Ch4: Formulas that Regulate Liver and Spleen Flashcards
What are the ingredients of Si Ni San?
- Chai Hu (bupleurum) 6g
- Bai Shao (white peony) 6g
- Zhi Shi (unripe bitter orange) 6g
- Gan Cao (licorice) 6g
What are the functions for Si Ni San?
- Dispel pathogenic factors and remove stagnation
- Regulate qi in spleen and liver
Indications for Si NI San?
- Cold limbs from wei qi stagnation, depressed liver in which flow of yang qi is impaired
- Epigastric and hypochondriac pain or diarrhea due to disharmony between liver and spleen
What causes feverishness (just the sensation of feeling warm but not high fever) and cold limbs?
- Exterior evil factors go inside
- Qi stagnation such that yang qi cannot reach hands and feet. Body is ok but cold limbs. (This is just from stagnation, not from deficiency)
Pathogenesis of epigastric and hypochondriac pain? Wiry pulse?
Qi stagnation in the liver
Qi stagnation generally
Pathogenesis of diarrhea, dysentery and tenesmus?
Prolonged stagnation of qi in the liver transforms into fire which impairs the spleen function of T & T
Actions of Chai Hu?
King herb
- Soothe the liver and resolve the stagnation
- Vent pathogens through the exterior
Actions of Bai Shao?
Deputy
- Nourish blood
- Replenish yin
- Pacify liver and stop pain
Zhi Shi (unripe bitter orange) actions?
- Promote qi circulation (regulate qi category)
- Regulate spleen and stomach
Gan Cao action?
Messenger
- Harmonize
- Tonify spleen
Describe the combination characteristics for Chai Hu and Bai Shao
Chai Hu dispels, Bai Shao astringes. Together they can soothe yang qi and harmonize yin qi. They can dispel without damaging yin.
This is also a common combination to regulate the liver.
(ZZJ used Si Ni San to treat Yang deficient Shaoyin syndrome)
How do Chai Hu (bupleurum, thorowax) and Zhi Shi (unripe bitter orange) work together?
Both break up stagnant qi. Chai Hu ascends (raises Yang Qi) while Zhi Shi descends. Together they can regulate qi movement.
Zhi Shi and Bai Shao combination characteristics?
Zhi Shi regulates qi while Bai Shao nourishes blood. Common combination for regulate qi and blood.
What are the key symptoms for Si Ni San?
- Cold extremeties
- Abdominal pain
- Wiry pulse
Western disorders that Si Ni San may treat?
- Cholecystitis
- Gastritis
- Gastric ulcer
- Hepatitis (no jaundice)
- Intercostal neuralgia
Applicable to Liver/Gallbladder disorders, Stomach and intestinal disorders
What are the precautions for Si Ni San?
Not suitable for cold extremeties due to yang deficiency
Why do we use Bai Shao to nourish blood in the Si Ni San formula?
To resolve liver qi stagnation we also need to consider the optimal form of the liver. Qi stagnation can easily cause heat and damage yin-blood. Liver is yin in form and yang in function. The function of soothing qi flow belongs to yang. This yang function depends on the liver having a certain level of moisture to nourish the yin and blood.
What are the ingredients for Xiao Yao San?
- Chai Hu (bupleurum) 30g
- Dang Gui (angelica) 30g
- Bai Shao (white peony) 30g
- Bo He (mint) 9g
- Bai Zhu (white atractylode) 30g
- Sheng Jiang (ginger) 6g
- Fu Ling (poria) 30g
- Gan Cao 15g
Function of Xiao Yao San?
- Promote qi circulation in the liver and remove stagnation
- Strengthen the function of the spleen and harmonize the ying system
Indications for Xiao Yao San?
- Disharmony between liver and spleen
- Blood deficiency and stagnation of liver qi
What are the three main pathogenic factors (patterns) involved in Xiao Yao San condition? What is the main problem?
1) Liver constraint causing 2) blood deficiency and 3) spleen deficiency
Spleen deficiency also contributing to blood deficiency
Liver qi constraint is the main problem.
Actions of Chai Hu?
King herb
- Soothe the liver
- Relieve stagnation
Bai Shao and Dang Gui actions?
Deputies
- Nourish blood
- Strengthen liver by removing stagnation of qi
Actions of Bai Zhu, Fu Ling, Sheng Jiang?
Assistants
- Tonify spleen and stomach
