Mr. Zhao Shaoqin was born into a family of imperial physicians and is a lifelong professor at Beijing University of Chinese Medicine. He serves as a consultant for the Chinese Association of Traditional Chinese Medicine, a director of the Chinese Medical Foundation, an advisor for the Chinese Oriental Culture Research Association, and was a member of the 7th and 8th National Committee of the Chinese People’s Political Consultative Conference.
Damp-Heat Syndrome is generally divided into four stages: obstruction by dampness, cooling restraint, cold congealment, and ice entrapment. This is a unique experience passed down in Mr. Zhao’s family. The initial stage of obstruction by dampness is characterized by an excess of dampness that blocks the middle and upper jiao, without yet transforming into heat, or with heat that is not predominant. The treatment should focus on aromatic transformation to promote the flow of qi; when qi is transformed, dampness will also transform. This is the key to treating damp obstruction in the lungs. If dampness obstructs the middle jiao, hindering the spleen and stomach, the treatment should primarily focus on moving the spleen qi, using pungent to open and bitter to descend, with pungent to promote the flow of qi to transform dampness, and bitter to dry dampness and drain heat, thus dispersing damp-heat. The specific treatment methods are as follows:
(1) Aromatic Transformation Method (Upper Jiao):
External invasion of summer heat, damp-heat and turbid accumulation internally.
Symptoms: dizziness, body heat, general heaviness and fatigue, chest tightness, epigastric fullness, cough, yellow and red urine, white greasy and slippery tongue coating, and a slippery pulse.
This is a case of initial damp-warmth, suitable for the aromatic transformation method. Mr. Zhao’s basic formula includes:
10g fresh Peilan (Pogostemon cablin) (add later), 10g soybean sprouts, 10g fresh Huo Xiang (Agastache rugosa) (add later), 3g tender Qian Hu (Peucedanum praeruptorum), 6g Chuan Yu Jin (Ligusticum chuanxiong), 10g Bai Jizhi (Tribulus terrestris),
10g ginger bamboo shavings, 5g prepared Hou Po (Magnolia officinalis), 3g Chuan Huang Lian (Coptis chinensis) (ground and mixed), 3g Tong Cao (Tetrapanax papyriferus).
(The above herbs are fresh, which reflects a key issue in the application of Chinese medicine: fresh and tender herbs are good at reaching the upper jiao, which is unmatched by dried herbs when treating exterior syndromes and Wei-level symptoms.)
(2) Aromatic Dispersion Method (Upper Jiao)
External invasion of summer heat, obstructed exterior qi.
Symptoms: feeling cold, dizziness, body aches, dry skin, fullness in the middle jiao, nausea and vomiting, abdominal discomfort. White greasy tongue coating, slippery pulse, slightly rapid upon palpation.
Should use aromatic dispersion to reduce heat and settle nausea.
12g Peilan leaves (add later), 10g Guang Huo Xiang (Agastache rugosa) (add later), 5g Chen Xiang Ru (Elsholtzia stauntonii) (add later), 10g soybean sprouts, 6g prepared Hou Po,
5g Bai Dou Kou (Amomum villosum), 3g ginger (prepared), 6g almonds, 1g Tai Yi Yu Shu Dan (a traditional formula) ground into fine powder and mixed.
(3) Aromatic Transformation of Turbidity Method (Upper and Middle Jiao)
Summer heat and damp stagnation, mutually obstructing the middle jiao.
Symptoms: body heat with nausea, vomiting phlegm and water, irritability, bright eyes, dry mouth with no desire to drink. Intermittent abdominal pain, difficulty in defecation. White greasy tongue coating, slippery and rapid pulse, with a string-like and slippery quality upon palpation.
Should use aromatic transformation of turbidity to settle nausea and descend counterflow heat.
10g Peilan leaves (add later), 6g Huo Xiang (add later), 6g prepared Hou Po, 12g Ban Xia (Pinellia ternata), 3g Chuan Lian (Coptis chinensis), 10g Fo Shou (Citrus medica), 10g Da Fu Pi (Areca catechu),
3g ginger (prepared), 12g Bao He Wan (a traditional formula) (wrapped), 12g Chi Shao (Paeonia lactiflora), 10g Jiao Mai Ya (Hordeum vulgare).
1g of water-sinked sandalwood powder and 1g of Bai Dou Kou powder, both ground and encapsulated to be taken in two doses. Sandalwood powder is used to descend counterflow qi, and Dou Kou transforms damp stagnation. If not treated properly, it may lead to dysentery.
(4) Light Elevation and Dispersion Method (Upper and Middle Jiao)
Summer warmth accumulates heat, mutually obstructing the lungs and stomach.
Symptoms: body heat, dizziness, cough with much phlegm, chest and epigastric fullness. Red tongue with white greasy coating, slightly rapid and slippery pulse, with a strong right pulse.
Heat is in the lungs and stomach, the method should be to disperse and resolve; damp turbidity is obstructing, and should also be lightly elevated.
12g Xiang Dou Chi (a traditional formula), 6g fried Shan Zhi (Gardenia jasminoides), 3g tender Qian Hu, 10g Xiang Bei Mu (Fritillaria), 10g almond paste, 12g Loquat leaves (wrapped),
15g Bao He Wan (wrapped), 30g fresh Lu Gen (Reed),
(5) Dispersion and Transformation Method (Upper and Middle Jiao)
Summer damp-heat stagnation, obstructing the lungs and stomach.
Symptoms: cough with much phlegm, fullness and oppression in the chest, constipation, red and yellow urine, thick yellow tongue coating, slippery pulse, with a strong right pulse.
Should disperse and resolve the upper jiao, and use methods to clear and transform the middle jiao.
