Using Herbs That Clear Heat To Calm The Spirit

For many years I’ve used cool and cold herbs and formulas to treat patients with anxiety, agitation and insomnia. A recent discussion online about the terms we use to describe anxiety and vexation led me to revisit this piece I wrote in 2013. It’s long been an academic and clinical preoccupation of mine. I was also interviewed by WHYY”S the Pulse on this topic.

by Cara O. Frank

 

Introduction

Chinese medicine has always treated the body and the spirit on a continuum. Historical references to emotional experiences are often described in terms of physical experiences. This article will explore how herbs that clear heat impact the spirit. These types of herbs are not typically thought of as spirit-calming herbs. For the purposes of this article, let us go so far as to pretend that we don’t have access to the entire category of herbs that settle and calm the spirit. We underestimate the enormous impact that heat-clearing herbs can have on the spirit. I want to shift our perspective of how to calm the spirit. By clearing heat that causes the spirit to be unsettled, the shen is able to be calm, clear and focused.

Commonly, in Chinese herbal training in America, students are taught to rely on medicinals from the ‘calm and settle the spirit’ category. We often use herbs that regulate the qi to treat depression. The categories of herbs that nourish and calm the spirit are primarily tonics; we use them to nourish the heart blood, heart yin, etc.  There is a shared perspective that the spirit will calm when it is nourished.

However, this not a historically accurate perspective. At the very least, it is incomplete. In fact, I would argue that it reflects a western perspective of treating only the spirit (and not the body-mind-spirit). If we limit ourselves to only this category of herbs, we do a disservice to our patients and we neglect to honor the traditions of Chinese diagnosis and treatment. In the herb program that I direct, when I have suggested that they use these strategies, it provokes a reaction. The students have always been taught to tonify the spirit using acupuncture and moxibustion. The mere idea that we could use herbs that clear heat to calm the spirit feels to them as if they are only treating a symptom. This simply is not true. In fact, it is the category of herbs that settle and calm the spirit that may only treat a symptom. Of course, many people truly do have deficient constitutions, and for those people we use tonics or warming medicinals. But that is not within the scope of this article

A similar thought line affects how we are taught to think about fu organs. zang organs are usually thought of as more precious than fu. This under serves the value of fu organs. Fu organs are conduits and houses for yin- fluids. And thus, they have a critical role in the generation and distribution of yin, blood, jin-ye, etc. Without fu organs, we die of malnutrition. To link the two to thoughts together, heat-clearing herbs balance digestive activity. This can be clearly demonstrated with the use of herbal bitters to stimulate digestive activity.

Using herbs that clear heat can form a deeply constitutional treatment; one that respects Chinese medicine and one that treats the entire person and not merely a symptom of emotional distress. In fact, heat-clearing medicinals can be as constitutional and as deeply spiritual as using a tonic herb such as Ren Shen- Ginseng. The key is to understand the full nature of the herb or formula, the constitution of the person and the disease pattern that the herb/formula treats. When this is honored, the person is always supported.

Anxiety vs. fan zao

References to anxiety can be called vexation/ agitation Fan Zao 煩躁.  Anxiety and Fan are similar, but not identical syndromes. Lets compare the definitions of the syndrome on the chart below:

Anxiety thefreedictionary.comdescribes these symptoms for Anxiety: SOMATIC. Headaches, dizziness or lightheadedness, nausea and/or vomiting, diarrhea, tingling, pale complexion, sweating, numbness, difficulty in breathing, and sensations of tightness in the chest, neck, shoulders, or hands BEHAVIORAL. Behavioral symptoms of anxiety include pacing, trembling, general restlessness, hyperventilation, pressured speech, hand wringing, or finger tapping. COGNITIVE. Cognitive symptoms of anxiety include recurrent or obsessive thoughts, feelings of doom, morbid or fear-inducing thoughts or ideas, and confusion, or inability to concentrate. EMOTIONAL. Feeling states associated with anxiety include tension or nervousness, feeling “hyper” or “keyed up,” and feelings of unreality, panic, or terror.

