of 50
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Formulas that Warm
Interior Cold & TonifyHBR class 10
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Formulas that WarmInterior Cold
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Tangkuei Decoction for Frigid
Extremities (dang gui si ni
tang) C: Dang Gui, Gui Zhi Xi Xin, Bai Shao, Zhi Gan Cao, Da Zao, Mu Tong
Pattern: Cold hands and feet caused by cold in thechannels in a patient with underlying blood deficiency.
Indications: Long-standing cold hands and feet thatare both cold to the touch and feel very cold to the
patient, a pale tongue with a white coating, and a
submerged, thin pulse or pulse that is so thin that it is
almost imperceptible.
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*Regulate the Middle Pill
(li zhong wan) C: Gan Jiang D: Ren Shen A: Bai Zhu E: Zhi Gan Cao Pattern: Middle burner cold from deficiency, also known
as middle burner yang deficiency.
Indications: Diarrhea with watery stool, nausea andvomiting, no particular thirst, loss of appetite, abdominalpain, a pale tongue with a white coating, and a
submerged, thin pulse.
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CAUTIONS AND CONTRAINDICATIONS: Becausethis formula contains ingredients that warm and dry, it
should not be used for externally-contracted conditions
with fever or yin deficiency.
For sudden turmoil disorder, its use should bediscontinued once the vomiting and diarrhea have
stopped.
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*Evodia Decoction
(wu zhu yu tang) C: Wu Zhu Yu D: Sheng Jiang
A: Ren Shen E: Da Zao Pattern: Cold from deficiency of the Stomach (and
Liver)
Indications: Used for three different presentations: 1) vomiting immediately after eating, indeterminate
gnawing hunger, and acid regurgitation with or without
epigastric pain due to cold from deficiency of the
Stomach;
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2) dry heaves or spitting of clear fluids with headacheat the vertex due to cold from deficiency of the
Stomach and Liver;
3) vomiting and diarrhea with cold hands and feet, andagitation so severe that the patient wants to die due tocold attacking the middle burner.
In all cases the tongue is not red, but the tongue has awhite, slippery coating, and the pulse is thin and slowor thin and wiry.
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CAUTIONS AND CONTRAINDICATIONS: Do not usein cases of acid regurgitation or vomiting due to heat.
In cases of severe vomiting, this formula should betaken at room temperature to help prevent vomiting ofthe formula.
Possible side effects of this formula include dizziness,headache, and chest discomfort.
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Decoction (da jian zhong
tang) C: Chuan Jiao D: Gan Jiang A: Ren Shen, Yi Tang
Pattern: Weakness and deficiency of the middle burneryang (the root), and yin cold in the interior (themanifestation).
Indications: Excruciating epigastric and abdominal painto the point that the patient cannot tolerate beingtouched, a strong sensation of cold in the epigastrium,
vomiting to the point of being unable to eat, a white,
slippery tongue coating, and a thin and tight or slow and
wiry (or in especially severe cases, hidden) pulse. There
may also be borborygmus.
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CAUTIONS AND CONTRAINDICATIONS: Thisformula is contraindicated in cases with internalclumping, damp-heat, or yin and blood deficiency.
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Minor Construct the Middle
Decoction (xiao jian zhong
tang) C: Yi Tang, Gui Zhi Bai Shao, Zhi Gan Cao, Sheng Jiang, Da Zao Pattern: Spasmodic abdominal pain due to
consumptive deficiency (xu lao); Deficiency Cold ofmiddle burner.
Indications: Intermittent, spasmodic abdominal painthat responds favorably to local application of warmth
and pressure, a lusterless complexion, reduced
appetite, a pale tongue with a white coating, and athin, wiry, and moderate pulse. There may also be
low-grade fever, palpitations, irritability, cold and sore
extremities with nonspecific discomfort, and a dry
mouth and dry throat.
