for some weeks, attention was

diverted to tonifying Qi and Blood. The main changes to look for to

decide when to switch the aim of treatment to tonification are a

lessening of the Red colour of the tongue body, a decrease in tongue

coating, a less Rapid and less Slippery pulse and a disappearance of the

thirst. The formula used was a variation of Liu Jun Zi Tang Six

Gentlemen Decoction:

Bai Zhu Rhizoma Atractylodis macrocephalae 9 g

Dang Shen Radix Codonopsis pilosulae 6 g

Fu Ling Sclerotium Poriae cocos 6 g

Zhi Gan Cao Radix Glycyrrhizae uralensis praeparata 3 g