stomachacheIn Part I we learned about the many signs and symptoms of Food Stagnation. In this segment we’ll cover how to treat and prevent it.

 

Therapies for Food Stagnation

 

Diet Therapy

Foods to Eat: Adequate amounts of protein (but not too much!), lots of cooked vegetables and dark leafy greens, and small amounts of grains and fruits (room temperature or cooked and with spices).

Foods to Avoid: Fatty, greasy, fried foods, excessive protein, cold drinks with fatty foods, excessive intake of dampening foods (see Part I for specific foods to avoid!)

 

Emotional Therapy

 Appropriate expression and release of emotional issues that cause emotional eating

 

Lifestyle Therapies

 One of my Chinese teachers always taught this healthy digestive sequence: eat calmly, rest 15 minutes, walk 15 minutes and then rest (nap) 15 or more minutes. This ensures good digestion and prevents Food Stagnation.

 

Other Therapies

 Stretching or yogic postures that compress and release the abdomen such as forward bends; swimming, brisk walking, running/jogging, bicycling and other similar active forms of exercise/fun; stomach wash or fire wash, one of the Four Purifications. Here’s how to do it:

 

Fire Wash (Agnisara Dhauti)

Perform this exercise with all air held out of the body. Begin by taking a normal inhalation and exhalation, expelling all air. While holding the breath out, pull the diaphragm up and toward the backbone, and then release it suddenly. Repeat this in-and-out movement rapidly, as long as the breath can be held out without strain, about 30 pulls. Then inhale gently. This makes one round. Start with three rounds, gradually increasing to ten, beginning with 30 pulls per breath and working up to 60.

This technique strengthens the `navel lock' (frequently used in breathing exercises), creating heat at the navel center (manipura chakra) that purifies nerve channels, stimulates digestion, increases gastric fire, strengthens lungs, and alleviates indigestion, abdominal diseases and menstrual disorders.

Kitchen medicine

 For quick use around the home, I find fermented foods, acidophilus, spouted grains (rice and barley), and spices such as fennel, caraway, anise, dill and clove to be useful for Food Stagnation.

 

Herbal Therapy

 Food Stagnation-relieving herbs tend to be warm and sweet in energy. They assist the passage of food through the digestive tract and aid assimilation. I imagine that some herbs, such as the sprouted grains, act as little "brushes" to cleanse old food matter from the intestinal walls, while fermented foods help break it down through their enzymatic actions.

Generally, Food Stagnation-relieving herbs are combined with digestive-aiding herbs such as carminatives, and possibly laxatives. As well, there is often concurrent Damp Stagnation and Deficient Spleen Qi, so herbs to address these issues are often combined with food stagnation relieving herbs.

Food Stagnation Herbs

  • Hawthorn berries (Crataegus spp.; shan za) – used specifically for overeating of meat and greasy foods
  • Radish seeds (Semen Raphanus sativus; lai fu zi)
  • Barley sprouts (Hordeum vulgaris; mai ya)
  • Rice sprouts (Oryzae sativa; gu ya)
  • Asafoetida (Rerula asafetida)
  • Bitters drinks
  • Masa Fermentata (shen qu) – This is a fermented mixture of wheat flour, bran and various herbs including wormwood, apricot seed and cocklebur (Xanthium).

Food Stagnation Formulas

 

Chinese Formulas

Bao He Wan (Preserve Harmony Pill; Citrus and Crataegus Formula)

This formula is a specific for food stagnation in the upper abdomen with stomach discomfort, distention and fullness, abdominal bloating, foul belching, sour regurgitation, and possible nausea or diarrhea.

Hawthorn berries (shan zha)           9-15 g Crataegus pinnatifida

Medicated leaven (shen qu)            9-12 g Massa fermentata medicinalis

Radish seed (lai fu zi)                      6-9 g Raphanus sativus

Citrus peel (chen pi)                         6-9 g Citri reticulatae

Pinellia (ban xia)                              9-12 g Pinelliae ternatae

Poria (fu ling)                                 9-12 g Poria cocos

Forsythia (lian qiao)                         3-6 g Forsythia suspensa

Properties and Actions:

a) Digestive

b) Reduces Food Stagnation

c) Harmonizes the Stomach

Indications: It is used for food poisoning and overindulgence in rich foods, alcohol, meat or greasy foods. There may be symptoms of abdominal distention with fullness of the stomach, epigastrium and chest, occasional pain, belching, acid regurgitation, nausea and vomiting, aversion to food, diarrhea, or constipation.

Tongue: Yellow, greasy coated tongue

Pulse: Slippery pulse

Variations: For more severe abdominal distention, add green citrus (zhi shi) and magnolia bark (hou po).

For constipation add rhubarb (da huang) and betel nut (bing lang).

Curing Pills (Pill Curing; Healthy Quiet Pills; Kang Ning Wan)

Chinese Curing Pills are one of the most famous Chinese herbal remedies. It alleviates most any kind of stomach upset, treating a variety of stomach disorders such as food poisoning, overeating, hangover, gas, nausea, acid indigestion, abdominal fullness, abdominal bloating with pain, motion sickness, acid regurgitation, and even the stomach flu. This is an excellent remedy to keep on hand and take on travels.

Contains: Gastrodia, red atractylodes, chrysanthemum, pueraria, trichosanthis, saussurea, coix, poria, magnolia bark, red tangerine peel, agastache (Korean mint or patchouli), angelica root, mint, shen qu, fermented rice sprout

Po Chai Pills (Bao Ji Pian)

A similar remedy to Curing Pills, Po Chai is another Chinese household remedy for stomach discomfort, food poisoning, motion sickness, hangover, acute stomach disorders, and overeating.

There may be up to 14 herbs in each formulation but in general it contains: citrus peel, magnolia bark, chrysanthemum, mint, barley sprouts, poria, saussurea, red atractylodes, agastache, angelica, pueraria, tricosanthis

Other formulas may include laxatives or purgatives to move matter out of the lower warmer. These may include such herbs as rhubarb, Cannabis seeds, senna leaf, or aloe.

Ayurvedic Formulas

Triphala: In Ayurveda, Triphala is used to clear stagnation of the Middle and Lower warmers.

Hingashtak: This Ayurvedic formula includes asafoetida as a major component and clears stagnation in the Middle and Lower warmers.

fullWe made it!

We got through Qi, Blood, Cold and Damp stagnations, and now we are on the fifth and last one: Food Stagnation. This one is perhaps the easiest to understand and relate to because certainly most of us have experienced over-eating during holiday meals. All you have to do is remember how you felt after eating too much food, and you’ve got it.

