Return to flip book view

Tian Hua Fen Ebook Tian Hua Fen Ebook Translated and Compiled by Sharon Weizenbaum 2021 1

Tian Hua Fen Ebook 2 Chai Hu Gui Zhi Gan Jiang Tang 2 Original Clause 3 Discourse by Feng Shi Lun 3 Discourse by Dr Li Pei Sheng This formula is indicated to treat for the presentation of Shaoyang illness accompanied by water congealed internally 6 Discourse by Tang Rong Chuan 7 Discourse By Liu Du Zhou 9 Further Discourse by Liu Du Zhou 10 1 The theory of the disease mechanism maintains it is gallbladder heat and spleen cold 10 2 To grasp this formula one must stress bitter mouth and viscous stool 11 3 Paying attention to the adjustment of the herbs dosages 13 Application 14 Case 1 Abdominal distention Chronic Hepatitis B 14 Case 2 Stomach Duct Pain Stomach prolapse 16 Case 3 Cough Chronic Bronchitis 17 Case 4 Heart Palpitations Sinus type Tachycardia 19 Case 5 Dizziness 21 Case 6 Rheumatic Fever 22 Case 7 Inhibited Urination Urinary Infection 25 Case 8 Stuttering 26 Case 9 Breast Mass 27 Case 10 Hepatitis 28 Case 11 Epilepsy 29 Case 12 Amenorrhea 31 Translated and Compiled by Sharon Weizenbaum 2021

3 Tian Hua Fen Ebook Gua Lou Bai He Shu Xiong Tang 32 Gua Lou Gui Zhi Tang 35 Original text From Experience with Classic Formulas from Renowned Physicians collected by Liu Du Zhou Case 1 Soft Spasms Case 2 Pediatric Soft Spasm Case 3 Postpartum convulsions Discussion Gua Lou Gui Zhi Tang VS Gui Zhi Jia Ge Gen Tang 42 Gua Lou Mu Li San Original Text Discussion 44 Gu L u Q M i W n Original Text Discussion Case 1 Blocked urination Case 3 Short scanty urination 46 Differentiating Gua Lou Qu Mai Wan and Wu Ling San 52 Mu Li Ze Xie Tang Original Text Discussion Case 1 Water Swelling Case 2 Suspended fluids Seeping type pleurisy 55 Translated and Compiled by Sharon Weizenbaum 2021 35 35 36 37 38 40 44 45 46 47 48 51 55 55 56 56

4 Tian Hua Fen Ebook Chai Hu Gui Zhi Gan Jiang Tang Chai Hu Jin 24 gm Gui Zhi peel 3 Liang 9 gm Gan Jiang 2 liang 6 gm Gua Lou Gen 4 liang 12 gm Huang Qin 3 liang 9 gm Mu Li Dry Fried 2 liang 6 gm Zhi Gan Cao 2 liang 6 gm removed Boil these 7 flavors in 1 Dou 2 Sheng down to 6 Sheng and remove foam Boil again down to 3 Sheng Drink 1 Sheng warm three times a day After the first dose there may be slight vexation Recovery will be brought about by sweating after taking it the second time Original Clause Translated and Compiled by Sharon Weizenbaum 2021

5 Tian Hua Fen Ebook Clause 147 After suffering from cold damage for 5 or 6 days sweating has been promoted first and then purging has been applied There is fullness in the chest and hypochondriac region with a feeling of slight blockage abnormal urination thirst and the absence of vomiting sweating only on the head alternating chills and fever and a sick and discomforting feeling in the stomach These indicate the disease has not resolved Chai Hu Gui Zhi Gan Jiang Tang governs Discourse by Feng Shi Lun Chai Hu 24 Gui Zhi 10 Gan Jiang 6 Tian Hua Fen 12 Huang Qin 10 Mu Li 10 Zhi Gan Cao 6 Formula Explanation This formula is a modified version of Xiao Chai Hu Tang It removes Ban Xia and adds Gua Lou Combining the bitter cold Huang Qin with the pungent warm flavor of Gan Jiang for the slight Translated and Compiled by Sharon Weizenbaum 2021

