Chapter Six. Syndrome of abnormal discharge and formula composition
CHAPTER CONTENTS
CHAPTER OUTLINE
This chapter introduces the principles, methods and strategies for the composition of formulas that stabilize the body essence, body fluids, blood and Qi. They are used to treat abnormal discharge of the essential substances of the body and abnormal consumption of the Qi. They can also be used for the composition of formulas that stabilize the structure of the internal organs, which slip from their normal places when the Qi is deficient.
Syndrome of abnormal discharge
Manifestations
Main symptoms
Excessive sweating, severe cough, shortness of breath, asthma, palpitations, uterine bleeding, spermatorrhea, premature ejaculation, large amount of leukorrhea, incontinence of urine, enuresis, diarrhea, prolapse of rectum and uterus.
Tongue
Pale or dull-pale, with a white coating.
Pulse
Rapid, restless or deep and weak.
Associated disorders in western medicine
Asthma, pulmonary emphysema, chronic bronchitis, hyperventilation, arrhythmia, tachycardia, insomnia, colitis, chronic enteritis, dysentery, food allergy, premature ejaculation, spermatorrhea, urinary incontinence and enuresis.
Analysis of the syndrome
The essence, fluids, blood and Qi are the basic substances of the body. They support the physiological functions of the internal organs and should be protected from abnormal leakage and consumption.
The direct cause of abnormal discharge of the essential substances is Qi deficiency.
• When the Qi of the internal organs is very weak, and is not able to keep the essence and fluids in the body and the organs in their proper places, abnormal discharge or so-called leakage occurs. Elderly people and people with chronic diseases or with a very weak constitution are more likely to have this disorder.
• When Lung-Qi and Kidney-Qi are weak, breathing becomes shallow and quick, and patients may also suffer from cough and wheezing.
• When the Defensive-Qi is weak, patients sweat profusely.
• When Heart-Qi is weak, patients may have palpitations, anxiety and restlessness.
• When Kidney-Qi and Kidney-Yang are weak, premature ejaculation, spermatorrhea, incontinence, enuresis and diarrhea may be present.
• The deficiency of Spleen-Qi may cause diarrhea, bleeding, a large amount of leukorrhea, and prolapse of uterus, rectum or other internal organs.
• A pale tongue with a white coating and a rapid pulse indicate Qi deficiency.
(See Figure 6.1 on page 200.)
Treatment principle: Stabilize the essence, fluids, blood and Qi; tonify and regulate the Qi
Herb selection principles and formula composition strategies
• The first priority is to select sour, astringent and calcined herbs to directly stabilize the essence, fluids, blood and Qi in order to stop their abnormal discharge and prevent further discharge.
• Along with these, it is equally important to select herbs that tonify and stabilize the Qi, blood, Yin and Yang in order to treat the cause of the syndrome and enhance the ability of the stabilizing and binding herbs.
• Herbs that have a sweet taste and can reduce the intensity of the abnormal discharge can be used.
• Herbs that regulate the function of the internal organs, especially Qi movement, should be used to prevent stagnation caused by the sour and astringent substances.
CAUTIONS
1. Make sure there are no excess pathogenic factors in the body:
The formulas that stabilize and bind are only used in deficiency conditions. There should be no exterior pathogenic factors or phlegm, dampness or blood stagnation in the body. Otherwise, they may retain the pathogenic factors in the body.
2. Make a correct differentiation:
There are many factors that can cause abnormal discharge of the body fluids and essence besides Qi deficiency. For example, diarrhea can be caused by damp-heat in the intestines; excessive urination or spermatorrhea can be the result of damp-heat in the Lower-Jiao; shortness of breath can be the consequence of phlegm accumulation; excessive sweating is often caused by excess heat or empty-heat in the body. Thus a correct differentiation of the syndrome is required.
3. Use only in acute and severe conditions for a reasonably short time:
The formulas that stabilize abnormal discharge of the essential substances focus on treating the manifestations. As they do not have sufficient function to treat the cause of the disorder, they are only used for a short period of time. When the abnormal discharge stops, formulas that tonify should be used in the first instance, or tonifying herbs should be added to the original formulas.
Structure of the formula and selection of herbs
Chief: Directly stop abnormal discharge
Most of the herbs that stabilize the essence, body fluids, blood and Qi are sour or astringent. Herbs with a sour taste have a contracting ability and inward-moving tendency; herbs with astringent properties are able to prevent or reverse abnormal discharge of essence, body fluids and Qi. When herbs are calcined, they develop an astringent property. This procedure is particularly useful in acute conditions.
Wu Wei Zi ( Schisandrae fructus), Wu Mei ( Mume fructus), He Zi ( Chebulae fructus) and Bai Guo ( Ginkgo semen)
These herbs are particularly able to stabilize the Lung-Qi. They are used to relieve thirst, shortness of breath and chronic cough. They are used in conditions of sudden or severe Qi scattering and fluid consumption of the Lung.