Generally, Phlegm and Food stagnate in the Middle Warmer, the location of the Stomach. However, symptoms may also arise in the Lower or Upper warmers. In fact, people often go to the emergency room thinking they have heart problems while actually it’s acute Food Stagnation causing heart symptoms.

Food Stagnation may be either acute or chronic. The acute type is how you feel after over-eating; with the chronic type, you may not experience any symptoms or you may have any of those listed below.

Ayurvedic medicine calls chronic Food Stagnation ama. Ama is like rotten sludge, the undigested food particles that lodge in the organs and channels of the body. Similar to Damp Stagnation, it has a consistency of sticky paste with a foul smell. Chronic Food Stagnation arises when digestion becomes impaired and the body can no longer fully digest or absorb nutrients. In this case, food overwhelms the Stomach, preventing its normal descent and the Spleen’s normal ascent. It then either results in stomach symptoms of sour regurgitation, reflux or vomiting, belching and/or hiccupping, or it passes on to the intestines causing foul gas or loose stool or diarrhea with foul-smelling stools. The partially digested food then lingers in the body, congesting the organs and channels and slowing the circulation of Qi, Blood and Fluids.

Food Stagnation is itself an Excess condition regardless of whether it occurs in someone with Deficiency or Excess. It may be associated with either Cold or Heat and this is reflected on the tongue as either a white or yellow coat respectively.

Signs of Food Stagnation

 

Pulse and Tongue

  • Pulse: full, slippery 
  • Tongue: thick, greasy coating, which could be white or yellow; possibly swollen tongue body

Food Stagnation by Location

 

Upper Warmer: Acute – Heart palpitations or stuffiness around the heart along within the epigastric region (Food Stagnation prevents Heart Qi from descending)

Middle Warmer: Acute – No appetite; fullness and distention of the epigastrium which are relieved by vomiting; insomnia with a full feeling in the stomach region (Heart Qi cannot descend); unrelieved hiccupping; epigastric spasms; nausea, vomiting. Chronic – Foul breath; sour regurgitation; belching; certain types of insomnia; abdominal fullness and bloating; poor distribution and/or assimilation of nutrients.

Lower Warmer: Chronic – Lower bowel stagnation; constipation.

Abdominal Diagnosis of Food Stagnation

 Tightness of the muscle under the epigastrium and/or ribs (could also be Qi stagnation) or of upper abdominal muscles; tightness of lower intestines (could also be Qi stagnation); I’ve also felt and seen that thickening of the fat layer over the upper abdomen is a reflection of Food Stagnation.

Causes for Food Stagnation

There are many factors that can cause food to stagnate. Here are several:

Pathogenic Influences: Invasion of Cold into the stomach or intestines, especially combined with poor diet or over-eating

Emotions: Worrying while eating; emotional eating; PMS eating (eating too much and then nothing); eating disorders such as bulimia

Diet: Excessive consumption of: fatty, fried and greasy foods (for example French fries, hamburgers, pizza, and cheese), cold foods and drinks (including raw foods, fruit, tofu, soy milk, iced drinks, salads, ice cream and other refrigerated or iced items), and simple carbs (especially flour products like muffins, pastries, crackers, breads, toast, pasta, cakes and chips of all types)

Lifestyle Habits: Overeating, especially of hard-to-digest foods; eating too quickly; eating while in a hurry; irregular eating times and amounts; working while eating; driving while eating

In Part II we will discuss treatments and therapies for Food Stagnation. However, if you feel stagnant just by reading all of this, I suggest you – you guessed it! Immediately get up and MOVE! Movement is one of the great keys to circulating all substances in the body. Walking and stretching are particularly good for Food Stagnation as are any bending postures that compress and release the stomach.

In Part I we learned about the many signs and symptoms of Damp Stagnation and its far reaching affects on health. In this segment we’ll cover how to treat and prevent Damp Stagnation and Phlegm. Of course you’ll be immediately interested in the herbs and formulas to use, but first I’ll cover other therapies since they are integral, even essential, to preventing and treating this issue.

Therapies for Damp Stagnation

Diet Therapy

Foods to Eat: Protein, grains, legumes, cooked vegetables, cooked fruits, spices added to food, warm drinks

Foods to Avoid: Cold foods and/or drinks; iced foods and drinks; raw foods such as raw veggies in salads, fried and fatty foods, greasy foods, dairy (yogurt is the consistency of mucus, right?!), sugar, alcohol, tofu, soy milk, and all flour products (bread, muffins, bagels, pastries, doughnuts, cake, crackers, pasta, and so on!)

Emotional Therapy

Appropriately express and release emotions on a regular basis

 

Lifestyle Therapies

Regular eating habits; alternate work with rest and play; sufficient exercise and activity; limit pharmaceuticals as much as possible

 

Other Therapies

Moxibustion, cupping (be sure to dress any water blisters that may appear); if working or living in damp environments such as concrete floors and rooms, wear protective shoes and sufficient clothing; avoid prolonged wearing of wet clothing (bathing suits for example) or standing in water

Herbal Therapy

Both diuretics and Phlegm-resolving herbs are used depending on the severity of the Damp Stagnation.

Diuretics/Herbs that Drain Dampness

  • coriander seed (Coriandrum sativum)
  • parsley leaf and seed (Petroselinum sativum)
  • hoelen (Sclerotium Poriae Cocos, fu ling)
  • pipsissewa (Chimaphilla umbellata)
  • water plantain (Alisma plantago)
  • cleavers (Galium aparine)
  • dandelion leaf (Taraxacum officinalis)
  • coix (Coicis lachryma-jobi, yi yi ren)
  • akebia (Caulis mutong, mu tong)
  • plantain seed (Plantago asiatica, P. depressa, che qian zi)
  • musk mallow seeds (Malva verticillata, dong kui zi)

Transform Phlegm

The following expectorants are used according to whether it is Cold Phlegm or Hot Phlegm.

Cold Phlegm:

  • pinellia (Rhizoma Pinelliae ternatae, ban xia)
  • platycodon (Platycodon grandiflorum, jie geng)
  • elecampane (Inula spp., xuan fu hua)
  • jack-in-the-pulpit rhizome (Arisaema spp., tian nan xing)
  • white mustard seed (Brassica alba, bai jie zi)

Hot Phlegm:

  • fritillary bulb (Fritillaria spp., chuan bei mu)
  • trichosanthes (all parts of Trichosanthes kirlowii: seed gua lou, peel gua lou pi, root tian hua fen, seeds gua lou ren)
  • bamboo (all parts of Bambusa breviflora, B. textilis, tian zhu huang, zhu li, zhu ru)
  • hogfennel root (Peucedanum praeruptorum, qian hu)
  • clam shell (Cyclinae sinensis, hai ge ke)
  • seaweeds

Kitchen medicine

For quick use around the home use parsley, coriander seed, celery, peas, carrots, corn silk, or aduki beans (especially with carp or other fish) as diuretics; for Phlegm use cardamom or cloves.