6 Tian Hua Fen Ebook knotting The moistening quality of Gua Lou Gen and the containing quality of Mu Li help to stop thirst Gui Zhi and Gan Cao treat the surging Qi while supplementing Ren Shen supplements the middle and Da Zao causes congestion In an effort to avoid knotting these are both removed Therefore the formula is for the Xiao Chai Hu Tang without Ban Xia and with Gua Lou Gen added presentation with Qi surging with slight knotting or with the exterior not harmonized Although this formula is a taken from Xiao Chai Hu Tang because the Ren Shen and Da Zao are removed and the Gan Jiang is added the whole formula is more heavily weighted to dispelling cold and expelling water Because of this it treats slight knotting and fullness below the heart Xiao Chai Hu Tang treat half exterior half interior Yang presentations which are Shaoyang illnesses This formula treats half exterior half interior Yin presentations which are Jueyin illnesses This difference is mainly due to the presence of Gan Jiang Zhang Zhong Jing s Discussion Clause 147 Shang Han Lun Clause 147 Shang Han for five or six days sweating has been promoted and then purgation method employed the chest and ribs are full with a slight bind of bowel urination is not free there is thirst but no vomiting sweating only from the head alternating Translated and Compiled by Sharon Weizenbaum 2021

7 Tian Hua Fen Ebook chills and fever heart vexation this means there is no resolution Chai Hu Gui Zhi Gan Jiang Tang governs Analysis There was Shang Han for five or six days and although sweating was promoted the illness did not resolve Commonly there will be a transmutation into a Xiao Chai Hu Tang pattern Because the patient was mistaken diagnosis and the patient was purged the evil heat caved inward The chest and rib side fullness had diminished slightly but there is slight knotting The fluids do not descend so there is inhibited urination The fluids are also scanty because the heat has damaged them and caused dryness This is why there is thirst but no vomiting The Qi surges upward and so sweat issues from the head The alternating chills and fever and heart vexation show that the Chai Hu presentation has not resolved In this case Chai Hu Gui Zhi Gan Jiang Tang governs Discussion The slight knotting is like that described for Da Xian Xiong Tang However in this case there is only slight knotting The Da Xian Xiong Tang presentation appears with harder knotting Jin Gui Yao Lue on Malarial Illness Chai Hu Gui Jiang Tang treats malarial illness with abundant cold There is only slight heat There may also be cold with no heat at all One package is very effective Translated and Compiled by Sharon Weizenbaum 2021