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*Frigid Extremities Decoction
(si ni tang) C: Fu Zi D: Gan Jiang A: Zhi Gan Cao
Pattern: Kidney yang and Spleen yang deficiencyaccompanied by an increase of internal cold.
Indications: Extremely cold extremities, aversion tocold, sleeping with the knees drawn up, a lethargic
state with a constant desire to sleep, vomiting,diarrhea with undigested food particles, abdominal
pain and cold, no thirst, a pale tongue with a white,
slippery coating, and a submerged, thin or submerged,
faint pulse.
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Formulas that Tonify
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*Four-Gentleman Decoction
(si jun zi tang) C: Ren Shen D: Bai Zhu A: Fu Ling E: Zhi Gan Cao Pattern: Spleen Qi Deficiency Indications: Pallid complexion, low and soft voice,
reduced appetite, loose stools, and weakness in the
limbs. The body of the tongue is pale, and the pulse is
thin and/or frail.
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CAUTIONS AND CONTRAINDICATIONS: The use ofthis formula for an overly prolonged period may result
in a dry mouth, thirst, and irritability.
It should not be used without modification in patientswith high fever, heat from deficiency, or a combination
of irritability, thirst, and constipation.
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MODIFICATIONS / Associated Formula #1:
Six-Gentleman Decoction (liu jun zi tang)
To Si Jun Zi Tang, add: Chen Pi, Ban Xia
Strengthens the Spleen, transforms phlegm, and stopsvomiting. For concurrent deficient Spleen qi and phlegmcharacterized by a loss of appetite, nausea or vomiting,
focal distention and a stifling sensation in the chest and
epigastrium, and often coughing of copious, thin, and white
sputum.
COMMENTS: This formula is a combination of Four-Gentlemen Decoction (si jun zi tang) with Two-Cured
Decoction (er chen tang), the primary phlegm-resolving
formula.
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Associated Formula #2:
Six-Gentleman Decoction with Aucklandia andAmomum (xiang sha liu jun zi tang)
To Si Jun Zi Tang, add: Chen Pi, Ban Xia, Sha Ren, Mu
Xiang
Strengthens the Spleen, harmonizes the Stomach, regulatesthe qi, and alleviates pain. For Spleen and Stomach qi
deficiency with damp-cold stagnating in the middle burner.
Symptoms include reduced appetite with a feeling of surfeitafter eating very little, belching, abdominal distention or
pain, and sometimes vomiting and diarrhea.
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C: Ren Shen, Bai Zhu, Fu Ling, Zhi Gan Cao (Si Jun ZiTang).
D: Shan Yao, Yi Yi Ren, Bai Bian Dou, Lian Zi
A: Sha Ren E: Jie Geng Pattern: Spleen qi deficiency leading to internally-
generated dampness.
Indications: Loose stools or diarrhea, reduced appetite,weakness of the extremities, weight loss, distention and astifling sensation in the chest and epigastrium, pallid and
wan complexion, a pale tongue with a white coating, and a
thin, moderate or deficient, moderate pulse. There may
also be vomiting.
Ginseng, Poria, & Atractylodes
Macrocephala Powder
(Shen Ling Bai Zhu San)
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*Tonify the Middle and Augment the Qi
Decoction (bu zhong yi qi tang)
C: Huang Qi D: Ren Shen, Bai Zhu, Zhi Gan Cao A: Dang Gui, Chen Pi E: Sheng Ma, Chai
Hu
Pattern: SP/ST Qi Deficiency leading to sinking of theyang.
Indications: Intermittent fever (that worsens upon exertion),
spontaneous sweating, aversion to cold, a thirst for warmbeverages, shortness of breath, laconic speech, a
tendency to curl up, weak limbs, a shiny, pale complexion,
loose and watery stools, a pale tongue with a thin, white
coating, and a flooding, deficient pulse in general, or a
deficient, rootless pulse at the middle position on the right.