Note: Because Drain Damp and Transform Phlegm herbs tend to be drying, use with caution in those with Deficient Blood or Yin. As well, combine with herbs to clear Heat or warm Internal Cold as appropriate.

Formulas for Damp Stagnation and Phlegm

Citrus and Pinellia Combination (Er Chen Tang or Two Cured Decoction)

This is the best general formula for most types of Damp Stagnation or Phlegm.

  • Pinellia (Pinellia ternate, ban xia) 15 g
  • Citrus peel (Citri reticulatae, chen pi) 15 g
  • Poria (Poria cocos, fu ling) 9 g
  • Baked licorice (Glycyrrhizae uralensis, zhi gan cao) 4 g

Prepare as a decoction adding 3 g of fresh ginger (sheng jiang) and one piece of umeboshi plum (dried or salt-preserved).

Properties and Actions

a) Dries Damp and dispels Phlegm

b) Regulates Qi and harmonizes the Middle Warmer (Stomach and Spleen).

Indications: Cough with Damp-Cold Phlegm caused by Damp-Cold of the Spleen and Stomach. Symptoms may include chest and epigastric fullness, nausea, vomiting, lassitude, feeling of heaviness (from excess mucus), possibly vertigo and palpitations in extreme cases. May be considered for upper respiratory tract infection, chronic bronchitis, cough, goiter, chronic gastritis, peptic ulcer and Meniere's disease.

Tongue: Moist, greasy white coat

Pulse: Slippery

There are many, many formulas for Damp stagnation and Phlegm. Following is a general list:

Upper Warmer Formulas

 

Phlegm-Heat Obstructing Lungs

Ephedra and Apricot Seed Combination (Ma Xin Shi Gan Tang)

  • Ephedra (Ephedra sinica, ma huang) 6-9 g
  • Apricot seed (Prunus armeniaca, xing ren) 6-9 g
  • Gypsum (Calcium sulfate, shi gao)  15-30 g
  • Baked licorice (Glycyrrhiza uralensis, zhi gan cao) 3-6 g

Properties and Actions:

a) Clears External conditions

b) anti-asthmatic

Indications: For External Wind Heat and Interior Lung Heat. Symptoms include fever, with or without perspiration, asthma, thirst and dryness.

Tongue: Either a thin white or yellow coat

Pulse: Floating, rapid and slippery

Contraindication: Not for asthma caused by Wind Cold

Other useful upper warmer formulas

Dampness or Phlegm Obstructing the Head: Pinellia and Gastrodia Combination

Damp Phlegm Obstructing the Lungs: Perilla Seed Decoction

Middle Warmer Formulas

Poria Five Herbs formula (Wu Ling San)

  • Poria (Poria cocos, fu ling) 6-9 g
  • Water plantain (Alisma plantago-aquatica, ze xie) 9-12 g
  • Polyporus (Polyporus umbellatus, zhu ling) 6-9 g
  • Cinnamon twig (Cinnamomum cassia, gui zhi) 6-9 g
  • White atractylodes (Atractylodes alba, bai zhu) 6-9 g

Properties and Actions:

a) Diuretic, clears edema

b) Diaphoretic

c) Digestive, strengthens the Spleen

Indications: This is the primary diuretic formula. It is used for Spleen dampness conditions, edema, thirst, headache, nausea and vomiting after drinking water, urinary retention, ascites, cardiac edema, digestive problems including acute gastritis, gastrectasis, ascites caused by liver cirrhosis, acute enteritis with diarrhea as well as swollen testicles.

Tongue: white and moist

Pulse: floating, slippery

Other useful Middle Warmer formulas

Phlegm and Dampness caused by Deficient Spleen: Six Gentlemen Decoction (Liu Jun Zi Tang)

Magnolia and Ginger Formula (Ping Wei San)

Magnolia and Hoelen Combination (Wei Ling Tang)

Obstruction of Spleen by Dampness with Stagnation of Liver Qi: Capillaris Combination (Yin Chen Hao Tang)

Stagnation of Phlegm in the Gall Bladder: Bamboo and Poria Combination (Wen Dan Tang; Gall Bladder Warming Decoction)

Lower Warmer Formulas

Two Effective Ingredients (Er Miao San)

  • Phellodendron (Phellodendron amurense, huang bai) 6-9 g
  • Black Atractylodes (Atractylodes lancea, cang zhu) 9-12 g

Properties and Actions: Clears Damp-Heat.

Indications: Lower back pain caused by Damp-Heat with symptoms of pain in the knees, eczema, leukorrhea, dark colored and scanty urine, tinea pedis (athlete’s feet), eczema, gonorrhea

Tongue: Yellow and greasy coat

Pulse: Soft and rapid

Other useful Lower Warmer formulas:

Vitality Combination (Zhen Wu Tang; Black Warrior Decoction)

Polyporus Combination (Zhu Ling Tang)

In the Channels and Meridians

Damp Stagnation or Phlegm in the Channels

Stephania and Astragalus Combination (Fang Ji Huang Qi Tang)

  • Stephania (Stephania tetrandra, fang ji) 6 g
  • Astragalus (Astragalus membranaceus, huang qi) 9 g
  • White atractylodes (Atractylodes alba, bai zhu) 6 g
  • Dry ginger (Zingiberis officinalis, gan jiang) 6 g
  • Jujube dates (Zizyphus jujube, da zao) 3-5 pieces
  • Licorice (Glycyrrhiza uralensis, gan cao) 1.5 g

Properties and Actions:

a) Diuretic, clears Excess fluid and removes edema

b) Tonifies the Spleen Qi

c) Calms External Wind

Indications: For swollen abdomen, ascites, edema with a Deficient exterior. Other symptoms include spontaneous perspiration, pale and puffy skin, obesity (especially useful with Ledebouriella and Platycodon Combination), arthritis and rheumatic problems. It can be considered for congestive heart conditions and nephritic edema.

Tongue: Pale with a white coat

Pulse: Floating, weak, soft or thready

Contraindications: Not used if there are no signs of fluid retention.

Whether you've had April showers or are experiencing May ones, rain is a great metaphor for Dampness in the body. Just as rain collects and congests traffic (Qi or Blood stagnation) it can also flood and eventually swamp an area (Damp Stagnation). Damp Stagnation can be likened to standing swamp that breeds bacteria.