8 Tian Hua Fen Ebook Analysis When malarial illness breaks out and there is more cold with less heat more chills than fever or cold with no heat chills with no fever this formula is suitable to use Discussion Reflections on the Clinical Presentation From the above two clauses one cans see that this formula treats illness that is half exterior and half interior This is like the Xiao Chai Hu Tang presentation However Xiao Chai Hu Tang treats a Yang heat presentation while the presentation for this formula is either abundant cold with slight heat or abundant cold with no heat This is why this is for a half exterior and half interior Yin presentation Generally Yin presentations do not present with heat The half exterior and half interior is not the same as the Shaoyin or Taiyin in which there is no heat and the evil has a pathway to exit A Jueyin evil has not pathway for exit and so it is very easy for cold to turn to heat This is why there is often upper heat with lower cold But this heat is very slight This formula treats malarial illness when there is abundant cold and slight heat It is also for cases in which cold is the main cause with heat being only minimally relevant A fellow student I know from when I was in Jiangxi named Zhang Qiu Shui treated constipation He often used this formula modifying according to the presentation and it was invariably effective Although the idea that this is a Spirit like formula that will cure with one package Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 9 is an exaggeration it is true that it is very effective and this should be believed However this formula is not only for this illness Many chronic illnesses match this formula presentation For example someone may have coldness of the four limbs This is inversion cold with a bitter taste in the mouth and a parched throat When there is an indescribable fever that goes on and on this is generally considered a chronic illness This is an opportunity to use this formula or a modification of it Important points for differentiating the pattern This is a half exterior and half interior deficiency cold pattern and so it manifests with coldness of the 4 limbs There is also dryness or bitter taste in the mouth and slight epigastric knotting Discourse by Dr Li Pei Sheng1 This formula is indicated to treat for the presentation of Shaoyang illness accompanied by water congealed internally In this case there has been damage from cold that has gone on for 5 or 6 days There has been sweating followed by purging After this the exterior is presentation is finished and the evil has entered the Shaoyang There is heat and cold alternating and heart vexation This is a Shaoyang presentation Usually the Shaoyang presentation is accompanied by chest and rib side fullness vomiting with lack of thirst and natural urination In this case there is only slight rib side knotting thirst but no vomiting and 1 From Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 10 inhibited urination This is Shaoyang illness accompanied by water congealed internally This is somewhat different than Shaoyang illness alone The Shaoyang includes both the foot Shaoyang gallbladder channel and the arm Shaoyang San Jiao channels When the pivot mechanism of the Shaoyang is inhibited the gallbladder inner fire is constrained in the interior This can lead to abnormality of the function of dredging the ditches of the San Jiao and this can lead to water accumulation in the middle In addition the evil is knotted in the Shaoyang and so there is slight fullness in the chest and rib side The ditches are not dredged so that they are open through The water fluids are not able to move downward and so the urination is not open through There is water stoppage and Qi constraint without the ability to transform and generate body fluid and so the Stomach Qi is still harmonious This is why there is no vomiting However there is sweating from the head and the Shaoyang pivot mechanism is inhibited The water pathways are not flowing The Yang is constrained and cannot drain the whole body or steam up to the upper parts For this presentation one uses Chai Hu Gui Zhi Gan Jiang Tang This method harmonizes the center of Shaoyang as well as transforms water and resolves accumulation A simple table to illustrate the presentation and treatment of the Shaoyang illness accompanied by water congealed internally Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 11 1 Disease Cause and Mechanism The evil enters the Shaoyang the San Jiao Qi mechanism is inhibited water fluids stop internally 2 Presentation 1 Heart vexation and still sweating from the head this is due to the evil being constrained in the Shaoyang the pivot mechanism is inhibited and gallbladder fire upwardly harasses 2 Slight knotting and fullness of the chest and rib side thirst with no vomiting and inhibited urination this is due to evil constrained in the Shaoyang San Jiao obstruction lack of dredging with water fluids stopping internally 3 Treatment Method Harmonize and resolve the Shaoyang warm and transform water fluids 4 Formula Chai Hu Gui Zhi Gan Jiang Tang Discourse by Tang Rong Chuan There has already been sweating and so the Yang Qi has been discharged out There has also been purging and so the Yang Qi has descended downward Water and fluids move internally reverting into the chest and rib side This is why there is fullness in the chest and rib side with slight knotting The urine is inhibited The knotted water causes the fluids to be Translated and Compiled by Sharon Weizenbaum 2021

12 Tian Hua Fen Ebook unable to rise and so there is thirst This is similar to the meaning behind the Wu Ling San presentation Yang is restrained in the interior and so is unable to scatter in the 4 directions It is however able to upwardly emit and so there is sweating on the head The bodies Yang Qi desires to go out but cannot and so there is alternating hot and cold This is similar to the meaning behind the Xiao Chai Hu Tang presentation This is all cold water Qi It stops in the chest diaphragm and connecting tissues and reverts into the heart wrapper causing heart vexation Chai Hu is used to penetrate through the membrane fascia Gui Zhi and Gan Jiang are used to break up and remove the cold water Huang Qin and Tian Hua Fen are used to clear the fire from inner constraint When scattering cold one must first assist the fire This presentation includes heart vexation This is fire constrained in the interior The Gui Zhi and Gan Jiang will assist the fire and that is why there is still slight vexation The nature of Gui Zhi and Gan Jiang are already rising upward and so the fire will issue out There will be a slight sweat and a cure will follow This formula is Xiao Chai Hu Tang with Ban Xia Ren Shen Gan Cao and Sheng Jiang removed and Gui Zhi Gua Lou Gen Mu Li and Gan Jiang added This harmonizes and resolves the Shaoyang and warms and transforms the water fluids Ban Xia is removed because there is thirst with no vomiting and so it is clear that there is no counter flow of the stomach Because there is water stoppage in the interior with obstruction Translated and Compiled by Sharon Weizenbaum 2021