Fan Zao 煩躁. The Practical Dictionary of Chinese Medicine defines fan zao as:   A subjective feeling of heat and disquietude in the chest (vexation) and An objective fidgetiness of the limbs (agitation).

Clearly, both syndromes overlap. Anxiety and fan both include symptoms of restlessness; both include symptoms that involve the upper body, which is suggestive of qi rising; both syndromes describe a sensation of tightness or disquietude in the chest. Anxiety also includes the feeling of hyperventilating. This may or may not be part of fan. A feeling in the chest is described, but not specifically, as rapid breathing. Further, anxiety can include catastrophic thoughts. This is not included in the scope of fan. In the clinic, your patients may report to you that they feel anxious. When listening and asking during your intake, carefully discern that their explanation of their experience, physically and emotionally is, in fact, fan- vexation agitation.

This article attempts to discuss vexation-agitation and stagnation syndromes that are caused by and cause heat.  These and other related patterns can be caused by vacuity taxation and vacuity cold, and thus are excluded from this article. This discussion overlaps with stagnation- depression. Depression-yu 郁is often described as stagnation. Heat often develops as a result of long-term stagnation. Like an engine caught in traffic, the body over heats. Just as when the traffic clears and the car is moving, the heat clears.

According to Dr. Huang, herbs can reflect a constitution; a specific body confirmation, and they treat a syndrome or disease pattern- zheng hou怔侯. Sometimes, they also can just treat a symptom. We might say that a person has a chai hu constitution, and that they have chai hu disease. They behave in a way that reflects a chai hu imbalance; and this symptom picture will resolve by using chai hu. This is similar to the idea of a causative factor that 5-element schools teach. It is a gestalt; a way of being in the world, and it predisposes one towards a set of symptoms based on their weakest energetic link. Having two simultaneous mental tracks helps to implement this system: that is, understand the nature of an herb or formula, and understand the physical and emotional constitution of the patient. Thus, a person who needs heat-clearing herbs will obviously manifest signs of heat and, to state the obvious, they will not be cold. If there are symptoms of cold, then it will present as a cold-heat disharmony, which can be corrected with any number of harmonizing formulas: ‘Ban Xia Xie Tang’, ‘Huang Lian Tang’, ‘Si Ni San’, and so on. By paying close attention to the entire mind-body symptom picture, we ensure clinical success.

Huang is not the first practitioner to adhere to this model of treatment. Kanpo (traditional Japanese herbology) has a long history of constitutional treatment. Hong–Yen Hsu published several texts on this topic in the late 1970’s and early 1980’s. Although his books are difficult to read because the translations are dated and use Wade-Giles terminology, they are rich with detailed illustrations of the physical confirmation: body type, symptomatology and, relevant to this discussion, emotional terrain.

When diagnosing and treating, one could go so far as to say that the beginning of the disease process is not always of consequence. With this system, we don’t always need the long recapitulation of a patient’s story. What matters is the bing – the disease itself. What is happening for the patient in this very moment? How the patient feels and how they act and react in their life becomes their pattern, and the pattern is an existential experience. Determining whether the heat causes the anxiety or the anxiety is caused by heat is beside the point. We treat the pattern of heat, vexation and agitation. We treat all of heat’s manifestations. We treat the character of heat.

Herbs that clear heat are used to treat problems of physical heat; symptoms can include fevers, menopause and bleeding. Heat that affects the physical body also affects the spirit in that the body experiences a lack of stillness. The emotions lack quiescence. The most common emotional scenario that we encounter when the body is affected by exogenous heat is fan vexation-agitation.

So what do we know for sure about heat? We know that heat is qi rising or ascending. This statement is intended to be a conundrum. Heat causes qi to rise; heat causes fan; fan causes heat, which causes the qi torise. There is no cause and effect; there is simply a pattern. Here’s another example: anger is not the cause of qi rising. Anger is qi rising.  Depression is not the cause of qi stagnation; it is qi stagnation. Trying to decide which came first is beside the point. The point is to simply understand the pattern of imbalance as it is affecting the patient right now.Fan-vexation agitation

According to Bob Flaws, in Chinese medical psychiatry [1] vexation means an annoyance due to a hot oppressive sensation in the chest. Agitation refers to a restless state of the limbs. The former is a subjective symptom, while the latter is an objective sign. Although they are different, they are usually considered one term since, in most cases, they occur in combination and share the same disease mechanisms.

