Class11~12: Herbs and Formulas That Calm the Spirit

1. Class11~12: Herbs and Formulas That Calm the Spirit Xianhui Li and Cui Han

2. Herbs • Herbs that anchor, settle and calm the spirit • Os Draconis (Long gu) • Magnetitum (Ci shi) • Haematitum (Dai zhe shi) • Cinnabaris (Zhu sha) • Fluoritum (Zi shi ying) • Concha Ostreae (Mu li) • Succinum (Hu po) • Herbs that nourish the heart and calm the spirit • Radix Polygalae (Yuan zhi) • Semen Zizyphi Spinosae (Suan zao ren) • Cortex Albizziae (He huan pi) • Caulis Polygoni Multiflori (Ye jiao teng) • Semen Biotae (Bai zi ren)

3. Long gu (Os Draconis ) • Taste and Property: Sweet, astringent, slightly cold • Meridian Tropism: HT LV • Actions: Calm the liver and suppress yang; calm the mind; and prevents leakage of fluids • Application: • Restlessness, irritability, dizziness and vertigo due to yin deficiency and hyperactivity of yang, often used with Mu Li, Bai Shao and Dai Zhe Shi, i.e. Zhen Gan Xi Feng Tang • Restlessness palpitation, insomnia, epilepsy, often used with Zhu Sha, Yuan Zhi and Suan Zao Ren, i.e. Jiu Ni Tang • Emission, leukorrhea, sweating due to deficiency and metrostaxis and metrorrhagia • Dosage: 15-30g. To be decocted first in decoction

4. Ci shi (Magnetitum) • Taste and Property: acrid, salty, cold • Meridian Tropism: KI LV • Actions: anchors and calms the spirit; nourishes the kidneys, augments the liver, and improves hearing and vision; aids the kidneys in grasping the qi • Application: • Restlessness, palpitations, insomnia, or tremors, especially in patients with yin deficiency and ascendant yang. Particularly useful when kidney deficiency leads to upward blazing of liver fire that deranges and disturbs the heart spirit. Also used for dizziness or vertigo in patients with similar patterns, or convulsions in children caused by shock • Impaired hearing or deafness, tinnitus, or visual disturbances due to liver and kidney deficiency • Chronic asthma due to failure of the kidneys to grasp the • Dosage: 15-30g. To be decocted first in decoctyion

5. Dai zhe shi (Haematitum) • Categories: herbs that extinguish wind and stop tremors • Taste and property: Bitter and cold • Meridian tropism: Liver and Heart • Actions: Suppress the liver yang, lower rising of qi and arrest bleeding • Applications: • Headache and dizziness due to hyperactivity of liver yang, used with Long Gu, Mu Li and Bai Shao, Zhen gan Xi Feng tang • Eructation, hiccup, vomiting or asthma: Used with Xuan Fu Hua, Sheng Jiang and Ban Xia, ie. Xuan Fu Dai Zhe Tang. For asthma due to deficiency of both the lung and the kidney, used with Dang Shen and Shan Zhu Yu, i.e Shen Zhe Na Qi tang • bleeding: bleeding in the upepr part: used with Bai Shao, Zhu Ru and Niu Pang Zi, i.e. han Jiang Tang • Dizziness and vertigo due to long-standing metrostaxis and metrorrhagia, used with Yu Yu Liang, Chi Shi Zhi and Wu Ling Zhi, i.e. Zhen Ling Dan • Dosage: 10-30g • Attention: Not used for pregnant woman

6. Zhu sha (Cinnabaris) • Taste and Property: Sweet, cool, toxic • Meridian Tropism: Heart • Actions: clears heart fire and focuses the mind, resolves toxicity • Applications: • Sedates the heart and calms the spirit, for restlessness, palpitations with anxiety, insomnia, or convulsion, used with dang gui, sheng di huang, i.e. zhu sha an shen wan, for blood and yin deficiency • For seizures, childhood, convulsions, and other problems due to phlegm-heat blocking the pericardium and heart, used with niu huang, she xiang, i.e. an gong niu huang wan • Topically for carbuncles, mouth sores, sore throat and snakebite • Dosage: 0.1~1.5g. • Attention: should not be used in large amounts or in long term, to prevent mercury poisoning, do not heat

