Dui-Yao Chapter 7 Herb Pairings that Descend Stomach Rebellious Qi Copyright by Dr.

Eric Hsiao

Zhu Ru Sweet, slightly cold (GB, LU, ST) Clears heat and transforms phlegm-heat

Ban Xia Acrid, warm, toxic (LU, SP, ST)

Dries dampness, transforms phlegm and descends rebellious qi Clears heat and stops vomiting Dissipates nodules and reduces distension Cools the blood and stops bleeding Harmonizes Middle Jiao and stops vomiting Commonly Used Dosage 6-10g 6-10g Combined Properties Zhu Ru is cool, with the ability to focus on treating vomiting due to heat accumulations and rebellious Qi Flow. Ban Xia is warming, with the ability to focus on treating vomiting due to accumulations of Dampness in the middle jiao. When combined, they mutually reinforce each other. They effectively dry dampness, clear heat, transform phlegm, harmonize the stomach and stop vomiting. Major Indications 1. Hiccup, nausea and vomiting due to disharmony and counter-flow of Stomach Qi 2. Vertigo, agitation and insomnia due to phlegm turbidity. 3. Nausea and vomiting during pregnancy due to disharmony of ST, Phlegm-Heat or Stomach-Heat Comments In cases of Middle jiao disharmony, use ginger-processed Ban Xia and ginger stir-fried Zhu Ru to warm up the middle jiao, dispel cold, and stop vomiting

Dui-Yao Chapter 7 Herb Pairings that Descend Stomach Rebellious Qi Copyright by Dr. Eric Hsiao

Zhu Ru Sweet, slightly cold (GB, LU, ST)

Chen Pi (Ju Pi) Acrid, bitter, warm, aromatic (LU, SP, ST)

Clears heat and transforms phlegm-heat Regulates the Qi , tonifies the Spleen Clears heat and stops vomiting Dries dampness and transforms phlegm Cools the blood and stops bleeding Harmonizes the Stomach and stops vomiting Commonly Used Dosage 6-10g 6-10g Combined Properties Zhu Ru focuses on clearing heat, stopping vomiting, descending rebellious qi and dispelling phlegm. Chen Pi (Ju Pi) is warming and acrid and is able to regulate qi, tonify the Spleen, harmonize the Stomach and transform phlegm. When combined, these two herbs simultaneously warm and clear. They effectively harmonize the middle jiao due to heat-cold accumulation, descend the counter-flow of Qi and stop vomiting. Major Indications 1. Nausea, vomiting, epigastric distention and abdominal distention due to SP/ST Deficiency with Cold and Heat. 2. Nausea and vomiting due to pregnancy. Comments To treat nausea and vomiting, identifying whether it is a heat or cold pattern is the first step. Ding Xiang and Shi Di are used for cold accumulation patterns. In the case of a heat accumulation pattern, Chen Pi and Zhu Ru should be used. Resource Jing Gui Yao Lou-Ju Pi Zhu Ru Tang

Dui-Yao Chapter 7 Herb Pairings that Descend Stomach Rebellious Qi Copyright by Dr. Eric Hsiao

Huang Lian Bitter, cold (HT, LI, LV, ST) Clears Heat and dries Dampness Drains fire and resolves toxins

Gang Jiang Acrid, hot (HT, LU, SP, ST)

Warms the middle and expels cold Rescues devastated yang and expels interior cold Clears Heart & Stomach fire Warms the Lung and transforms phlegm Clears heat and stop bleeding Warms the channel and stops bleeding Commonly Used Dosage 3-5g 1.5-10g Combined Properties One is acrid and frees the flow, while the other is bitter and drains; one is warm and dissipating, and the other is cold and down bearing. When these two herbs are combined together, they eliminate cold accumulation and depressive heat. Together, they drain mixed cold and heat in order to stop vomiting, acid regurgitation and harmonize the stomach. Major Indications 1. Vomiting, belching, acid regurgitation, and epigastric pain due to mixture of heat and cold in the Middle Jiao. 2. Diarrhea and dysentery. Comments In the case of predominant heat, one can prescribe a small quantity of Gan Jiang and a larger quantity of Huang Lian. In the case of predominant cold, one can prescribe a small quantity of Huang Lian and a large quantity of Gan Jiang. If cold and heat are in equal proportion, Gang Jiang and Huang Lian should be prescribed equally. Resource Shan Han Lun Ban Xia Xie Xin Tang