Lets restate this in the simplest terms. The patient can’t settle down; they feel nervous and tense; they are worried about forgetting things; they are reactive; they experience an inability to concentrate and are forgetful; they have difficulty memorizing.

Practitioners often call it heart deficiency or spleen deficiency and prescribe ren shen-ginseng or ‘Liu Wei Di Huang Wan’- ‘Six Flavor Rehmannia Pill’, but to no effect. This is because the causative factor is Heart Fire.

Presentation of heat in relation to the spirit

Pathogenic heat is both the cause and the result of emotional distress. In a state of health, qi moves freely throughout the body. Qi is yang in nature. When qi becomes blocked by any number of pathogenic factors both physical and emotional, the stagnation will always generate heat. If there is depression/stagnation, then over time that stagnation will generate heat. When heat affects the shen, the spirit lacks stillness, reflectiveness, and quiescence. The person is uncomfortable in their body. Nothing feels right; nothing feels at ease. There can be anxiety, insomnia, and restlessness.

If there are signs and symptoms of stagnation/depression, the treatment strategy will focus on regulating qi and clearing heat. If there is vexation/ agitation, then the treatment strategy focuses on clearing heat.Why not nourish the yin to clear empty heat? Because heat is the causative factor that creates the agitation, and because clearing heat allows the spirit to settle. This boils down to a shift in clinical perspective. Rather than focus on the long trail of signs and symptoms that make a diagnosis, just focus on the simplest energetic imbalance. Restore the body’s righteous qi mechanisms.

Using such herbs to treat the spirit, as in all of Chinese medicine, hinges on accurate differentiation of the patients presentation. When the constellation of signs and symptoms matches the herbs presentation, these medicinals can be used safely. In “ Ten Lectures on the Use of Medicinals from the Personal Experience of Jiao Shu De” there are 15 entries for medicinals that treat vexation. 9 that treat vexation-agitation, and 6 entries that treat vexing heat in the five hearts. The heat-clearing herbs he references include chai hu-rx. bupleurum, huang lian-rx. coptis, zhi mu- rx. anemarrhena, zhu ye-fm. bambusae, qing hao-hb. artemesia, zhu ru-cs. bambusae in taenis, zi hua di ding-hb. viola, lian qiao-fr. forsythiae suspensae, zhi zi-fr. gardenia, long gu-os. draconis, and mu li-concha ostrea.Twice this year I have had the privilege of studying with Dr. Huang Huang, a Shang Han Lun scholar. His special focus has been the development of the system of 10 body types. These body types are archetypal representations of pattern imbalances. Just as we might diagnose a person as having a wood or fire constitution, this system presents constitutional constellations that are reflected in the patterns treated by an herb and its formulas. Thus, an herb reflects a type of person or way of being in the world and also a predisposition towards developing a certain kind of disease pattern. Dr. Huang presents with such clarity that he reduces the most complex cases to their simplest components; those of the qi dynamic of the body. His perspective is refreshing in its depth, focus and simplicity. It reminds us that Chinese herbs treat an entire gestalt; how a person comes into the world and how they are predisposed to imbalance – and it awakened this trajectory of thought about how heat-clearing herbs affect the spirit.

Usually vexation is described without emphasis, and it’s easy to overlook the full weight of what this can mean clinically. Over the past year, I have emphasized the value of this in my clinical practice. I’ve put the symptom of vexation at the forefront of understanding a medicinal’s action.

For an example of this thought process, The Materia Medica 3^rdedition says this about lian qiao-fr. forsythiae:

Clears heat and resolves toxicity. Reduces abscesses and dissipates clumps. Hidden is the list of actions are a couple of combinations to clear heat that has entered the pericardium causing loss of consciousness.