7. Zi shi ying (Fluoritum) • Taste and Property: Sweet, warm • Meridian Tropism: HT, LV • Actions: sedates the heart and settles tremors and palpitations, warms the lungs and directs the qi downward, warms the womb, chong and ren vessels • Applications: • For disorientation, insominia, palpitations with anxiety, or convulsions due to either heart blood deficiency or ascendant liver yang, used with bai zi ren, suan zao ren or long gu, han shui shi • For cough or wheezing due to cold from deficiency of the lungs, used with wu wei zi, kuan dong hua • For excessive menstruation, uterine bleeding, or infertility due to cold from deficiency of the womb, used with dang gui, shu di huang • Dosage: 9~15g. • Attention: spleen and stomach cold from deficiency, sinking due to qi deficiency, or during pregnancy

8. Mu li (Concha Ostreae ) • Taste and Property: Salty and slightly cold • Meridian Tropism: Liver and Kidney • Actions: Calms the liver, suppresses yang, softens hardness, dissipates nodules, astringe • Applications: • Restlessness, palpitation, insomnia, dizziness, vertigo or tnnitus due to yin deficiency and hyperactivity of yang: Used with Loong Gu, Gui ban and Bai Shao. • Scrofula: Used with Zhe Bei and Xuan Shen, Xiao Luo Wan. Hepatomegaly or splenomegaly, used with Dan Shen, Ze Lan and Bie Jia • Roasted one is good at astringing, used for sweating, emission, leukorrhea and metrostaxis or metrorrhagia • Sweating: Used with Fu Xiao Mai and Ma Huang gen, i.e. Mu Li San • Emission: With Sha Yuan Ji Li, Qian Shi and Lian Xu, i.e. Jin Suo Gu Jing Wan • This herb can also reduce secretion of acid • Dosage: 9-30g. To be decocted first in decoction

9. Hu po (Succinum) • Taste and Property: sweet, neutral • Meridian Tropism: UB, HT, LV • Actions: arrests tremors and calms spirit, invigorates blood, promotes urination, reduces swelling and promotes healing • Application: • For palpitations with anxiety, excessive dreams, insomnia, forgetfulness, anxiety, and seizures due to disturbance of the spirit, also used for childhood convulsions and seizures • For amenorrhea or pain associated with palpable fixed masses due to blood stasis. • For urination retention and or painful urinary dribbling, especially with bloody urine • Topically applied for sores, carbuncles, and ulcerations of the skin. Also for swelling and pin in the area of the scrotum or vulva • Dosage: 1~1.5g, do not decoct

10. Yuan Zhi (Radix Polygalae) • Taste and Property: bitter, acrid, slightly warm • Meridian Tropism: heart, lung • Actions: Calms the spirit and quiets the heart, reestablishes harmonious communication between heart and kidneys, transforms phlegm, reduce abscesses and dissipates swellings • Applications: • For insomnia, and palpitations with anxiety, restless and disorientation. Use with suan zao ren, bai zhu, dang gui, gui pi tang, used with huang qi, dang gui, long yan rou for forgetfulness, palpitations and insomina • For phlegm envelops the orifice of the heart : emotional land mental disorientation, spasms, or seizures, used with yu jin, shi chang pu. Also for phlegm affecting the lungs with copious sputum, especially when it is difficult to expectorate, used with chuan bei mu, gua lou, xing ren. Used for angina pectoris, used with lai fu zi, wang bu liu xiu • For boils, abscesses, sores and swollen, painful breasts • Dosage: 6-15g • Attention: contraindicated for those with yin deficiency with heat signs as well as those with peptic ulcers or gastritis

11. Suan Zao Ren (Semen Zizyphi) • Taste and Property: Sweet, sour and neutral • Meridian Tropism: Gallbladder, liver, heart and spleen • Actions: nourishes the heart yin and liver blood, promotes sleep, inhibits the sweating • Applications: • For irritability, insomnia, and palpitations with anxiety due to either blood deficiency or yin deficiency, used with zhi mu, fu ling, suan zao ren tang, used with dang shen, fu ling, long yan rou, gui pi tang • For both spontaneous sweating and nightsweats, used with huang qi, wu wei zi, shan zhu yu • Dosage: 9-15g • Attention: used with caution in cases of severe diarrhea or heat from excess

12. He huan pi (Cortex Albizziae ) • Taste and Property: Sweet and neutral • Meridian Tropism: LV, HT • Actions: calms the spirit and relieves constraints, harmonizes the blood, stops pain and reconnects the tendons and bones, reduces swellings and abscesses • Applications: • For bad temper, depression, insomnia, irritability, and poor memory due to constrained emotions, used with bai shao, ye jiao teng • Ro pain and swelling due to trauma, including fractures, used with ru xiang, mo yao • For the pain and swelling of abscesses, both external and internal, used with dong gua zi, yu xing cao, tao ren • Dosage: 6-15g • Attention: used with caution during pregnancy

