Chapter 7 Formulas for warming the interior

The formulas for warming the interior refer to those that mainly consist of herbs in warm nature with the effect of warming the interior, restoring yang, and dispelling cold and promoting blood circulation for the treatment of syndrome of interior cold. Mostly, the syndrome of interior cold results from yang-deficient constitution, or cold originating from interior or from impairment of yang due to erroneous treatment, or from exopathic cold directly attacking the viscera, meridians and collateral. Since the syndrome of interior cold differs in degrees of severity and varies in distribution of impaired regions, the formulas for warming the interior is accordingly subdivided into three kinds, namely, the formulas for warming the middle warmer to dispel cold, the formulas for recuperating depleted yang to rescue the patient from collapse and the formulas for warming the meridians to dispel cold.

Section 1 Formulas for Warming the Middle-warmer to Dispel Cold

This group of formulas is composed of interior-warming herbs in compatibility with the herbs for strengthening the spleen and replenishing qi, having the functions of warming the middle warmer to dispel cold. The formulas are indicated in the treatment of cold syndromes due to hypo-function of spleen and stomach.

Lizhong Wan (Bolus for Regulating the Function of Middle-warmer )

Ingredients Ginsena, Radix Ginseng 90g Dried ginger, Rhizoma Zingiberis 90g Bighead atractylodes rhizome, Asizoma Atractylodes Macrocephalae 90g Prepared licorice root, Radix Glycyrrhizae Praeparata 90g Administrations Grind the above herbs into fine powder, mix it with honey and make them into boluses, take the boluses orally with warm boiled water, 9g each time, two or three times a day, or decoct the herbs for oral dose with the orignal dosage of the ingredients taken proportionally. Functions Warming middle-warmer to dispel cold and replenishing qi to invigorate the spleen. Indications Hypo-function of the spleen and stomach marked by abdominal pain with predilection for warmth and for pressure by hand, watery diarrhea, fullness of the abdomen, anorexia, vomiting, pale tongue with white coating, deep and thready pulse, or manifested by bleeding due to yang-deficiency; or chronic

infantile convulsion, or predilection for spitting saliva after recovery from illness, or by obstruction of qi in the chest due to yang-deficiency of the middle-warmer. The formula can be modified to treat cold syndromes due to hypo-function of the spleen and stomach as seen in case of chronic gastritis. gastroduodenal ulcer chronic colitis, indigestion, gastric dilatation, gastropotoisa, or cold syndromes of excess type in the spleen and stomach as seen in case of acute gastritis and enteritis. Modern researches Modern researches have ascertained that this formula has the efficacy in adjusting the functions of the stomach and intestine, promoting blood circulation, strengthening metabolism, relieving spasm, alleviating pain, arresting vomiting and diarrhea, inducing diuresis, etc. Cautions Since the formula tends to be warm and dry in property, it is not advisable for cases with fever due to exo-pathogens, or with internal heat due to yin deficiency.

Xiao Jianzhong Tang ( Minor Decoction for Strengthening the Middle-warmer )

Ingredients Peony root, Radix Paconiae 18g Cinnamon twig, Ramulus Cinnamomi 9g Licorice root, Radix Glycyrrhicae 6g Fresh ginger, Rhizoma Zingiberis Recens 10g Chinese-dates, Fructus Ziziphi Jujubae 4pcs. Malt extract, Saccharum Granorum 30g Administrations The decoction is prepared by decocting all the herbs but the last one, filtering out residue, and adding No.6 into the already-decocted solution. It should be taken warm, Functions Warming the middle-warmer, tonifying deficiency and relieving spasm and pain. , Indications Abdominal pain due to cold of deficiency type, marked by abdominal pain which can be relieved by warming and pressing, or consumptive diseases manifested by palpitation, restlessness, pale complexion, whitish coating of the tongue, thready, taut and weak pulse, or fever due to yangdeficiency.

Modern Researches Studies in recent years have confirmed that this formula possesses the efficacy in relieving spasm, alleviating pain, promoting blood circulation, strengthening absorption, promoting the healing of ulcers, nourishing the body, consolidating the constitution, etc. Cautions 1. Contraindicated in cases with hyperactivity of pathogenic fire due to yin-deficiency. 2. Not administered to those suffering from vomiting since the sweet flavor of the herbs may induce vomiting. 3. Contraindicated in patients who vomit ascaris, because ascaris tends to reverse upwards when meeting the sweet flavor of food or herbs. 4. Contraindicated in patients with fullness in the stomach, for the sweet flavor makes the above symptoms worse by replenishing qi.

Wuzhuyu Tang ( Decoction of Evodia Fruit )

Ingredients Evodia fruit, Fructus Evodiae 3g Ginseng, Radix Ginseng 6g Chinese-dates, Fructus Ziziphi Jujusae 4 pcs. Fresh ginger, Rhizoma Zingiberis Recens 18g Administrations All the above herbs are to be decocted in water for oral administration. Functions Warming the middle-warmer and restoring qi, sending down the ascending reverse flow of qi to arrest vomiting. Indications 1.Cold syndrome due to yang insufficiency of the liver and stomach manifested by the tendency to vomiting after meals, fullness and stuffiness in the chest, or by epigastralgia and gastric discomfort with acid regurgitation. 2. Headache due to Jueyin meridian syndrome characterized by retching, salivation, and pain and cold feeling in the vertex.