13 Tian Hua Fen Ebook of the San Jiao and the Shaoyang evil has not been resolved the sweet supplementation of Ren Shen and Da Zao are removed After listing the formula the text says Taking three doses in one day first there will be slight vexation and then there will be sweating and then there will be a cure This is a formula for coursing and disinhibiting the Shaoyang half interior half exterior At the start herbs are for the correct Qi and then the correct and the evil mutually wrestle The constrained Yang must spread but at first the Qi mechanism does not flow and open through and there for there is a slight feeling of vexation Continuing to take the herbs promotes the unimpeded flow of the Qi mechanism The interior and exterior Yang flows smoothly and so there is sweating of the whole body and through the sweating the evil is resolved The illness is cured This is not the evil steaming upward causing the disease symptom of sweating from the head This is sweating that causes a cure This formula has a broad clinical application It is able to treat conditions with a lot of cold and less heat or malaria with cold and no heat It is also often used to treat Chai Hu presentations accompanied by phlegm fluids knotting in the interior Regardless of whether or not there are external symptoms this formula is very effective A simple breakdown of the formula Chai Hu and Huang Qin harmonize the Shaoyang Mu Li and Tian Hua Fen expel fluids and open knotting Chai Hu and Mu Li together are able to transform phlegm and open Translated and Compiled by Sharon Weizenbaum 2021

14 Tian Hua Fen Ebook knotting and treat epigastric and rib side hard fullness Gui Zhi Gan Jiang and Gan Cao warm and transform water fluids Discourse By Liu Du Zhou Chai Hu Gui Zhi Gan Jiang Tang is a modified version of Xiao Chai Hu Tang Because Ban Xia Ren Shen Da Zao and Sheng Jiang are removed and Gan Jiang Gui Zhi Mu Li and Tian Hua Fen are added it is for treating gallbladder heat with Taiyin spleen cold with inhibited Qi transformation and dry fluids all causing abdominal distention sticky diarrhea stool inhibited urination and chest and rib side fullness This can also cause a presentation of rib side pain into the back thirst heart vexation alternating cold and heat numbness of the arms and fingers red tongue with white moss and wiry moderate pulse This formula harmonizes and resolves Shaoyang while warming the cold damp in the spleen Da Chai Hu Tang also harmonizes and resolves Shaoyang while discharging the Yangming internal excess Together they express one formula is for excess and the other for deficiency We can know that Shaoyang influences the spleen and stomach yet one must differentiate cold and heat excess and deficiency in order to treat Further Discourse by Liu Du Zhou Harmonize resolve and scatter cold generate fluid and absorb Yin This formula treats Shaoyang patterns with light alternating chills and fever chest and rib side fullness with slight knotting inhibited urination Translated and Compiled by Sharon Weizenbaum 2021

15 Tian Hua Fen Ebook thirst without vomit heart vexation and sweating from the head malaria with more chills than fever or chills with no heat 1 The theory of the disease mechanism maintains it is gallbladder heat and spleen cold Dr Liu Du Zhou considered it to be the Shang Han Lun s half exterior half interior and the pivot mechanism between the exterior and interior Shaoyang is the pivot and is not just the pivot mechanism between exterior and interior It iw the pivot mechanism where the 3 Yang changes into the 3 Yin Because of this the Shaoyang illnesses commonly have both interior and exterior presentations For example when Shaoyang is shows with an exterior pattern there is Chai Hu Gui Zhi Tang When Shaoyang manifests with an interior excess pattern there is Da Chai Hu Tang or Chai Hu Jia Mang Xiao Tang Chai Hu Gui Zhi Gan Jiang Tang is the opposite of Da Chai Hu Tang This pattern is a Shaoyang pattern with interior deficiency cold Thus it is exterior and interior simultaneously with both interior excess and interior deficiency Shaoyang has the meaning of the pivot In clause 146 Zhang Zhong Jing wrote that a Shaoyang with simultaneous exterior pattern is governed by Chai Hu Gui Zhi Tang Right after this clause is clause 147 in which the Shaoyang transfers into Taiyin This is governed by Chai Hu Gui Zhi Gan Jiang Tang The meaning here is very profound Modern people ponder this endlessly Therefore commenting about chapter 14 of the Shang Translated and Compiled by Sharon Weizenbaum 2021