13. Ye jiao teng (Caulis Polygoni Multiflori ) • Taste and Property: Sweet and neutral • Meridian Tropism: LV, HT • Actions: nourishes the heart, calms the spirit, nourishes the blood, unblocks channels, alleviates itching • Applications: • For patterns of yin or blood deficiency with insomnia and irritability. Especially useful for dream-disturbed sleep, used with he huan pi, suan zao ren, bai zi ren • For generalized weakness, soreness, pain and numbness due to blood deficiency. Used with dang gui, ji xue teng, and dan shen. Also used as an auxilliary herb for wind-damp painful obstruction, used with qiang huo, sang ji sheng, qin jiao • Used as an external wash for itching and skin rashes, used with chan tui, da fu zi • Dosage: 15-30g

14. Bai zi ren (Semen Biotae ) • Taste and Property: Sweet, neutral • Meridian Tropism: Heart, kidney and large intestine • Actions: nourishes the heart blood and yin to calm the spirit, moisten large intestines • Applications: • For irritability, insomnia, forgetfulness, and palpitations with anxiety due to heart yin deficiency and insufficient blood, also used for night terrors in children, used with suan zao ren, dang gui, fu shen, i.e. yang xin tang, used with mai men dong, shu di huang shi chang pu, i.e. bai zi yang xin tang, for lack of communication of heart and kidney • For constipation in the elderly, debilitate, and postparturm women due to blood or yin deficiency, used with tao ren, xing ren, yu li ren, i.e. wu ren wan • Also used for night sweats due to yin deficiency, used with ma huang gen, mu li • Dosage: 3~9g. • Attention: contraindicated loose stools or phelgm disorders

15. Formulas • Formulas that nourish the heart and calm the spirit • Emperor of Heaven's Special Pill to Tonify the Heart (tian wang bu xin dan) • *Sour Jujube Decoction (suan zao ren tang) • Settle the Emotions Pill (ding zhi wan) • Licorice, Wheat, and Jujube Decoction (gan mai da zao tang) • Coptis and Ass-Hide Gelatin Decoction (Huang Lian E Jiao Tang) • Formulas that sedate and calm the spirit • Bupleurum plus Dragon Bone and Oyster Shell Decoction (chai hu jia long gu mu li tang)

16. Tian Wang Bu Xin Dan (Emperor of Heaven’s Special Pill to Tonify the Heart) Ingredients: Sheng di huang, Tian men dong, Mai men dong, Suan zao ren, Dang gui, Dan shen, Xuan shen, Ren shen, Fu ling, Wu wei zi, Yuan zhi, Jie geng, Bai zi ren, Zhu sha

17. Actions and indications of the formula • Actions • Enrich yin, nourish blood, tonify heart and calm the spirit. • Indications • Irritability, palpitations with anxiety, insomnia, fatigue, poor concentration, nocturnal emissions, forgetfulness, dry stool, red tongue little coating, thin rapid pulse. Sores of mouth and tongue. Low grade fever, night sweat.

18. Analysis of Formula • Sheng di huang, Tian men dong, Mai men dong, Xuan shen: nourish yin and clear heat. • Dang gui, Dan shen: tonify heart and nourish blood. • Ren shen, Fu ling: augment heart qi. • Bai zi ren, Suan zao ren: nourish heart blood and calm the spirit. • Wu wei zi, Yuan zhi: astringe heart qi and calm the spirit. • Jie geng: conduct herbs upward. • Zhu sha: anchor and calm spirit.

19. Modern application and modifications • Modern application: • Heart disease, menopausal syndrome, chronic urticaria and neurasthenia • Modifications: • For severe palpitations and insomnia: add long yan rou, ye jiao teng • For severe dry mouth and throat, add shi hu • Fro mouth and tongue sores, add lian xin • Attentions: not be taken long-term, some prepared formulations do not contain zhu sha and can taken long-term

20. Suan zao ren tang (sour jujube decoction) Ingredients: Suan zao ren 15-18g, Fu ling 6g, Zhi mu 6g, Chuan xiong 6g, Gan cao 3g

21. Actions and indications of the formula • Actions • Nourish the blood, calm the spirit, clear heat and eliminate irritability • Indications • irritability, inability to sleep, palpitations, night sweats, dizziness and vertigo, dry throat and mouth, a dry red tongue, and a wiry or thin rapid pulse.