Ma Huang Gen ( Ephedrae radix)* and Nuo Dao Gen Xu ( Oryzae glutinosae radix et rhizoma)
These herbs specialize in stabilizing the exterior and can effectively stop sweating.
Wu Wei Zi ( Schisandrae fructus), Fu Xiao Mai ( Tritici fructus germinatus), Mu Li ( Ostrea concha) and Long Gu ( Mastodi fossilium ossis)
These substances are particularly effective in stabilizing the Heart-Qi. They are used to treat palpitations, restlessness, spontaneous sweating, night sweats and insomnia. Of these herbs, Mu Li is particularly effective for treating night sweats; Fu Xiao Mai and Long Gu can treat both night sweats and spontaneous sweating.
Shan Zhu Yu ( Corni fructus), Wu Wei Zi ( Schisandrae fructus), Wu Zei Gu ( Sepiae seu sepiellae os), Qian Shi ( Euryalis semen), Fu Pen Zi ( Rubi fructus), Lian Zi ( Nelumbinis semen) and Lian Xu ( Nelumbinis stamen)
These are the substances that particularly stabilize the Kidney-essence. They are used in the treatment of frequent night urination, enuresis, spermatorrhea and premature ejaculation in conditions of Kidney-Yang or Kidney-Qi deficiency.
Wu Mei ( Mume fructus), Wu Bei Zi ( Chinensis galla), Ying Su Ke ( Papaveris somniferi pericarpium), Qian Shi ( Euryalis semen), Rou Dou Kou ( Myristicae semen), He Zi ( Chebulae fructus), Chi Shi Zhi ( Halloysitum rubrum), Lian Zi ( Nelumbinis semen), Fu Long Gan ( Terra flava usta) and Jin Ying Zi ( Rosae laevigatae fructus)
These herbs bind up the intestines and are used to treat chronic diarrhea or heavy diarrhea due to deficiency of Spleen-Qi, Spleen-Yang, Kidney-Qi and Kidney-Yang.
Qian Shi ( Euryalis semen), Jin Ying Zi ( Rosae laevigatae fructus), Sang Piao Xiao ( Mantidis oötheca), Shan Zhu Yu ( Corni fructus) and Yi Zhi Ren ( Alpiniae oxyphyllae fructus)
These substances are particularly effective in stabilizing the Bladder and are used to stop frequent urination, a large amount of urine, incontinence of urine and enuresis in the syndrome of Kidney-Qi deficiency.
Duan Mu Li (calcinated Ostrea concha) and Duan Long Gu (calcinated Mastodi fossilium ossis)
After being calcined, these minerals develop an astringent nature. They can stabilize the essential substances of the body and prevent leakage.
Deputy: Tonify Qi, Yin and Yang of the related organs
Ren Shen ( Ginseng radix), Mai Men Dong ( Ophiopogonis radix), Bei Sha Shen ( Glehniae radix) and Sheng Huang Qi (raw Astragali radix)
These herbs are often used to tonify the Qi and nourish the Yin of the Lung when shortness of breath and cough are caused by Lung-Qi deficiency.
Ren Shen can strongly tonify the Lung-Qi and Kidney-Qi and therefore smooth the breath. Mai Men Dong and Bei Sha Shen can nourish the fluid and Yin of the Lung, and relieve dry cough, thirst and chest pain. Their function of generating Yin can be increased by Ren Shen.
If spontaneous sweating is present and is obviously caused by deficiency of Spleen-Qi and Defensive-Qi, Sheng Huang Qi can be selected in the formula to strengthen and ascend the Qi, stabilize the exterior and stop the sweating.
Zhi Gan Cao ( Glycyrrhizae radix preparata), Suan Zao Ren ( Ziziphi spinosae semen), Fu Shen ( Poriae cocos pararadicis) and Mai Men Dong ( Ophiopogonis radix)
In a syndrome of Heart-Qi deficiency, astringent herbs should be prescribed with herbs that tonify the Qi and Yin of the Heart and calm the mind. Zhi Gan Cao and Fu Shen can tonify the Heart-Qi and calm the mind. Suan Zao Ren can nourish the blood, stabilize the Yin, improve sleep and therefore calm the mind. Mai Men Dong can nourish the Heart-Yin and the sweet Zhi Gan Cao and sour Suan Zao Ren can enhance its function.
Huang Qi ( Astragali radix), Bai Zhu ( Atractylodis macrocephalae rhizoma), Fu Ling ( Poria) and Bai Bian Dou ( Dolichoris lablab semen)
These herbs can be used in the formula to treat diarrhea and prolapse of internal organs due to Spleen-Qi deficiency.
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