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COMMENTS: The flagship formula of the TonifyEarth school. Originally indicated for Qi deficiencyfevers and now widely used for conditions involving
prolapse. May be modified to suit a variety of Qi
deficiency presentations, including those with
concurrent Liver depression Qi stagnation.
CAUTIONS AND CONTRAINDICATIONS: Thisformula is contraindicated for fever due to heat from
yin deficiency.
It should also be remembered that this formula is notindicated in all instances of prolapse, but only in those
due to qi deficiency.
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*Generate the Pulse Powder
(sheng mai san) C: Ren Shen D: Mai Men Dong
A: Wu Wei Zi Pattern: Concurrent deficiency of Lung qi and yin Indications: Chronic cough with sparse sputum that is
difficult to expectorate, shortness of breath, spontaneous
sweating, a dry mouth and tongue, a pale, red tongue with a
dry, thin coating, and a deficient, rapid or deficient, thin
pulse.
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CAUTIONS AND CONTRAINDICATIONS: This formulashould be used only with extreme caution in cases with
high fever, or in which the pathogenic influence has not
been resolved, or pathogenic influence has yet to injure
the fluids.
If it is used in cases where the external pathogenicinfluence remains in the system, it will prolong the
disease.
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Ginseng and Gecko Powder
(ren shen ge jie san) C: Ge Jie Ren Shen, Fu Ling, Sang Bai Pi, Xing Ren, Chuan Bei Mu,
Zhi Mu, Gan Cao
Pattern: Lung Qi Deficiency w/ chronic Phlegm-Heat in theLungs
Indications: Chronic coughing and wheezing, thick, yellowsputum, coughing of pus and blood, a sensation of heat andirritability in the chest, facial edema, gradual emaciation, a
purple tongue with either a thin and white or a tongue with
greasy, thin, and yellow tongue coating, and a floating,
deficient pulse, especially at the distal position.
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*Four-Substance Decoction
(si wu tang) Shu Di Huang, Bai Shao, Dang Gui, Chuan Xiong Pattern: Liver Blood Deficiency
Indications: Dizziness, blurred vision, lusterlesscomplexion and nails, generalized muscle tension,
irregular menstruation with little flow or amenorrhea,
periumbilical and lower abdominal pain, a pale tongue,
and a thin and wiry or thin and choppy pulse. Also used
for menorrhagia, hard abdominal masses with recurrent
pain, restless fetus, or lochioschesis with a firm and
painful abdomen and sporadic fever and chills.
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CAUTIONS AND CONTRAINDICATIONS:
This formula is appropriate for chronic conditionswhich are not too severe. It should not be used intreating acute, severe blood loss or other problems of
blood deficiency which include severe weakness and
labored breathing. In such cases one should heed the
adage, For exhaustion of blood, tonify the qi; a formulasuch as Tangkuei Decoction to Tonify the blood (dang
gui bu xue tang) should be used instead.
Furthermore, if this formula is used in treating patients
who have a constitutional deficiency of Spleen yang
with a poor appetite and loose stools, it should be
modified to include herbs which strengthen the middle
burner.
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MODIFICATIONS: Associated Formula #1:
Four-Substance Decoction with Safflower andPeach Pit (tao hong si wu tang)
To Si Wu Tang, add: Tao Ren, Hong Hua
Tonifies the blood, invigorates the blood and regulatesmenstruation. For concurrent blood deficiency and
blood stasis leading to a shortened menstrual cycle
with copious bleeding of dark-purple, sticky blood withor with no clots. Also used when menstruation is
accompanied by abdominal pain and distention due to
the same mechanism.
T K i d P
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Tang Kuei and Peony
Powder (dang gui shao yao
san) C: Dang Gui, Bai Shao, Chuan Xiong Fu Ling, Bai Zhu, Ze Xie Pattern: Liver-Spleen Disharmony with Blood
Deficiency and Dampness
Indications: Continuous, cramping pain in theabdomen which is not severe, urinary difficulty, andslight edema (primarily of the lower limbs). Originally
used in pregnancy.