In TCM, when Dampness collects over time, Heat develops and dries Fluids. The Dampness then congeals to form Phlegm. Phlegm is a more serious condition that can cause such conditions as cough, wheezing, nausea, vomiting, loss of appetite, GERD, scrofula, goiter, arthritis and lymphadenitis, or it can lead to major diseases like cancer, stroke, atherosclerosis, plaque in the arteries, coma, lockjaw, contracted limbs, cerebral vascular accident, and seizures. While Phlegm is a secondary pathogen, it is considered "the mother of 100 diseases" by the Yuan dynasty physician, Wang Gui. In Ayurvedic medicine, it is called kapha, or the mucus humour.

In general, Fluid (Damp) Stagnation is often associated with Qi Deficiency or low energy. It is accompanied by a general appearance of edema or tissue swelling, especially seen on the abdomen, face, enlarged glands, nodules and/or any other puffy, swollen areas of the body. The tongue reflects generalized edema by appearing enlarged, swollen, scalloped on the sides, and very moist. The pulse feels "slippery," gliding or "rolling," whichever description aptly describes its manifestation.

Phlegm has the following characteristics:

  1. Yin in nature, and as such, can injure Yang Qi
  2. Heavy in nature: feels like a weight or oppression/heaviness in limbs, head, chest, or whole body
  3. Gives rise to lumps and masses: these are soft, movable nodules and not usually painful; swollen joints, goiter, scrofula, cysts
  4. Sticky and obstructive: it can appear as such in the stools, throat, nausea, vomit, or in the channels (numbness); if there’s phlegm in the throat, this is enough to determine the existence of phlegm (especially if this occurs in the morning or after meals and if the tongue is swollen)
  5. Moves and changes: phlegm often moves with Liver Yang or Liver Wind, causing such issues as strokes, or hypertension
  6. Interacts with Blood Stasis (mainly in the elderly); when the two interact, it causes major diseases and death. As well, Phlegm aggravates and harbors Blood stasis (both together create dark nails, a dark complexion, purple lips, and a purple and swollen tongue)
  7. Damages the Spleen and especially, the Stomach
  8. Easily mixes with other pathogenic factors
  9. Is the origin of other diseases: when symptoms don’t fit, think of Phlegm as Phlegm conditions are complicated and a strange group of symptoms

 

Pulse: Slippery and/or wiry

Tongue body: Swollen – where the tongue is swollen indicates the location of Phlegm

Tongue coat: Sticky

Combinations of body and coat:

  • swollen body, sticky coat: phlegm
  • swollen body, sticky coat without root and partially peeled: Phlegm and Stomach Yin Deficiency
  • swollen body, sticky coat, deep cracks: Phlegm and Yin deficiency
  • swollen body, sticky coat, deep crack in heart area: Phlegm misting the Shen
  • swollen body, no coat, slightly purple: phlegm and Blood stasis
  • swollen body, no coat: Phlegm and Yin Deficiency
  • swollen body, dry, yellow inside stomach crack: Phlegm Fire in Stomach
  • swollen body and red: Phlegm Heat

Frankly, if you’ve got to spit out mucus from your throat first thing in the morning or after eating meals, you’ve got phlegm.

Dampness vs. Phlegm

Dampness

Phlegm

Can be external

Is only internal

Not obstructive

Obstructive

Slimy and/or sticky

Sticky

Doesn’t move

Moves and changes

Diseases not so serious

Causes serious diseases

From Spleen impairment

From Spleen, Kidney and Lung impairment

Usually affects lower body

Usually affects middle and upper body

Doesn’t affect the mind

Affects the mind

Combines with Heat or Cold

Combines with Heat, Cold, Fire, Blood, Wind, Dryness

Mostly affects the Spleen, Gall Bladder, Urinary Bladder, Large Intestine, Small Intestine Mostly affects the Lungs Heart, Kidneys, Stomach

Affects the Spleen

Affects the Stomach

Stagnates

Moves with (or blocks) Qi and Blood

Sticky, heavy, dirty, flows downward

Sticky only

Only assumes one form: watery

Can be Phlegm, Phlegm Fluids

Use "drain Dampness" herbs

Use "resolve Phlegm" herbs

 

Phlegm always affects the Spleen but it accumulates in the Lungs. However, because it moves and changes, it can be found anywhere in the body, such as:

Phlegm in the Lungs: cough, wheezing, stifling sensation in the chest, pain in the ribs

Damp Phlegm Obstructing the Lungs: chronic cough coming in bouts, profuse white sputum which is easy to expectorate, white-pasty complexion, stuffiness of the chest, feeling "clogged up," shortness of breath, dislike of lying down, slippery or weak-floating and fine pulse and thick-sticky white tongue coating.

Phlegm Heat in the Lungs: barking cough, profuse yellow or green or dark sputum which is foul-smelling, shortness of breath, asthma, stuffiness of the chest, slippery, rapid, full pulse and red tongue body with a thick-sticky yellow coating

Phlegm in the Stomach: nausea, vomiting, loss of appetite, epigastric distention

Phlegm in the Channels: scrofula, goiter, lymphadenitis

Turbid Phlegm blocking the Heart orifices: wind stroke, coma, lockjaw, contracted limbs, CVA, seizures

Upper Warmer Symptoms: edema in top part of body such as face and hands, congestion in the head and/or chest

Middle Warmer Symptoms: sound of abdominal fluid, damp abdomen, ascites, edema in the middle part of the body

Lower Warmer Symptoms: Edema in lower part of body, such as the legs and ankles, pitting

Is Damp Stagnation Hot or Cold?

Dampness and Phlegm always appear with either Heat or Cold. If with Heat, there’ll be other signs of Heat along with a yellow tongue coat and yellowish excretions and secretions; if with Cold, there’ll be other signs of Cold along with a white tongue coat and clear to white excretions and secretions.

Causes for Damp Stagnation

Dampness and Phlegm are always pathologies of the Qi mechanism. While it is primarily caused by deficient Spleen Qi or Yang failing to transform and transport Body Fluids, it may also be created by deficient Kidneys unable to control the Fluids and/or Liver Qi Stagnation failing to facilitate the transportation and transformation functions of the Spleen. As well, it may be caused by the invasion of pathogenic influences such as External Wind-Cold that interferes with the Lung’s function of dispersing and descending. Here are several other factors that can cause Damp stagnation and Phlegm to develop:

Pathogenic Influences: Phlegm easily combines with other pathogens to create many conditions such as:

  • Wind-Phlegm
  • Dry-Phlegm
  • Phlegm-Fire
  • Phlegm with Qi Stagnation
  • stone Phlegm (chronic swelling of the glands or nodules on the vocal chords)
  • food Phlegm
  • shock Phlegm
  • wine Phlegm
  • Phlegm obstructing the Heart
  • Lung Deficiency with Phlegm
  • Phlegm-Fire in the Lungs
  • turbid Phlegm in the Lungs
  • Phlegm obstructing the Lung Qi
  • Phlegm-Fluids in the Lungs
  • Spleen Qi Deficiency with Phlegm
  • Phlegm obstructing the middle burner
  • Phlegm-Fire in the center
  • Phlegm-Fluids in the center
  • Liver-Wind harboring Phlegm
  • Phlegm-Heat in the Liver channel
  • Liver Qi Stagnation and Phlegm
  • Liver Blood Deficiency and Phlegm
  • Kidney Yang Deficiency with Phlegm
  • Kidney Yin Deficiency with Phlegm

Emotions: Any emotional excess can eventually lead to Damp Stagnation and Phlegm

Diet: High consumption of cold foods and/or drinks; raw foods; dampening foods like fried and fatty foods, dairy, sugar, tofu, soy milk, alcohol, and flour products

Lifestyle Habits: Irregular eating habits, overwork, inactivity, excessive or long-term use of many pharmaceuticals such as antibiotics and antidepressants

In Part II we will discuss treatments and therapies for Damp Stagnation. However, if you feel stagnant just by reading all of this, guess what I’m going to suggest that you do? That’s right! Immediately get up and MOVE! Movement is one of the great keys to circulating everything in the body. It can be exercise, but if you do what you love at the same time, it also smoothes emotions and nourishes you, preventing further stagnation. 

In Part I we learned about the many signs and symptoms of Cold Stagnation and its effects on physical and mental health. In this segment we’ll cover how to treat and prevent Cold Stagnation. You may be most interested in herbs and formulas that treat this condition, but first I’ll cover other therapies integral to preventing and treating this issue.

Therapies for Cold Stagnation

Diet Therapy:

Foods to Eat: All cooked foods, warm drinks; spices added to food; animal protein (except crabmeat and shellfish); cooked and spiced vegetables and fruits 

Foods to Avoid: Refrigerated foods and drinks; raw foods (including salads); iced drinks; frozen yogurt, ice cream, popsicles, etc.; most fruit and vegetable juices; melons, bananas; crabmeat and shellfish (except shrimp); soy milk and tofu

Emotional Therapy: Appropriate expression and release of emotions

 

Lifestyle Therapies: Dress warmly and adequately for the weather; cover neck with a high collar or scarf; cover lower back, waist and midriff

 

Other Therapies: As with Blood Stagnation, moxibustion is the main therapy for Cold Stagnation, although other heat applications may be used such as hot stones, hot packs, warming herbal patches, ginger fomentations, and so forth.

 

Herbal Therapy: Herbs for Cold Stagnation tend to come from the "Herbs That Warm the Interior" or "Herbs that Tonify Yang" categories. In Western herbalism this can include stimulants along with certain adaptogens. These herbs have a warm to hot energy and generally pungent and/or sweet flavor. If there is also Wind or Dampness involved, then herbs that resolve Wind-Cold or disperse Cold Damp are also used. Take these herbs with cooked, warm food or as warm teas. Examples of herbs used for Cold Stagnation follow:

  • cayenne pepper
  • pippali long pepper
  • anise seed
  • horseradish root
  • cloves
  • prickly ash
  • bayberry bark
  • ginger, especially dried
  • cinnamon
  • garlic
  • black pepper
  • fenugreek
  • damiana
  • dipsacus
  • cuscuta

 

Kitchen medicine: Many kitchen spices are warming in energy, which disperse Cold Stagnation, such as ginger, cinnamon, cloves, black pepper and garlic.

Formulas for Cold Stagnation

Stagnation of Cold in the Upper Warmer

Aconite Combination (Si Ni Tang)

  • *Prepared aconite (fu zi, Aconitum carmichaeli) 9-12 g 
  • Dry ginger  (gan jiang, Zingiberis officinalis) 6-9 g 
  • Baked Licorice (zhi gan cao, Glycyrrhiza uralensis) 9-12 g 
  • *Substitute for aconite: cinnamon bark, rou gui

Properties and Actions:

a) For Yang exhaustion of the Lesser Yin (Xiao Yin) stage.

b) For Yang Deficiency caused by excessive perspiration.

 

Indications: This formula can be used for collapse of vital functions and cardiac failure. Symptoms include: cold extremities, fear of cold, fatigue and exhaustion, diarrhea with undigested food in the stool, nausea and vomiting, abdominal pain and lack of thirst. This formula was originally indicated for individuals who were inappropriately prescribed diaphoretics.

 

Pulse: Deep and weak

 

Tongue: Pale or dark purplish-blue

Contraindications: Avoid if there is Excess Heat or Yin Deficiency.

 

Stagnation of Cold in the Middle Warmer

Ginseng and Ginger Combination or Regulate the Middle Pill (Li Zhong Wan)

  • Dry ginger (gan jiang, Zingiber officinalis) 9 g 
  • Ginseng (ren shen, Panax ginseng) 9 g 
  • White atractylodes (bai zhu, Atractylodes alba) 9 g 
  • Baked licorice (zhi gan cao, Glycyrrhiza uralensis) 9 g 

Preparation: Grind the ingredients into a powder. Warm honey until it is liquid. Stir the herb powder into the honey until it is a thick doughy consistency. Roll into balls about half the size of a lime. Take two or three daily before meals. A single dose of pills should equal to about 6-9 grams of the powdered herb. It can also be taken as a decoction. The pill is often taken with rice congee. Unless it is an acute case, codonopsis (dang shen) can be doubled in amount and substituted for ginseng (ren shen).

Properties and Actions:

a) Tonic, warms and tonifies Spleen and Stomach Yang

b) Strengthens digestion and raises digestive metabolism

Indications: It may be considered for symptoms of deficiency such as diarrhea with watery stool, nausea and vomiting, no particular thirst, loss of appetite, abdominal pain.

Pulse: Deep and thin

Tongue: Pale tongue with white coat

Note: This formula is often combined with either or both 6 g of cinnamon bark (rou gui) and 6 g of prepared aconite (fu zi) to make it stronger and warmer; this is Aconite, Ginger and Ginseng Combination (Fu Zi Li Zhong Wan). It is particularly useful for vegetarians, who through eating too much cold, raw food, have injured the Spleen Yang and seriously weakened their digestive metabolism.

Contraindications: Avoid if there is Excess Heat or Yin Deficiency.