3g Qian Hu, 12g Xiang Bei Mu, 10g almond paste, 12g Xiang Dou Chi (wrapped), 3g Shan Zhi, 12g fried Pa Ye (Eriobotrya japonica), 10g Huang Qin (Scutellaria baicalensis),
15g Bao He Wan (wrapped), 10g Jiao Mai Ya, 3g Zhi Ke (Aurantii Fructus).
(6) Light Dispersion and Clear Transformation Method (Upper and Middle Jiao)
Excess summer heat, with slightly less dampness.
Symptoms: body heat, cough, dry skin, desire for cool drinks, slight fullness in the chest and epigastrium. Red tongue with yellow coating, slippery and slightly rapid pulse, with a strong right pulse.
Should clear and resolve summer heat, and lightly disperse turbidity.
2g mint twigs (add later), 10g Peilan leaves (add later), 12g Lian Qiao (Forsythia suspensa), 12g fried Pa Ye, 12g Bai Jizhi, 3g Qian Hu,
10g almonds, 5g Chuan Bei Mu (Fritillaria), 30g fresh watermelon rind, 1 piece of fresh lotus leaf, 12g Yi Yuan San (wrapped),
6g bamboo leaves, 6g Huang Qin.
Note: Yi Yuan San: 600g talcum powder, 100g licorice, 30g cinnabar. Preparation: The above three ingredients, cinnabar is water-fly into a very fine powder; talcum and licorice are crushed into fine powder, mixed with the above powder, sieved, and blended to obtain.
(7) Pungent Opening and Bitter Descending Method (Middle Jiao)
Damp-heat disease, heat stagnation in the middle jiao, dampness obstructing and not transforming.
Symptoms: dizziness and fullness, chest tightness and body aches, nausea, constipation, red and yellow urine, white slippery tongue coating, slippery pulse that is strong upon palpation.
Should use pungent to open the stagnation to benefit the three jiao, and bitter to descend the heat to dry damp turbidity, with a little assistance from light diuretics.
10g Bai Jizhi, 12g Peilan leaves (add later), 3g Bai Zhi (Angelica dahurica) (add later), 10g Ban Xia, 10g Huang Qin, 3g Huang Lian (ground and mixed),
12g fried Yi Yi Ren (Coix lacryma-jobi), 12g Bai Dou Kou, 12g Chi Ling (Poria), 12g talcum powder.
(8) Dispersion and Transformation Method for the Lower Jiao (Middle and Lower Jiao)
Summer heat combined with damp stagnation, mutually obstructing and not transforming.
Symptoms: nausea and vomiting, abdominal distension and gas, constipation, difficult urination. White greasy tongue coating, thick root coating, slippery pulse, with a strong pulse at the guan and chi positions.
Should use methods to disperse and transform, settle counterflow, and promote qi to open the bowels, with one formula and two methods, considering both stomach and intestines.
12g fresh Peilan (add later), 6g fresh Huo Xiang (add later), 12g Xiang Dou Chi, 5g Shan Zhi, 5g old Chen Pi (Citrus reticulata), 10g Fo Shou slices,
10g betel nut, 10g almonds, 6g Qian Hu, 3g Tong Cao, 2g ginger (prepared).
0.5g wine military, 1g Tai Yi Yu Shu Dan, ground together, encapsulated, taken in two doses with 10g Fo Shou slices and 3g ginger decocted and taken first (this is the method to settle nausea).
(9) Dispersing and Transforming Residual Pathogens, Lightly Opening the Stomach and Intestines (Middle and Lower Jiao)
Late stage of damp-warmth, body heat has subsided, symptoms are greatly alleviated, residual heat has not been eliminated, damp-heat accumulation is still present.
Symptoms: constipation, obstructed bowel qi, abdominal discomfort, yellow and thick greasy tongue coating, slippery pulse, with a strong right pulse at the guan and chi positions.
Should disperse and transform residual pathogens to open the stomach and intestines.
10g Bai Jizhi, 6g powdered Dan Pi (Moutan Cortex), 1g fragrant Qing Hao (Artemisia annua), 3g Zhi Shi (Aurantii Fructus), 12g fresh Pa Ye, 15g Bao He Wan (wrapped), 30g whole gourd,
6g Zhi Mu (Anemarrhena asphodeloides), 12g fried Yi Yi Ren, 12g charred Hawthorn, 10g almonds, 12g Yin Chen (Artemisia capillaris), 0.6g Bai Dou Kou powder, 1g raw and cooked Da Huang (Rheum palmatum) powder each, ground together and encapsulated, taken in two doses with decoction.
(10) Dispersing and Transforming Residual Pathogens, Sweetly Moistening and Harmonizing the Middle (Middle and Lower Jiao)
Early recovery from damp-warmth, pathogens have retreated but not completely, middle yang has not yet recovered, yin is also deficient, and transformation is inadequate.
Symptoms: poor appetite, general fatigue, pale and swollen tongue, weak and slippery pulse, weak upon palpation.
Should disperse and transform residual pathogens, sweetly moisten and harmonize the middle to ensure a good recovery. As the condition improves, attention should be paid to the temperature of food and drink.
12g Chuan Shi Hu (Dendrobium), 6g Dan Pi, 0.5g fragrant Qing Hao, 10g sweet almonds, 12g Jian Qu (a traditional formula), 10g chicken inner gold, 20g winter melon seeds,
15g Poria peel, 12g raw and cooked barley malt each, 12g Xiang Sha Zhi Shu Wan (wrapped).
For reference and to promote Mr. Zhao’s effective and methodologically unified approach to differentiating and treating damp-heat syndrome.
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