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Peony and Licorice Decoction
(shao yao gan cao tang)
Bai Shao Yao, Gan Cao
Pattern: Spasms due to Deficiency of Yin-Blood Indications: Irritability, slight chills, spasms of the calf
muscles and lack of coating on the tongue. There
may also be cramps and abdominal pain.
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*Restore the Spleen
Decoction (gui pi tang) C: Ren Shen, Huang Qi, Bai Zhu, Zhi Gan Cao D: Long Yan Rou, Dang Gui, Suan Zao Ren, Fu Shen,
Yuan Zhi
A: Mu Xiang E: Sheng Jiang, Da Zao Pattern: SP & HT deficiency or Qi & blood deficiency due to
fatigue or over-thinking
Indications: Forgetfulness, palpitations (with or withoutanxiety), insomnia, dream-disturbed sleep, anxiety and
phobia, feverishness, withdrawal, reduced appetite, a pallid
and wan complexion, a pale tongue with a thin, white coating,
and a thin, frail pulse.
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Indications,continued: Chronic bleeding syndromesmay also be part of the presentation. Women may
experience early periods with copious, pale blood orprolonged, almost continuous periods with little flow.
COMMENTARY: This formula is basically a modifiedcombination of Si jun zi tang and Dang gui bu xue
tang.
It is used for three types of manifestations: 1) restlessHeart spirit; 2) qi and blood deficiency; and 3) the
inability of the Spleen to control the blood. All three
patterns arise from the deficiency of qi and blood.Although the formula is used in treating deficiency of
both the Heart and Spleen, it focuses primarily on the
Spleen.
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Honey-fried Licorice
Decoction (zhi gan cao tang) C: Zhi Gan Cao Ren Shen, Da Zao, Sheng Di Huang, E Jiao, Mai Men
Dong, Huo Ma Ren, Gui Zhi, Sheng Jiang Pattern: Palpitation and intermittent pulse due to Qi
and blood deficiency.
Indications: Palpitations with anxiety, irritability,insomnia, emaciation, shortness of breath,constipation, a dry mouth and throat, a pale, shiny
tongue, and a pulse which is consistently irregular,
slow-irregular, or pulse that is thin, faint, and forceless.
This is the principal formula for irregular pulses.
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Eight Treasure Decoction
(ba zhen tang) C: Ren Shen, Shu Di Huang. Bai Zhu, Fu Ling, Bai Shao, Dang Gui, Chuan Xiong, Zhi
Gan Cao, Sheng Jiang, Da Zao
Pattern: Qi and blood deficiency, due to chronic disease orexcessive blood loss.
Indications: Pallid or sallow complexion, palpitations with
anxiety that may be continuous, reduced appetite,shortness of breath, laconic speech, extremities which
become easily fatigued, light-headedness and/or vertigo, a
pale tongue with a white coating, and a pulse which is
either thin and frail or a pulse that is large, deficient, and
without strength.
*All I l i G t T if i
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*All-Inclusive Great Tonifying
Decoction (shi quan da bu
tang) C: Ren Shen, Shu Di Huang D: Bai Zhu, Fu Ling, Bai Shao, Dang Gui, Rou Gui,
Huang Qi
A: Chuan Xiong, Zhi Gan Cao E: Sheng Jiang, Da Zao Pattern: qi and blood deficiency tending toward cold Warms and tonifies the qi and blood. For qi and blood
deficiency in consumptive disorders with coughing,
reduced appetite, spermatorrhea, and weakness of the
lower extremities. This is a very commonly used formula
for qi and blood deficiency tending toward cold.