3. Vomiting and diarrhea due to Shaoyin syndrome marked by symptoms such as cold extremities, dysphoria, etc. The modified formula can be applied to the treatment of such diseases as chronic gastritis, acute gastritis, gastroduodenal ulcer, hepatitis, vomiting of pregnancy, migraine, Menierei's disease and others that pertain to cold syndrome due to yang insufficiency of the liver and stomach and with turbid yin reversing upwards. Modern studies Modern studies have showed that this formula produces the effect of promoting blood circulation in the digestive tract, lowering tension of the smooth muscle, decreasing peristalsis, relieving spasm, preventing vomiting, alleviating pain, facilitating digestion, strengthening the functions of the whole body and so on. Cautions 1. The formula should never be administered to patients with stomachache or vomiting of bitter fluid due to stagnated heat, as well as acid regurgitation that is ascribed to heat syndrome. 2. For the treatment of severe vomiting, the decoction should be taken cold so as to prevent vomiting of the herb. 3. In a few patients, vomiting of the herb may become worse but it will subside by itself in half an hour. The patients should be advised to take a little rest after taking the herb to alleviate the reaction.

Section 2 Formulas for Recuperating Depleted Yang to Rescue the Patient from Collapse
This kind of formula is chiefly composed of the herbs of heat nature with the functions of warming the kidney recuperating depleted yang to rescue the patient from collapse. It is usually indicated for the treatment of general cold syndrome due to yang-deficiency of the kidney or both the heart and kidney.

Sini Tang ( Decoction for Resuscitation )

Ingredients Prepared aconite root, Radix Aconiti Praeparata 9g Dried ginger, Rhizoma Zingiberis 9g Prepared licorice root, Radix Glycyrrhizae Praeparata 12g

Administrations Ingredient Prepared aconite root is to be decocted one hour prior to the other two. The decoction should be taken warm. Functions Warming the spleen and kidney, recuperating depleted yang to rescue the patient from collapse. Indications Syndrome of cold limbs due to insufficiency of yang marked by cold limbs, intolerance to cold, lienteric diarrhea, cold-pain of the abdomen, mental fatigue and sleepiness, tastelessness with no desire for drink, pale complexion, profuse sweat, deep slow and thready pulse. In addition to the above symptoms, syndromes such as domination of cold due to yang deficiency as seen in cases of distinct declination of bodily strength caused by chronic disorders or hypopituitarism,hypothyroidism, hypoadrenocorticism, yang depletion as seen in shock due to heart failure, cardiac infarction and other diseases can respond well in treatment to the modified formula mentioned above. Modern Researches Recent studies have confirmed that this formula has the efficacy in exciting central nervous system, Promoting metabolism, improving functions, preventing shock and so on. Cautions 1. Since it is indicated for the treatment of cold limbs due to yang insufficiency, the formula should never be administered for syndromes attributable to cold limbs caused by excess of heat. 2. Patients with flushed face and restlessness ascribed to cold syndrome with pseudo-heat symptoms, should take the decoction cool to prevent rejection of the herb. 3. Prolonged decocting aconite root is advisable to reduce its toxic action.

Section 3 Formulas for Warming the Meridians to Dispel Cold

These formulas are chiefly composed of the herbs for warming the meridians to dispel cold and the herbs for nourishing blood and promoting blood circulation, possessing the therapeutic effect of warming the meridians to dispel cold. They are indicated for the arthralgia-syndrome marked by insufficiency of yang-qi, internal insufficiency of blood, and stagnated cold pathogens in the meridians.

Danggui Sini Tang ( Chinese Angelica Decoction for Restoring Yang )

Ingredients Chinese angelica root, Radix Angelicae Sinensis 9g Cinnamon twig, Ranmulus Cinnamomi 9g Peony root, Radix Paeoniae 9g Asarum herb, Herba Asari 6g Prepared licorice root, Radix Glycyrrhizae Praeparata 6g Fiveleaf akebia stem, Caulis Akebiae 6g Chinese-dates, Fructus Ziziphi Jujubae 8pcs. Administrations All the above herbs are to be decocted in water for oral administration. Functions Warming the meridians to dispel cold, nourishing the blood and promoting blood circulation. Indications Cold limbs due to cold stagnation with insufficiency of blood, marked by cold limbs, without thirst, soreness of extremities, or abdominal colic, Pale tongue with whitish fur, deep and thready pulse, which is even too thready to be felt. The formula can be modified to deal with cases such as Raynaud's disease, thrombotic phlebitis, chilblain, chronic rheumatic arthritis, dysmenorrhea, neuralgia, lumbago and gastroduodenal ulcer which pertain to cold stagnation with insufficiency of blood. Modern researches Modern researches have ascertained that this formula possesses the efficacy in improving peripheral circulation dilating blood vessels, alleviating pain, relieving spasm, promoting digestion and absorption, tonifying the blood and restoring qi. Cautions 1. The formula is only indicated for the cold limbs syndrome caused by insufficiency of blood and stagnation of cold. Those related to cold limbs due to excess of heat are prohibited from taking it. 2. The formula is contraindicated in patients suffering from late-stage chilblain marked by transformation of stagnated cold into heat which is distinct.