 

Stagnation of Cold in the Lower Warmer

Rehmannia Eight Combination (Jin Gui Shen Qi Wan or Ba Wei Di Huang Wan)

  • Prepared aconite (fu zi, Aconitum praeparata) 10-15 g 
  • Cinnamon twigs (gui zhi, Cinnamomum cassia) 6-9 g 
  • Prepared Rehmannia (shu di huang, Rehmannia glutinosa) 20-30 g 
  • Cornus (shan zhu yu, Cornus officinalis) 10-15 g 
  • Dioscorea (shan yao, Dioscorea opposita) 10-15 g 
  • Water Plantain (ze xie, Alisma plantago-aquatica) 9-12 g 
  • Moutan Peony (mu dan pi, Paeonia suffruticosa) 6-9 g 
  • Poria (fu ling, Poria cocos) 9-12 g 

Properties and Actions:

a) Tonifies Yang

b) Warms the Kidneys and lower extremities

Indications: For symptoms of Kidney Yang Deficiency with lower backache, coldness in the lower extremities, impotence, spermatorrhea, prostatic hypertrophy, frequent urination, nocturia, cough, asthma, persistent diarrhea, dysuria, spasms of the lower abdomen. It can be considered for diabetes mellitus and insipidus, hyperaldosteronism, Addison’s disease, hypothyroidism, arteriosclerosis, hypertension, edema, cystitis, chronic nephritis, kidney stones, albuminaria, chronic bronchitis, edema, chronic diarrhea, rectal prolapse, chronic gonorrhea, arthritis, menopausal problems, eczema, senile pruritis, vaginal itching, urticaria, neurasthenia, cataracts, glaucoma, keratitis.

 

Pulse: Sunken, slow and weak

Tongue: White

Contraindications: Avoid if there is Excess Heat, Yin Deficiency or gastrointestinal weakness.

 

Stagnation of Cold in Liver Channel

Warm the Liver Decoction (Nuan Gan Jian)

  • Angelica sinensis (dang gui) 6-9 g
  • Lycii berries (gou ji zi, Fructus lycii) 9 g 
  • Fennel seeds (xiao hui xiang, Foeniculi vulgaris) 6 g 
  • Cinnamon bark (rou gui, Cinnamomi cassiae) 3-6 g 
  • Lindera root (wu yao, Linderae strychnifoliae) 6 g 
  • Aquilaria wood (chen xiang, Lignum aguilariae) 6 g 
  • Poria (fu ling, Poria cocos) 6 g 
  • Fresh ginger (sheng jiang, Zingiberis officinalis) 3-5 slices 

Preparation: Take warm. Saussurea (mu xiang) is often substituted for the harder to obtain aquilaria, which is also known as Lignum vitae. This formula is particularly indicated for hernial disorders for which fennel seed is a near specific.

Contraindications: Avoid if there is Excess Heat, Yin Deficiency or gastrointestinal weakness.

 

Cold Invading the Large/Small Intestine

Magnolia and Hoelen Combination (Wei Ling Tang)

  • Alisma (ze xie, Alisma plantago-aquatica) 2.5 g 
  • Poria (fu ling, Poria cocos) 2.5 g
  • Polyporus (zhu ling, Polyporus umbellatus) 2.5 g 
  • Cinnamon twig (gui zhi, Cinnamomum cassia) 2 g 
  • White Atractylodes (bai zhu, Atractylodes alba) 2.5 g 
  • Black Atractylodes (cang zhu, Atractylodes lancea) 2.5 g 
  • Magnolia bark (hou po, Magnolia officinalis) 2.5 g 
  • Citrus peel (chen pi, Citrus reticulata) 2.5 g 
  • Licorice (gan cao, Glycyrrhizae uralensis) 1 g 
  • Fresh ginger (sheng jiang, Zingiberis officinale) 1.5 g 
  • Jujube dates (da zao, Zizyphus jujuba) 3-5 pcs

Properties and Actions:

a) Eliminates Dampness of the Spleen (relieves bloating)

b) Carminative, restores the function of the Stomach and assists digestion.

Indications: Abdominal bloating and fullness, loss of appetite, dull heavy feeling in the head and body, watery diarrhea, decreased urination.

Pulse: Slippery and thready

Tongue: White with a greasy coat

Contraindications: Avoid if there is Excess Heat, or Yin Deficiency.

 

Cold Obstruction of the Channels

Frigid Extremities Decoction (Si Ni Tang)

  • *Prepared Aconite (fu zi, Aconitum carmichaeli) 6-9 g
  • Dry ginger (gan jiang, Zingiber officinale) 4.5 g 
  • Honey baked licorice (zhi gan cao, Glycyrrhiza uralensis) 6 g 
  • *Substitute cinnamon twig for the aconite

Properties and Actions:

a) Metabolic Stimulant, stimulates Yang

b) Warms and counteracts internal Cold

Indications: Aversion to cold, coldness in the hands and feet, coldness in the Stomach and Spleen, vomiting, diarrhea, lethargy, abdominal pain, lack of thirst.

Pulse: Thin, deep and faint

Tongue: White, moist coat

Variation: By adding 6-9 g of ginseng (ren shen), the formula has wider tonic properties, tonifying Yin, Blood and Qi. Both these formulas are appropriate for both the Xiao Yin and Jue Stages as well.

Note: This is the basic metabolic stimulant formula.

Contraindications: Avoid if there is Excess Heat or Deficient Yin.

 

Ayurvedic Compounds for Cold Stagnation

Trikatu is used for Internal Cold Stagnation and to dry mucus. It consists of equal parts powdered black pepper, pippali long pepper and ginger mixed with honey. A teaspoon is taken 2 or 3 times daily to lessen mucus and treat upper respiratory allergies.

Sito Paladi Churna is a traditional household formula used to treat the symptoms of the common cold. It consists of equal parts sugar, bamboo manna, pippali long pepper, cardamom seeds, cinnamon bark and ginger. It is warming, anti-mucus and clears Dampness.

 

Western Thompsonian Herbal Formula for Cold Stagnation

Composition Powder

  • 4 parts bayberry bark powder
  • 2 parts white pine bark powder
  • 2 parts powdered ginger root (dried)
  • 1/2 part cayenne pepper
  • 1/2 part cloves powder

A teaspoon of this can be taken in hot or warm water three or four times daily. While this helps induce perspiration in someone with the first sign of a cold or flu (followed a half hour later with a bowl of thin porridge such as rice cream or oatmeal if the patient is weak), this formula may also be taken in smaller doses to move Cold Stagnation. As well, it may be modified with cinnamon bark and licorice.

frozenYears ago when I worked in Cleveland, I’d stare out the office window at a sunny spring day. Ecstatic to finally have warm weather, I’d rush out at lunchtime without a coat – it looked warm after all – only to find it was still cold. It’s behaviors like this that are one of the reasons why the winter-into-spring turning point of the seasons is one of the two most vulnerable times of year for colds and flu.