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*Six-Ingredient Pill with Rehmannia
(liu wei di huang wan)
C: Shu Di Huang D: Shan Zhu Yu, Shan Yao A: Ze Xie, Mu Dan Pi, Fu Ling
Pattern: Kidney and Liver yin deficiency Indications: Soreness and weakness in the lower
back, light-headedness, vertigo, tinnitus, decreased
hearing, night sweats, spontaneous and nocturnal
emissions, a red tongue with little coating, and a rapid,
thin pulse. The patient may also present with a variety
of other symptoms including hot palms and soles, a
chronic dry and sore throat, toothache, or wasting and
thirsting disorder.
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CAUTIONS AND CONTRAINDICATIONS: Despite itselegant design, this formula still has cloying properties
and should be used with caution in cases with
indigestion, diarrhea due to Spleen deficiency, or a
white, greasy tongue coating.
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MODIFICATIONS: Associated Formula #1:
Lycium Fruit, Chrysanthemum, and Rehmannia Pill(qi ju di huang wan)
To the original formula, add Gou Qi Zi and Ju Hua.
For dry eyes with diminished visual acuity,photophobia, tearing when exposed to drafts, or
painful eyes...The use of this formula has been
extended to include all conditions of Kidney and Liver
yin deficiency in which Liver deficiency is the
predominant aspect.
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Associated Formula #2:
Anemarrhena, Phellodendron, and Rehmannia Pill (zhibai di huang wan)
To the original formula, add Zhi Mu and Huang Bai.
For yin deficiency with vigorous fire, consumptive heat, orsteaming bone disorder characterized by night sweats, adry mouth and dry tongue, and a large pulse only in the rear
position.
Also for urinary difficulty and lower back pain from damp-heat in the lower burner in patients with underlying Kidneyyin deficiency.
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Associated Formula # 3.
Eight-Immortal Pill for Longevity (ba xian changshou wan) (aka Mai Wei Di Huang Wan)
to Liu Wei Di Huang Wan add Mai Men Dong, Wu WeiZi
Indicated for cough (possibly with blood), tidal fever,
night sweats due to Lung and Kidney Yin deficiency.
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Associated Formula #4:
Pill for Deafness that is Kind to the Left Kidney (erlong zuo ci wan)
to Liu Wei Di Huang Wan add Ci Shi, Shi Chang Pu, WuWei Zi
For continuous tinnitus, deafness, irritability, vertigo, blurry
vision, all symptoms worse at night.
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Restore the Left [Kidney]
Decoction (zuo gui yin) C: Shu Di Huang Shan Zhu Yu, Gou Qi Zi, Shan Yao, Fu Ling, Zhi Gan
Cao
Pattern: Kidney Yin Deficiency with Essence depletion Indications: Lower back soreness, spontaneous
emissions, night sweats, a dry mouth and throat, thirst
with a desire to drink, a peeled, shiny tongue, and a
thin, rapid pulse.
This formula is used for treating relatively pureconditions of deficiency with little fire
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Restore the Left [Kidney] Pill (zuo gui wan)
Shu Di Huang, Shan Zhu Yu, Gou Qi Zi, Shan Yao,Chuan Niu Xi, Tu Si Zi, Lu Jiao Jiao, Gui Ban Jiao
Nourishes the yin, tonifies the Kidneys, supplementsthe essence, and benefits the marrow. This is a
stronger version of the principal formula which is used
in more severe cases.
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C: Shu Di Huang, Gui Ban Huang Bai, Zhi Mu Pattern: Upward-rising of fire due to Liver and Kidney
yin deficiency.
Indications: Steaming bone disorder with afternoontidal fever, night sweats, spontaneous emissions,
irritability, a sensation of heat and pain in the knees
and legs which is sometimes accompanied byweakness, a red tongue with little coating, and a pulse
which is rapid and forceful in the rear position. May
also be accompanied by coughing of blood or constant
hunger.
Great Tonify the Yin Pill
(da bu yin wan)
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Linking Decoction (yi guan
jian) C: Sheng Di Huang, Gou Qi Zi Sha Shen, Mai Men Dong, Dang Gui, Jin Ling Zi Pattern: Yin deficiency of the Liver and Kidneys with
concurrent qi stagnation.