Dui-Yao Chapter 7 Herb Pairings that Descend Stomach Rebellious Qi Copyright by Dr. Eric Hsiao

Huang Lian Bitter, cold (HT, LI, LV,ST) Clears Heat and dries Dampness

Wu Zhu Yu Acrid, bitter, hot, slightly toxic (KD,LV,SP,ST)

Warms the Middle Jiao, disperses cold, relieves constraint in the LV channel, and stops pain Drains fire and resolves toxins Warms the ST & SP, disperses cold, stops diarrhea Clears Heart & Stomach fire Redirects rebellious qi downward and stops vomiting Clears heat and stop bleeding Leads fire downward Commonly Used Dosage 1.5-5g 1.5-5g Combined Properties Huang Lian is cold and draining while Wu Zhu Yu is hot and opening. When combined, they effectively drain LV Fire, harmonize the Stomach, descend reversal, and stop pain, acid regurgitation and vomiting. Major Indications 1. Lateral costal pain/distention, acid regurgitation, nausea, belching, clamoring stomach, bitter taste in the mouth and red tongue body covered with yellow coating, wiry and rapid pulse due to LV Fire attacking ST. 2. Diarrhea and dysentery due to Damp-Heat. 3. For acute or chronic gastritis, gastric and duodenal ulcers. Comments As a chief herb, Huang Lian is able to treat ST heat, vomiting and acid regurgitation due to LV/ST disharmony as well as drain fire from the LV channel. As a messenger, Wu Zhu Yu guides the action of Huang Lian towards the LV, reinforces the action of Huang Lian to treat vomiting and acid regurgitation as well as draining fire from the LV channel. Traditionally this combination is used to treat LV/ST Disharmony causing nausea, vomiting and acid regurgitation. In this case, Huang Lian should be used in larger quantity than Wu Zhu Yu. This combination can also be used in patterns where cold and heat are mixed. If heat is more prevalent, use Huang Lian in a larger dosage. If cold is more prevalent, use Wu Zhu Yu in a larger dose. If cold and heat are in equal proportions, the quantities of both medicinals should be equal. Resource Dan Xi Xing Fa- Zuo Jin Wan (Huang Lian : Wu Zhu Yu= 6:1 ratio) for LV Fire attacking ST Tai Ping Shen Hui Ju Fang-Zhu Yu Yuan Fan (1:1 ratio) for Diarrhea and dysentery due to deficiency cold accumulation pattern Zhang Jing Yue-Huang Liang Wan (1:1 ratio) for hemorrhoids and associated symptoms with LV fire 4

Dui-Yao Chapter 7 Herb Pairings that Descend Stomach Rebellious Qi Copyright by Dr. Eric Hsiao

Xuan Fu Hua Bitter, acrid, slightly warm (LV, LU, ST, SP) Redirects qi downward and expels phlegm Stops vomiting and calms rebellion

Dai Zhe Shi Bitter, cold (HT, LV, PC) Calms the Liver, anchors the floating yang and clears Liver fire Directs Qi downward

Cools the blood and stops bleeding Combined properties One is lightweight with an acrid taste, while the other is a heavy substance that is bitter & cold. When combined, one is dispersing and the other is descending. This combination can increase the function of calming rebellious qi, lowering blood pressure, stopping wheezing, dispelling phlegm, and eliminating abdomen distension. Major Indications 1. Nausea, vomiting and hiccup due to turbid phlegm stagnation in diaphragm area. 2. Coughing and wheezing with phlegm, nosebleed and hematemesis. 3. Hypertension. Comments This combination can be used for esophageal spasm or asthma and COPD (excess pattern). Resource Shan Han Lun-Xuan Fu Hua Dai Zhe Shi Tang