From the discussion in this book, you might never grasp the full impact this herb can have on the spirit. Jiao Shu De is more on track when he writes about lian qiao. As its primary action, he states that it clears heart fire. The second action is fire in the heart channel spreading to the small intestine. And finally, heart fire flaming upwards. Still, Jiao is mostly addressing consciousness that is affected by fevers and infections. Dr. Huang says that lian qiao is used to clear the emotions and get rid of agitation. It treats insomnia and irritability[2]. He likes to combine it with zhi zi- fr. gardeniae for this purpose.

Let’s examine heat-clearing medicinals from the Shang Han Lun:

Shi gao-gypsum fibrosum

Shi gao is the main medicinal for treating yang ming stage disorders. Symptoms include what is often referred to as the “The Big 4”: great fever, great sweat, great thirst, and great pulse. The person feels hot subjectively and has a preference for cold food and drinks. Further, the patient experiences vexation agitation. Because this is a syndrome of great heat, symptoms also include delirious speech, mania, psychosis, and schizophrenia. A shi gao presentation can also be used to treat ADHD and panic attacks. Dr Hsu writes that shi gao, and its representative formula, ‘Bai Hu Tang’-’White Tiger Decoction’ can be used for delusions[3]

Other symptoms that shi gao treats include fever, toothache, headache, and swollen and painful throat. Encountering a shi gao person is to meet a loud, boisterous, red-faced person. Their temper may be short. There can be reflux, bleeding gums and inflammation. There are four key symptoms to a shi gao presentation:

1. The complexion of the patient will be red or ruddy, and there is a haggard look to the patient.
2. The tongue is dry with a thin coating, as heat has injured fluids.
3. A floating and large or flooding pulse.
4. Patient’s presentation is that of a robust person who tends to be sweaty, and their voice might be loud.

Shi Gao formulas are not appropriate if:[4]

• The pulse is thready, wiry, or deep.
• There is no thirst.
• The patient is not sweaty.

The heat that shi gao treats is in no way related to the heat of yin vacuity.

To expand on the shi gao tongue, even though there is great heat, the tongue does not have a coating because there is not substantial physical accumulation. If the tongue is coated and if the abdomen is firm upon palpation, then the conversation moves towards a Da Huang presentation; this would be considered Yang Ming with Form.

An excellent formula example of the use of shi gao to treat the spirit can be found by studying ‘Zhu Ye Shi Gao Tang’:

‘Zhu Ye Shi Gao Tang’-’Bamboo and Gypsum Decoction’

Zhu Ye Herba Lophateri gracilis 15 g

Shi Gao Gypsum fibrosum 30 g

Ban Xia Rhizoma Pinelliae ternatae 10g

Mai Men Dong Tuber Ophiopogonis japonici 20 g

Ren Shen Radix Ginseng 6 g

Gan Cao Radix Glycyrrhizae uralensis 6g

Geng Mi Semen Oryzae sativae 20 g

Indications for this formula include:

• Insomnia
• Oppression of the chest
• Parched lips
• Restlessness
• Stifling sensation
• Red tongue, thin coating
• Rapid-Empty pulse

The formula is used to treat the sequelae of fever with insomnia and irritability, mouth ulcers and chest oppression. The tongue is dry, The body is thin, and They lack robustness. Sweet, bland and cool, zhu ye cools the heart and shi gao’s sweet and acrid properties disperse heat. Ban xia is used to clear heat from the gallbladder and relieve anxiety and harmonize the stomach. Mai men dong generates fluids, nourishes the yin and calms the spirit. Ren shen and gan cao are qi tonics that generate fluids. The patient looks thin, dry, and anxious. They may be suffering from a chronic physical condition. There is a vestige of heat that disturbs the spirit. This can also be used to treat the side effects of chemotherapy.

There are several aspects of ‘ZhuYe Shi Gao Tang’ that garner discussion. The formula uses a lower dose of shi gao than one would with a yang ming fever. In fact, the chief herb in the formula is zhu ye, which enters the heart channel to clear vexation. Zhu ye and shi gao are both sweet. Historically, it was indicated for lingering vestiges of heat that cause insomnia [5]. The heat referred to is heat from fever, but emotions cause heat to linger. Fear, resentment, and upset all can cause low-level heat that disturbs the spirit in relation to sleep. The formula goes on to include ban xia, which is down-bearing and relieves anxiety. Ban xia, mai men dong, and shi gao all enter the lung and stomach channels. But the acrid nature of shi gao serves to vent the heat and re-order the qi dynamic. Yi Tian Shi, in discussion of warm heat pathogen disorders, says this about the formula: “One fears that although the stove no longer smokes, there is still fire within the ashes”.[6]The primary goal of the formula is first to clear heat, and secondarily to nourish fluids and tonify the qi.