Indications: Hypochondriac and chest pain, epigastric
and abdominal distention, a dry and parched mouthand throat, acid regurgitation, a red and dry tongue,
and a thin, frail or deficient, wiry pulse.
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Two-Ultimate Pill (er zhi wan)
Nu Zhen Zi, Han Lian Cao
Pattern: Deficiency of Kidney and Liver Yin
Indications: Weakness and soreness of the lower backand knees, or even weakness and atrophy of the lower
extremities, dry and parched mouth and dry throat,
dizziness and blurred vision, insomnia and dream-
disturbed sleep, spontaneous emissions, prematuregraying or loss of hair, and a red, dry tongue.
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Seven-Treasure Special Pill for
Beautiful Whiskers (qi bao mei ran dan)
C: He Shou Wu Gou Qi Zi, Tu Si Zi, Huai Niu Xi, Fu Ling, Dang Gui, Bu
Gu Zhi, Hei Zhi Ma
Pattern: Deficiency of Kidney Yin and Liver Blood Indications: Premature graying of the hair or hair loss,
loose teeth, spontaneous and nocturnal emissions,and soreness and weakness of the lower back and
soreness and weakness of the knees.
*Kidney Qi Pill from the
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Kidney Qi Pill from the
Golden Cabinet (jin gui shen
qi wan) C: Shu Di Huang D: Shan Zhu Yu, Shan Yao, Fu Zi, Gui Zhi
A: Ze Xie, Mu Dan Pi, Fu Ling Pattern: Kidney Yang Deficiency Indications: Lower back pain, weakness of the lower
extremities, a cold sensation in the lower half of thebody, tenseness in the lower abdomen, a pale,
swollen tongue with a thin, white, and moist coating,
and an empty or frail pulse which is submerged and
faint at the proximal position.
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Indications, continued: The patient may also beirritable to the point of having difficulty lying down, and
will breathe most comfortably while leaning against
something. There is either urinary difficulty with
edema, or excessive urination, sometimes to the pointof incontinence.
CAUTIONS AND CONTRAINDICATIONS:Contraindicated in cases of yin deficiency with a dry
mouth and dry throat and a red tongue with little
coating.
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Restore the Right [Kidney]
Pill (you gui wan)
C: Fu Zi, Rou Gui, Lu Jiao Jiao Shu Di Huang, Shan Zhu Yu, Shan Yao, Gou Qi Zi, Tu
Si Zi, Du Zhong, Dang Gui
Pattern: Kidney yang deficiency with waning of the fireof the gate of vitality.
Indications: Exhaustion from long-term illness, aversionto cold, coolness of the extremities, impotence,
spermatorrhea, and aching and weakness of the lower
back and knees. There may also be infertility, loose
stools (sometimes with undigested food particles),
incontinence, and edema of the lower extremities.
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ASSOCIATED FORMULAS
Restore the Right [Kidney] Decoction (you gui yin)
Shu Di Huang, Shan Zhu Yu, Shan Yao, Gou Qi Zi, ZhiGan Cao, Du Zhong, Fu Zi, Rou Gui
Warms the Kidneys and replenishes the essence. Thisformula is slightly weaker than the principal formula.
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Two-Immortal Decoction
(er xian tang)
C: Xian Mao, Yin Yang Huo Ba Ji Tian, Huang Bai, Zhi Mu, Dang Gui Pattern: Deficiency of both Kidney yin and yang
accompanied by a flaring-up of fire from deficiency.
Indications: Symptoms of menopause includinghypertension, menstrual disturbances such as
amenorrhea, hot flushes, sweating, nervousness,
fatigue, lassitude, depression, irritability, insomnia,
palpitations, and urinary frequency. May also be usedfor other chronic disorders which present with signs
and symptoms of Kidney yin and yang deficiency and
flaring-up of fire from deficiency.