22. Analysis of Formula • Chief: Suan zao ren • Nourishes the heart and liver while calming the spirit • Deputy: Chuan xiong • Regulates liver blood by encouraging it to flow freely. Chief and deputy, the combination of one astringent and one dispersing herb is very effective in nourishing and regulating the liver while calming the spirit. • Assistant: fu ling, zhi mu • Fu ling: calm the spirit and tonify the spleen and stomach • Zhi mu: enrich the yin, clear heat and moisten internal dryness • Envoy: Gan cao • Regulates the actions of other herbs and harmonize the middle burner.

23. Ding zhi wan (Settle the Emotions Pill ) Ingredients: ren shen 90g, fu ling 90g, chang pu 60g, yuan zhi 60g

24. Actions and indications of the formula • Actions • Tonifies the heart qi and calms the spirit • Indications • Apprehensiveness, easily frightened, or incessant laughter and glee, together with palpitations , anxiety and forgetfulness.

25. Analysis of Formula • Chief: ren shen, fu ling • Calm the spirit by augmenting the qi. • Depute: chang pu, yuan zhi • Clear the senses in order to calm the spirit

26. Modern application and modifications • Modern application: • A wide range of psychological disorders including anxiety neurosis and obsessive compulsive disorders • Modifications: • For severe palpitations, add long gu, hu po • For upward rebellion of phlegm, add ban xia, zhu li • For heart blood deficiency, add suan zao ren, long yan rou, dang gui

27. Gan mai da zao tang (Licorice, Wheat, and Jujube Decoction ) Ingredients: gan cao 9g, fu xiao mai 9-15g, da zao 10 pieces

28. Actions and indications of the formula • Actions • Nourishes the heart, calms the spirit, and harmonizes the middle burner • Indications • Disorientation, frequent attacks of melancholy and crying spells, inability to control oneself, restless sleep, frequent bouts of yawning, a red tongue with a sparse behavior and speech become abnormal.

29. Analysis of Formula • Chief: fu xiao mai • regulates and nourishes the qi and yin of the heart and liver, calms spirit. • Depute: gan cao, da zao • Gan cao: nourishes the heart and harmonizes the middle burner • Da zao: arguments qi and moistens internal dryness

30. Modern application and modifications • Modern application: • Hysteria, neurosis, menopausal syndrome, autonomic dystonia, enuresis • Modifications: • For irritability with sensation of heat in the chest, add bai he, bai zi ren • For insomnia, add suan zao ren • For constipation: add he shou wu, hei zhi ma

31. Chai hu jia long gu mu li tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction ) Ingredients: chai hu, huang qin, ban xia, ren shen, sheng jiang, gui zhi, fu ling, long gu, mu li, da huang, da zao, qian dan

32. Actions and indications of the formula • Actions • Unblocks the three yang stages, and sedates and calms the spirit • Indications • Fullness in the chest, irritability with occasional attacks of palpitations, urinary difficulty, constipation, delirious speech, inability to rotate the trunk, a sensation of extreme heaviness throughout the body, a red tongue with a slippery coating and a wiry rapid pulse.

33. Analysis of Formula • Chief: gui zhi, chai hu, huang qin, da huang • Gui zhi: resolve the problems in the superficial levels, and to promote the flow of yang qi in order to relieve the sensation of heaviness in the body • Chai hu, huang qin: resolves lesser yang disorders • Da huang: resolves yang ming symptoms. • Assistant: • mu li, long gu, qian dan: weigh down and calm the floating spirit • Ren shen, fu ling: tonify spleen qi and calm the spirit • Ban xia: transforms the phlegm and open the diaphragm • Envoy: sheng jiang, da zao • Harmonize ying and wei

34. Modern application and modifications • Modern application: • Neurosis, schizophrenia, hysteria, epilepsy, hypertension, first or second degree A-V block, hyperthyroidism, meniere’s disease, spasm of the sternocleidomastoid muscle, gastritis, menopausal syndrome and postconcussion syndrome • Modifications: • For nightmares, vertigo, fever, add long dan cao, xia ku cao • For cases with regular bowel movements, omit da huang • For severe irritability and difficult sleep, add zhu sha, suan zao ren, ye jiao teng