16 Tian Hua Fen Ebook Han Lun Dr Liu says This formula is used to harmonize and resolve Shaoyang while simultaneously treating spleen cold He also talks about Da Chai Hu Tang harmonizing and resolving Shaoyang while simultaneously treating stomach excess It can be seen that Shaoyang illness influences the spleen and stomach yet we must be able to differentiate cold heat deficiency and excess in order to treat In terms of gallbladder heat and spleen cold Dr Liu discussed the idea that Shaoyang illness is a transfer into a Yin pattern Generally everyone thinks that the mechanism of this formula is difficult to understand Dr Chen say that Chai Hu Gui Zhi Gan Jiang Tang is a transfer into a Yin pattern Dr Liu asked what the meaning of transfer into Yin pattern is Dr Chen looked to the left and said that he could not explain it Dr Liu thought long and hard about these words for many years He combined this thinking into his clinical practice and discovered the theory and from this he could treat In the clinic Chai Hu Gui Zhi Gan Jiang Tang has amazing effectiveness Dr Liu was a stickler for clinical effectiveness and his power of understanding was extremely high He is worthy of the title of great doctor He explains this idea of gallbladder heat and spleen cold This is logical There is chest and rib side fullness with slight knotting and only the head sweats There is mouth thirst alternating chills and fever and heart vexation These symptoms all indicate that the illness is in Translated and Compiled by Sharon Weizenbaum 2021

17 Tian Hua Fen Ebook Shaoyang The Shaoyang pivot mechanism is inhibited and this is the cause of the gallbladder heat being constrained above The cause of the inhibited urination is two fold On the one hand the Shaoyang pivot mechanism influences the Qi transformation On the other the spleen Yang is insufficient so the transformation and transport of the fluids is not good The lack of retching tells us that the Shaoyang evil has been transferred to the Taiyin so it is not influencing the stomach Fu Although Zhang Zhongjing was not clear about the condition of the bowels a viscous stool presentation is unavoidable Without saying it the disease pathology indicates this involvement of Taiyin It may not influence the bowel so therefore there is the saying that it has transferred into a Yin pattern This has the same meaning as when we look at the Taiyang opening clause It does not say fever The meaning is identical 2 To grasp this formula one must stress bitter mouth and viscous stool In regard to the application of Chai Hu Gui Zhi Gan Jiang Tang Dr Liu thinks that chapter 14 of the Shang Han Lun clearly points out that this formula treats gallbladder heat and spleen cold with inhibited Qi transformation and diminished fluids This causes abdominal distention sticky diarrhea inhibited urination mouth thirst heart vexation or rib side pain effecting the back numbness of the arms and fingers wiry Translated and Compiled by Sharon Weizenbaum 2021

18 Tian Hua Fen Ebook moderate pulse and a pale tongue with white moss Dr Liu says that the primary symptoms are bitter mouth and viscous stool This was deduced by understanding the disease mechanism Since this is a concurrent Shaoyang Taiyin presentation there should be evidence of a Shaoyang pattern and evidence of a Taiyin pattern Then one can boldly use this formula Dr Liu determines the Shaoyang illness with the bitter mouth This is also how he determines when to use a Chai Hu family formula Dr Liu has said that it is fire that has the bitter taste Even if this fire causes an extremely slight bitter mouth this can only be liver gallbladder fire It is very common to see bitter mouth and therefore bitter mouth has a very practical significance for reflecting the Shaoyang evil heat This is why Dr Liu considered bitter mouth to be the primary symptom from the Shaoyang opening clause in the Shang Han Lun As for the symptom of sticky stool it is a very important symptom for determining Taiyin illness In the Taiyin opening clause of the Shang Han Lun it says When there is Taiyin illness there is abdominal fullness with vomiting The food does not go down There is extreme spontaneous diarrhea occasional spontaneous abdominal pain Below the chest there his knotting and hardness This stresses diarrhea This is why Dr Liu saw diarrhea as the principle deficiency symptom In the clinic no matter what the disease is or how long the patient has suffered for all who have abdominal distention and extreme diarrhea one should consider the Taiyin deficiency cold illness and you will probably be in the right vicinity Translated and Compiled by Sharon Weizenbaum 2021