Huang lian

Huang lian is a bitter and cold medicinal. It enters the heart and stomach channels, it clears heat from the stomach, clears heat and dries dampness, can stop bleeding, treat boils, infections and sore throat. Very importantly, it can treat glomus below the heart that causes heat and pain.[7] Huang lian also has a profound effect on spirit. By draining heart fire, huang lian can be used to treat irritability, delirium and disorientation. Agitation, anxiety, obsessive-compulsive disorder, attention deficit, headache, insomnia or profuse dreaming all fall under the umbrella of symptoms that huang lian addresses. The key symptom that huang lian treats is vexation in the heart. Thus, one can make an argument that the herb is primarily one to treat the spirit. The huang lian presentation is that the person cannot settle down; they worry, are anxious, nervous, and easily awakened. To summarize, huang lian treats a syndrome of symptoms that can be called huang lian diseases. These include:

• Fan: vexation, agitation
• Focal distention: glomus
• Diarrhea

Huang lian has a specific tongue and pulse presentation. The pulse is, for the most part, slippery and rapid. The tongue is red with a firm or tough appearance. There may be red prickles and a thick yellow, dry coating. If the tongue is not coated or the body pale, then huang lian should be used cautiously or not at all.

The trifecta of symptoms for using Huang Lian includes vexation, glomus and diarrhea. There are several key formulas that use huang lian that treat diarrhea from cold or deficiency, ‘Ban Xia Xie Xin Tang’ being the most important example. Another is ‘Huang Lian Tang’.

 

Ban Xia Xie Xin Tang’-‘Pinellia Drain the Epigastrium Decoction’ •Huang lian, 2-4 g. •Huang qin, 5-10 g. •Dang shen, 10-15 g. •Ban xia, 6-12 g. •Gan jiang, 5-10 g. •Gan cao, 3-6 g. •Hong zao, 10-20 g.

Huang Lian Tang’-‘Coptis Decoction’ •Huang Lian •Gan Jiang •Gui Zhi •Gan Cao •Ban Xia •Ren Shen •Da Zao

These similar formulas both treat heat above and cold below. Using a sophisticated combination of warm and cold ingredients, they both correct an up and down qi mechanism that allows yin and yang to become harmonized. By clearing heat from the heart, huang lian allows the spirit to become calm and settled. Huang lian can be used to improve memory for this reason. The best example we have using huang lian to calm the spirit is ‘Huang Lian E Jiao Tang’.

‘Huang Lian E Jiao Tang’-‘Coptis-Ass Glue Decoction’

• Huang lian-rhizoma coptidis, 3 g.
• Huang qin-radix scutellariae baicalensis, 9 g.
• Bai shao-radix paeoniae albae, 9 g.
• Ji zi huang-egg yolk, 2 yolks
• E jiao-gelatinum corii asini, 9 g.

This formula employs a sophisticated dui yao of huang lian and e jiao. Huang lian drains heart fire to eliminate vexation, while e jiao enriches kidney water. When water is nourished, then it can ascend to the heart. When fire is directed downwards, then the kidneys are warmed. Thus, the formula corrects the qi mechanism seen with the pattern we call heart and kidneys lacking communication.  Another huang lian formula used to treat the spirit is ‘Huang Lian Wen Dan Tang’-’Coptis Warm Gallbladder Decoction’.