For this reason, I’m choosing to discuss Cold Stagnation in this blog. In April, there is often still a chill in the air. While we want it to be warm outside and so dress more lightly, generally it’s still frigid, particularly with wind, and so this is one of the times of year when cold can penetrate or congest more easily.

Coldness

Cold itselftends to contract like ice. It causes a person to hunch over or curl up in order to minimize exposed body surface and maintain inner warmth. With lack of heat, activity in all forms slows.

Coldness is characterized by:

  • lowered metabolism
  • feelings of coldness, severe chills, aversion to cold and craving of warmth
  • pale complexion, anemia, poor circulation, low blood pressure
  • weakness, lethargy, slowness, somnolence
  • poor digestion, poor appetite
  • lowered immunity
  • diarrhea or loose stools, frequent and copious clear urination, night time urination
  • fluid retention, no thirst or sweating
  • weak senses
  • timidity, soft voice, quietness
  • few body odors
  • clear to white mucus, stools, urine or vaginal secretions
  • achy pain in the joints
  • frigidity, impotence, infertility
  • all hypo-conditions such as hypothyroidism, hypo-adrenalism or hypoglycemia

Signs of Cold Stagnation

Coldness impedes circulation, causes contraction and slows activity internally. If there’s Cold in the body, eventually it leads to other forms of stagnation or it depletes the inner fires. Cold Stagnation can be acute or chronic. If acute, it usually causes severe pain; if it’s chronic, you may not even be aware of its presence except for perhaps feelings of coldness in the affected area.

Cold Stagnation is sometimes called "Full Cold." Full Cold only exists a short time because it quickly consumes the Yang, turning into Yang Deficiency (Empty Cold) instead. Pain from Cold Stagnation is generally severe, but not fixed or stabbing, and it’s alleviated by warmth and pressure. Cold Stagnation often combines with Damp to form Cold-Damp Stagnation as well.

Pulse and Tongue:

Pulse: The pulse is slow (less than 60 BPM); deep and tight. Fewer than four beats per complete breath (60 beats/minute) indicates Cold:

  • slow and empty designates Yang Deficiency
  • slow and full indicates Cold Stagnation.

Tongue: pale with a thick white coat (acute); pale with a thin white coat (chronic)

Cold Stagnation in the Upper Warmer:

Feelings of coldness in the head, arms, chest and back; pale complexion.

 

Cold Stagnation in the Middle Warmer:

"Cold" indigestion; anorexia; diarrhea

 

Cold Stagnation in the Lower Warmer:

Cold abdomen, legs, and/or feet; impotence; frigidity

Cold Obstruction in the Channels:

Pain in the joints and/or muscles with feelings of coldness

Stagnation of Cold in the Liver Channel:

In men: straining of the testes or contraction of the scrotum; fullness and distension of the bladder area with pain that refers to the scrotum and testes

In women: shrinking of the vagina; pain alleviated by warmth

Cold Obstructing the Large and/or Small Intestines:

Abdominal pain alleviated by heat and pressure; loose stools or diarrhea; if the Cold invades the Large or Small intestines, the pain is sudden and severe; diarrhea with pain; feeling of cold and cold sensation in abdomen

This is an acute condition from the invasion of Exterior Cold into the Large Intestine that occurs usually from sitting on cold and wet surfaces for prolonged periods, exposure to very cold weather, or from having the abdomen insufficiently covered.

This happened to our son one day when he was about 8 years old. He had been playing outdoors von a cool day when suddenly, he ran inside and rolled on the floor, holding his abdomen and crying with pain. When I felt the area, it as cool to the touch and so I applied heart. Very quickly the pain dispersed.

Cold Invading/Obstructing the Stomach:

Sudden pain in the epigastrium, feelings of coldness with preference for warmth, vomiting of clear fluid, worse after drinking cold fluids that are then vomited

Cold Invading/Obstructing the Uterus:

Infertility; miscarriage; leucorrhea; pain and cold feeling before or during period in the lower abdomen referring to the waist and back with the pain alleviated by warmth; scanty dark red menstrual blood with clots

Causes for Cold Stagnation

Factors that can lead to Cold Stagnation are:

Pathogenic Influences: Wind-Chill invading the skin, channels, Stomach, Intestines, or Uterus.

Emotions: Inward behavior, passivity and dullness can all be signs of Cold Stagnation.

Diet: Excessive intake of cold drinks and foods, including the following:

  • Refrigerated foods and drinks
  • Raw foods, including salads
  • Iced drinks
  • Frozen yogurt, ice cream, popsicles, etc.
  • Most fruit juices
  • Melons
  • Bananas
  • Crabmeat and shellfish
  • Soy milk and tofu

Lifestyle Habits: Not wearing sufficient clothing for the weather, bear midriffs, standing or sitting in cold environments (like concrete floors and basements).

In Part II, we will discuss treatments and therapies for Cold Stagnation. However, if you feel cold just by reading all of this, I suggest you immediately get up and – you got it: MOVE! While you certainly may be tired of reading this repeated suggestion by now, movement is still one of the great keys not just to circulating Qi and Blood, but also to warming the body and dispersing Cold Stagnation.

gymnastIn Part 1 we learned about the many signs and symptoms of Qi stagnation and its far reaching affects on physical and mental health. In this segment we’ll cover how to treat and prevent Qi stagnation. Of course you’ll be immediately interested in the herbs and formulas to use, but first I’ll cover other therapies since they are integral, even essential, to preventing and treating this issue.

 

Therapies for Qi Stagnation:

 

Diet Therapy:

Foods to Eat: Foods that decongest and aid the Liver include vegetables, bitter foods and dark leafy greens such as kale, collards, dandelion, mustard, beet and mustard greens. Lemon juice also helps decongest the liver. A good morning liver cleanse is a fresh squeezed lemon in water with 1 or 2 teaspoons of olive oil and a couple of "00" sized capsules of cayenne pepper. This is followed with fennel seed tea.

Foods to Avoid: Avoid fried, fatty and oily foods, nuts and nut butters, avocados, cheese and dairy, chips of all kinds, turkey and red meats, alcohol, spicy foods, caffeinated foods and drinks, coffee, black tea, cocoa, colas and chocolate, recreational drugs and stimulants.

 

Emotional Therapy: Turning the "vices" of the Liver into "virtues" helps smooth Liver Qi Stagnation. The Liver’s vices are anger and frustration; its virtues are benevolence, forgiveness, esteem, respect and kindness. Ever hear of that saying, "Do acts of kindness?" Such actions actually cultivate the positive aspects of the Liver and help Qi flow smoothly and regularly. There are many ways to do this; choose ones that express and release emotions in constructive ways and cause no harm to you or others. Above all, do not repress or stuff your emotions, as this is what helped create these physical symptoms in the first place. Of course my new book, Metaphor-phosis: Transform Your Stories from Pain to Power, is a perfect tool to help you do this!

