Source: Complete Book of Patterns and Treatments in External Medicine (1831)
Category: Formulas that are Applied Externally
Pattern: Heat-Toxin, or Blood Dryness of the skin
Key Symptoms: Lip sores, rashes, dry itching or painful lesions, calluses, dry cracked skin.
Ingredients
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Zi Cao
| 30g | |
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Pinyin: Zi Cao
Chinese: 紫草
Pharmaceutical: Radix Lithospermi seu Arnebiae
English: Purple Gromwell Root / Chinese Stoneseed Root |
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Tastes: Bitter, pungent, cold
Meridians Entered: Heart and Liver |
Actions & Indications:
- Clears Heat, cools the Blood, invigorates Blood circulation, relieves Fire toxins and encourages rashes
Xue Stage Heat, Blood Heat, Toxic Heat and dark purple rashes (measles, chicken pox)
- Moistens the Intestines, unblocks the bowels and promotes urination
Blood Heat constipation and rashes accompanied by constipation and/or urinary dysfunction
- Clears Damp-Heat from the skin (aids healing of tissues)
Damp-Heat skin lesions or vaginal itching topically Burns and wounds topically
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Standard Dosage: 5-10g in decoction. For external use it is usually soaked in oil.
Cautions: It is contraindicated in cases of diarrhea due to spleen deficiency, for its defecation-promoting action.
In the UK it is prohibited for internal use due to pyrrolizidine alkaloid content. External use is still permitted. |
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Dang Gui
| 30g | |
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Pinyin: Dang Gui
Chinese: 當歸
Pharmaceutical: Radix Angelicae sinensis
Taxonomy: Angelica sinensis
English: Chinese Angelica Root / Tang-Kuei / Dong Quai Root |
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Tastes: Sweet, Pungent, Warm
Meridians Entered: Heart and Liver |
Actions & Indications:
- Tonifies the Blood and regulates the menses
Blood Deficiency, especially when affecting the Heart and Liver with pale, ashen complexion, lusterless nails, tinnitus, blurred vision and palpitations
Blood Deficiency associated irregular menstruation, amenorrhea and dysmenorrhea
- Invigorates and harmonizes the Blood and disperses Cold (stops pain due to Blood Stasis)
Blood Stasis causing abdominal pain and carbuncles and pain due to Blood Stasis from traumatic injury, especially when accompanied by Deficiency Cold
Postpartum menstruation
Pregnancy (use with caution)
Blood Deficiency with chronic Wind-Damp-Bi
- Moistens the Intestines and unblocks the bowels
Dry Intestines due to Blood Deficiency
- Reduces swelling, expels pus, generates flesh and alleviates pain
Sores and abscess (Chuang Yung), internally and topically
- Stops coughing and treats dyspnea
Used adjunctively for coughing
- Tonifies the Blood while suppressing Parasites
Gu Sydnrome (Fruehauf, 1998)
Chronic inflammatory disease (Fruehauf, 2015)
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Standard Dosage: 6-12g in decoction.
Cautions: It is contraindicated in cases of Damp-Heat stagnating in the Middle, Lung Heat with Phlegm Fire, and Yin deficiency with effulgent Yang because it is warm and sweet in properties. In addition, it should be used with caution in cases of loose stool because it can moisten intestines to smooth stool.
Many sources recommend using caution, avoiding or only taking under guidance of a TCM physician during pregnancy as it can cause uterine contractions. However, there are no studies supporting this and the only scientific literature seems to suggest that Z-Ligustilide has anti-spasmodic activities that alleviate dysmenorrhoea by inhibiting uterine contractions (Du et al., 2006; Dietz et al., 2016).
Caution is also advised in breast cancer patients due to its oestrogen stimulating activity. This based upon Lau et al (2005) who found it may stimulate breast cancer growth in vitro, however Yue et al, (2019) demonstrated that it is not that stimulatory in breast cancer both in vitro and in vivo through a series of tests, although they suggested it should still be used with caution in estrogen receptor-positive breast cancer. Conversely, a large population study in Taiwan by Wu et al (2014) found it reduced the subsequent risk of endometrial cancer in breast cancer survivors taking tamoxifen, especially in those of reproductive age. |
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Ma You
| 350g | |
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Pinyin: Ma You
Chinese: 香油
Pharmaceutical: Oleum Sesami
English: Sesame Oil |
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Tastes: Sweet, cool
| Actions & Indications:
- Moistens Dryness
- Promotes bowel movement
- Neutralizes toxins
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Standard Dosage: Normally used as a medium for external applications.
Cautions: It is contraindicated in case of spleen deficiency and loose stool. |
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Feng La
| 50-100g | | |
Pinyin: Feng La
Chinese: 蜂蜡
Pharmaceutical: Cera Flava
English: Beeswax |
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Tastes: Sweet, slightly warm
Meridians Entered: Spleen |
Actions & Indications:
- Arrests discharges, promotes healing of wounds, promotes tissue regeneration and alleviate pain
Ulcer which is difficult to heal, wounds, burns and scalds, ecthyma erosion, ulcerated trauma
- Aids fasting
Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of animal products which can boost the Qi, make one free from hunger, and siow aging. This may suggest it was part of supplementing the diet when engaging in an "avoiding grain" (Bigu 辟穀) fasting regime to cultivate life (Yangsheng 養生) but is not recommended for protracted taking like many other superior class products.
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Standard Dosage: Melted into Ma You in approx 1:3 - 1:9 ratio to make external ointments.
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Subsitutions:
Zi Cao is not allowed to used internally in the UK due to fears over Pyrrolizidine Alkaloids but external use is still permitted.
Preparation: Soak the first two ingredients in the sesame oil for one week then gently heat until it starts to bubble. Lower the heat and cook until the Dang Gui starts to brown. Turn off the heat and cool, traditionally by placing the pan in a bowl of cold water like a double boiler. When it is cool enough to not burn the skin strain out the herbs and reheat the liquid over a low flame and stir in the beeswax until it is melted. Pour into glass containers to cool and harden into an ointment. The amount of beeswax varies according to the desired hardness of the resulting ointment and the season (more in summer, less in winter).
It may be applied gently to the area 3-4 times per day, or for acute cases spread onto a gauze pad and secured over the area and changed once per day.
Actions: Clears Heat, cools the Blood, resolves Toxicity, moistens Dryness, relieves pain and itching
Notes:
This is a common burn ointment for applying after moxibustion.
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Several variations of this formula exist for different patterns:
Run Ji Gao: Lower the proportion of Zi Cao to Dang Gui and reduce the proportion of wax to sesame oil to make for White Scaling Wind (白屑风 - Bai Xie Feng) rashes due to dry skin.
Qing Liang Gao: Lower the ratio of Zi Cao to Dang Gui and increase the wax to oil ratio considerably and then add powdered Da Haung at the end for Heat rashes due to dry skin.
Research Links:
Reference Notes: (click to display)
Most formulas are found in Scheid, Bensky, Ellis & Barolet (2009): Chinese Herbal Medicine: Formulas & Strategies and Chen & Chen (2015) Chinese Herbal Formulas and Applications. Others are from translations of primary sources. It is recommended that the original material is cross-referenced for mistakes and additional information.
Substitutions have been taken from Ken Lloyd & Prof. Leung (2004): Mayway UK Substitution List or the above publications and are intended as suggestions to help navigate the tight restrictions in the UK quickly. More applicable substitutions may be appropriate in specific situations.
Individual herb information has initially been sourced from TCM Wiki and American Dragon for basic data and then updated manually with my own notes.
These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.