 ‘Huang Lian Wen Dan Tang’-’Coptis Warm the Gallbladder Decoction’

• Huang lian-rhizoma coptidis, 4.5 g.
• Ban xia-rhizoma pinelliae ternatae, 6 g.
• Fu ling-sclerotium poriae cocos, 5 g.
• Chen pi-pericarpium citri reticulatae, 9 g.
• Zhu ru-caulis bambusae in taeniis, 6 g.
• Zhi shi-fructus citri aurantii immaturus, 6 g.
• Zhi gan cao-radix glycyrrhizae uralensis praeparata, 3 g.
• Sheng jiang-rhizoma zingiberis officinalis recens, 5 slices
• Da zao-fructus ziziphi jujubae, 1 date

The actions of the formula are to clear phlegm heat, harmonize the stomach to stop vomiting, clear the gallbladder and regulate the qi. The indications for the formula include dizziness, nausea, dream disturbed sleep, glomus, restlessness, irritability, and bitter taste in the mouth. The tongue is red with a thick yellow coat and the pulse is slippery or wiry. When I studied in China, ‘Wen Dan Tang’ was the most commonly used formula in the psychiatry-neurology department. The formula’s actions hinge on the application of bitter, descending herbs that clear heat from the Gallbladder. On the surface, it appears that there are no spirit-calming herbs in the formula. But it deals with the core pathology of phlegm heat as it impacts the spirit. Dr. Huang thinks about ban xia in a way that is similar to the way we think about the homeopathic remedy pulsatilla. The constellation of signs and symptoms for both include anxiety, phlegm and a kind of clinginess.

Ban xia is discussed in textbooks as being used for phlegm and nausea, but the realm of its use is wider. It includes the experience of anxiety. This is easily evidenced in the formula ‘Wen Dan Tang’. When combined with huang lian, a dui yao is formed that is especially effective for treating anxiety and irritability.

Ge gen

Ge gen-rx. pueraria is considered to be sweet, acrid and cool. It enters the spleen and stomach channels, and its function is to raise the clear yang qi of the stomach, release the muscles, and generate fluids to alleviate thirst. Further, ge gen can be used to lower blood pressure, treat headaches and dizziness. Ge gen hua – the flowers of ge gen are known to be an antidote to alcohol poisoning.

Dr. Huang teaches that the key to understanding a ge gen constitution lies in its ability to treat drunkenness.  If we extrapolate on the experience of drunkenness we know that we are treating dizziness, and dizziness suggests confusion or clouded thinking. So ge gen can be used for many experiences that involve a lack of groundedness and a lack of clarity. Since ge gen treats muscular tension, especially in the neck and shoulders, the body type is that of a large and muscular person. The person is thirsty, and there can be symptoms of diarrhea, stiff neck and acne. Ge gen allows clear yang to reach the head. Ge gen is one of the best medicinals we have for clearing the head. Think about ge gen for its opening, mobilizing and softening action.

A ge gen body-type is robust. When ge gen is combined with huang lian and huang qin, as ‘Ge Gen Qin Lian Tang’-‘Pueraria-Scutellaria-Coptis Decoction’, then we can treat vexation, agitation, thirst, headache, and muscle spasms. The ge gen body type is that of a robust person who enjoys alcohol.

‘Ge Gen Qin Lian Tang’-’Pueraria-Scutellaria-Coptis Decoction’

• Ge gen-radix puerariae, 9 g.
• Huang qin-radix scutellariae baicalensis, 9 g.
• Huang lian-rhizoma coptidis, 4.5 g.
• Zhi gan cao-radix glycyrrhizae uralensis praeparata, 3 g.
• Da zao-fr. ziziphi jujubae, 2 pieces

 Zhi zi

Zhi zi-fr. gardeniae is bitter and cold. It enters the heart, lungs, stomach, liver and triple burner. It is used to clear heat from all three burners, draining it through urination. Under that, it’s used to resolvedamp- heat jaundice, for damp heat lin syndrome. It also cools the blood and relieves toxicity. Thus, we can use it when there is bleeding from heat that causes the blood to move recklessly. Zhi zi-fr. gardeniae treats vexing heat and stifling oppression in the chest. Zhong Zhang Jing says that zhi zi “resolves anguish and vexation in the heart and depressed heat bind”[8]. When Zhong Zhang Jing uses the term anguish, he means that they feel harassed to the point where they cannot calm down. Further, there is shallow, rapid breathing.