 

Lifestyle Therapies: To rebalance the Liver, go to sleep by 11 PM at the latest, move regularly through walking, dancing, swimming, cycling, jogging, exercise, hiking (especially in the woods), Tai Chi, Qi Gong, yoga or another physical activity and regular exercise, and engage in creative projects as this releases pent-up Liver energy and moves Qi. For computer work (and other electronic tools) and desk jobs, be sure to move and/or stretch for five minutes every 30 – 60 minutes. 

 

Other Therapies: Participate in regular life activities, sex and exercise as regularity of habits helps regulate Qi. Go to sleep by 11 pm at the latest since the Wood Element time of the Liver and Gallbladder does its major work from 11 pm – 3 am (if there’s also Deficient Kidney Yin, go to bed by 9 - 9:30 PM). Find work and jobs you enjoy and are fulfilling.Alternate work with rest and play as over-working can cause this pattern. Do cupping (especially over the back), dermal hammer where needed, breathing exercises, abdominal massage, massage therapies, singing and wear a haramaki around the waist to keep the kidneys warm, the "mother" of the Liver.

Herbal Therapy: Finally - herbal therapy for Qi stagnation! This encompasses so many herbs and formulas that we can’t cover them all here, but I’ll give you enough juicy ones to start exploring. First of all, herbs that move Qi are those that help it move smoothly, regularly and in the right direction. In Western herbalism this includes carminatives. Examples include:

 

  • Bupleurum(Bupleurum falcatum; chai hu)
  • Citrus peels (Pericarpium citri reticulatate; chen pi, qing pi, zhi ke, zhi shi, fo shou)
  • Cyperus (sedge root, Cyperus spp. Especially C. rotundus, xiang fu)
  • Chinese rose buds (Rosae rugosa; mei gui hua)
  • Mint (Menthae haplocalycis; bo he)
  • Fennel seed (Foeniculi fructus; xiao hui xiang)
  • Saussurea (Aucklandiae lappa; mu xiang)
  • Aquilariae (aloeswood; Aquilaria sinensis; chen xiang)
  • Persimmon calyx (Calyx Diospyros kaki; shi di)
  • Sandalwood (Santalum album; tan xiang)
  • Lindera (Lindera spp.; wu yao)
  • Chinese garlic (garlic chive; Allium macrostemon; xie bai)
  • Cumin (Cuminum cyminum)
  • Vitex (V. Agnus-castus)
  • Areca peel (Arecae pericarpium; da fu pi)
  • Melia (Sichuan chinaberry, Sichuan pagoda tree; Melia toosendan; chuan lian zi)

Qi-regulating herbs tend to be aromatic, warm and acrid or bitter in energy, treating symptoms of pain that comes and goes, and/or changes location and severity; distention, stifling feelings in the chest, belching, nausea, vomiting, wheezing, acid regurgitation, loss of appetite, diarrhea or alternating diarrhea or constipation, pain in the flanks or under the ribs, depression, mood swings, and hernias.

Qi-moving herbs are rarely used alone; rather they are combined with others based upon the nature of the condition being treated. Typically, they are combined with Blood-moving herbs as Qi and Blood are intricately intertwined. For this reason, when one tonifies Qi, it’s important to tonify Blood and when one moves Qi, it’s also important to move Blood.

Kitchen medicine: For quick use around the home, I find citrus peel tea to be very effective to move Qi. While the Chinese use mandarin orange peels, in Italy I was surprised with lemon peel tea after one dinner. As well, rose buds make a wonderful jam, delighting the senses and spirit as well as moving Qi. Fennel seeds, normally found mixed with sugar and taken after dinner in Indian restaurants, are great as a tea, eaten raw or toasted and cooked with vegetables and meats.

Caution: Because Qi-moving herbs tend to be warming and drying, use with caution in those with Deficient Blood or Yin, or Excess Heat; because they are dispersing, use with caution if there’s Deficient Qi.

Qi-Moving Formulas:

There are lots of formulas that move the Qi and many are available in Chinese patent teapill form, which are easy to find and take. Because bupleurum is one of the major Qi-moving herbs, there are literally dozens of formulas based on this herb alone. Perhaps one of the best known is Bupleurum and Dang Gui Formula (Xiao Yao San) and its variation, Bupleurum and Peony Combination (Jia Wei Xiao Yao San). These two formulas treat most symptoms of Liver Qi stagnation. The first is more warming while the second also clears Heat.

Bupleurum and Dang Gui Formula (Rambling Powder, Xiao Yao San,or in Planetary Formulas: Bupleurum Calmative):

  • Bupleurum (chai hu), 6-9g
  • Dang gui (dang gui), 6-9g
  • White peony (bai shao), 9-12g
  • White atractylodes (bai zhu), 6-9g
  • Poria (fu ling), 9-15g
  • Mint (bo he), 1-3g
  • Fresh ginger (shen jiang), 1-3g
  • Baked licorice (zhi gan cao), 3-6g

Bupleurum and Peony Formula (Jia Wei Xiao Yao San):

Add to the above formula:

  • Gardenia fruit (zhi zi), 1-3g
  • Moutan peony (mu dan pi, tree peony), 3-6g

Uses: Both formulas regulate the function of the Liver and Spleen, move Liver Qi stagnation and replenish Blood. They are used for anemia, costal pain, headache, mouth and throat dryness, dizziness, lassitude, loss of appetite, irregular menses, leukorrhea, uterine bleeding, PMS, mood swings, depression, breast distention, chronic hepatitis, and alternating chills and fevers as in shao yang stage diseases.

Other Bupleurum Formulas to Consider:

  • Minor Bupleurum (Xiao Chai Hu Tang)
  • Major Bupleurum Formla (Da Chai Hu Tang)
  • Bupleurum and Chih Shih Formula (Frigid Extremities Powderor Si Ni San)
  • Bupleurum and Cinnamon Combination (Chai Hu Gui Zhi Tang)
  • Bupleurum and Dragon Bone Combination (Chai Hu Jial Long Gu Mu Li Tang)
  • Bupleurum and Schizonepeta Formula (Shih Wei Pai Tu Tang)
  • Bupleurum Formula (Yi Gan San)

 

More Useful Qi-Moving Formulas:

  • Pinellia and Magnolia Combination (Ban Xia Hou Pu Tang)
  • Powder to Disperse Vital Energy in the Liver (Chai Hu Shu Gan San)
  • Pills of Tangerine Seed (Ju He Wan)

Happy Spring to you! May your Qi flow smoothly and your energy rise with the sap in trees!

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