 ‘Zhi Zi Dou Chi Tang’-’Gardenia-Prepared Soybean Decoction’

• Zhi zi-fructus gardeniae jasminoidis, 9 g.
• Dan dou chi-semen sojae praeparatum, 9 g.

‘Zhi Zi Dou Chi San’ is used to treat lingering heat following a febrile illness. The heat causes insomnia with tossing and turning, and anguish in the heart.[9] Thus, ‘Zhi Zi Dou Chi San’ is used to treat restless sleep patterns following emotional upset.

Another familiar formula that uses zhi zi to calm the spirit is ‘Jia Wei Xiao Yao San’. This modification of ‘Xiao Yao San’ adds zhi zi and mu dan pi to clear heat that causes restlessness and irritability. Other symptoms include sweating, a feeling of heat rising causing red ears, red eyes, breast distention and menstrual irregularities, what we call PMS. The pulse is wiry and the tongue is reddish.

 ‘Jia Wei Xiao Yao San’-’Free and Easy Wanderer Powder’ (with additions)

• Bo he-herba menthae,3 g.
• Chai hu-radix bupleuri, 9 g.
• Dang gui-radix angelicae sinensis, 9 g.
• Bai shao-radix paeoniae albae, 12 g.
• Bai zhu-rhizoma atractylodis macrocephalae, 9 g.
• Fu ling-sclerotium poriae cocos, 15 g.
• Gan cao-radix glycyrrhizae uralensis, 6 g.
• Sheng jiang-rhizoma zingiberis officinalis recens, 3 slices
• Mu dan pi-cortex moutan radicis, 6 g.
• Shan zhi zi-fructus gardeniae jasminoidis, 6 g.

In relation to the spirit, zhi zi releases heat from constraint. This is a concept that we usually associate with the liver. Qi stagnation depression over time will always result in constrained heat. This results in frustration and irritability.

Not all herbs that clear heat affect the spirit per se; one key is whether the medicinal enters the heart channel. If so then that can be a key that it is used to treat fan-vexation/ agitation.

In conclusion,  heat clearing herbs deserve to be thought of as an opening move for treating the spirit. They should not be relegated to treat only physical symptoms of heat.

 

Ready to use heat clearing herbs and formulas to treat your patients? We stock them in raw and granule form. Hop online to our HerbScript Pro and build your custom formula today!

Cara Frank, L.OM. was raised in a health food store in Brooklyn NY. When she was 8 she cartwheeled 5 miles from Greenwich Village through Soho and Chinatown and across the Brooklyn Bridge. For over 35 years she has had the same crazy passion for Chinese medicine. At 17 she had her first acupuncture treatment. At 20 she enrolled in acupuncture school. In 1998 she went to China to study where she fell deeply in love with Chinese herbs. Since then, she has devoted her life to studying and teaching the topic.

Cara is the founder of Six Fishes Healing Arts and Six Fishes Neighborhood Acupuncture, both in Philadelphia where she maintains a busy acupuncture practice and acts as the head fish of two warm and lively offices. She is the president of China Herb Company, a Chinese Herb Dispensary that provides classical and custom formulas to acupuncturists across the US. She teaches Chinese Herbology at the Won Institute of Graduate Studies. You can read her full bio or schedule an appointment.

[1]Chinese Medical Psychiatry, Flaws and Lake, Blue Poppy Press, 2001, pg 135

[2]Person… Illness… Prescription. An interview with Dr Huang Huang by Michael Max. The Lantern. Volume 4-2

[3]Commonly Used Chinese Herb Formulas with Illustrations, Hong-Yen Hsu, Oriental Healing Arts Press, 1980, pg 185

[4]Wen Bing Tiao Ben- Systematized Identification of Warm Diseases.

[5]Chinese Herbal Materia Medica, 3rd Edition, Bensky, Clavey, Stoger, Eastland Press, 2004, pg 91

[6]Chinese Herbal Medicine, Formulas and Strategies, 2^ndEdition, Sheid, Ellis, Bensky, Barolet, Eastland Press, 2009

[7]Glomus: refers to the sensation of a ball or lump below the diaphragm.

[8]Line 261, Shang Han Lun, Mitchell, Ye, Wiseman, Paradigm Publications,

[9]Line 76b.