19 Tian Hua Fen Ebook One accommodates oneself to what one sees in the clinic Dr Liu on the basis of sticky stool or watery diarrhea or viscous diarrhea or extreme unformed stool one can understand that the movement of the terrestrial pole and give this formula The scholar should give this on the basis of the disease mechanism and flexibly apply it One shouldn t base your work on whether or not there is one symptom This formula can teach us about Chinese medicine 3 Paying attention to the adjustment of the herbs dosages On the basis of this formula s clinical application in relation to chapter 14 of the Shang Han Lun Dr Liu Duzhou wrote this formula can be used to treat chronic hepatitis In this pattern you will see rib side pain abdominal distention viscous stool diarrhea dry mouth In these cases this formula will often be effective If you see a diabetes manifesting with a Shaoyang illness pattern this formula is extremely right on In the beginning Dr Liu s use of this formula for hepatitis with abdominal distention was very effective Patients with hepatitis because they have used bitter cold clearing and disinhibiting liver gallbladder herbs for a long period of time often the heat toxin does not clear and the spleen yang is damaged One sees that the liver gallbladder have heat and there is also cold in the spleen stomach Clinically not only will one see liver gallbladder constraint and heat and inhibited Qi mechanism signs like Translated and Compiled by Sharon Weizenbaum 2021

20 Tian Hua Fen Ebook discomfort in the liver area bitter mouth and poor appetite one will also see spleen and stomach deficiency cold signs such as abdominal distention and viscous stool When the liver gallbladder Qi mechanism isflowing and discharging is inhibited and in addition the spleen deficiency leads to lack of movement so that the spleen and stomach Qi mechanism of up bearing and down bearing is without command this causes abdominal distention that is particularly extreme Because the Taiyin is deficient and cold often the abdominal distention comes on or is worse at night In terms of treatment clearing heat can further damage the spleen and warming the spleen yang can aggravate the heat and generate toxin making the liver heat symptoms worse And yet Liu Du Zhou uses this formula for this pattern Moreover he has amazing results This is by no means accidental To apply this formula clinically one should explain its meaning There should be nimble adjustment of the herbal dosage Chai Hu and Huang Qin clear and dishinhibit the liver gallbladder while Gan Jiang and Zhi Gan Cao warm and supplement the spleen Yang Gui Zhi helps open through the cold and hot Yin Yang function When using this formula in the clinic if the viscous stool is serious increase the dosage of Gan Jiang or decrease the Huang Qin If there is more serious bitter mouth increase the dosage of Huang Qin and decrease the Gan Jiang Translated and Compiled by Sharon Weizenbaum 2021

21 Tian Hua Fen Ebook Application Case 1 Abdominal distention Chronic Hepatitis B 2 Dr Liu Duzhou The patient was a mister Liu age 54 He had Hepatitis B In spite of this his body condition had been very stable and he had not suffered Recently he began to have abdominal distention This always got worse in the late afternoon and evening When this came on he was extremely uncomfortable and in pain sitting or lying down Not only did he come for a consult his family also requested to come to the consultation He put his hands on his belly and said When the illness is not flaring I can speak At night time my abdomen becomes distended The Qi gathers in my abdomen and I can t belch It is so stifling that I want to die I requested treatment and was given many western medicines that were not effective His stool was viscous and thin without form He moved his bowels frequently each day three times At night his distention became severe His urine was short and scanty he had rib side pain that radiated into his should and back that was hard to bear His pulse was wiry and moderate His tongue was pale and tender with white slippery moss Dr Liu said that Zhong Jing says When Taiyin has illness the abdomen is full and food does not go down and there is extreme diarrhea This tells us 2 1996 77 78 Translated and Compiled by Sharon Weizenbaum 2021

22 Tian Hua Fen Ebook that diarrhea with abdominal fullness and lack of thirst is related to Taiyin Yin cold flourishes at night and that is why it gets extreme at night The moderate pulse is Taiyin and the wiry pulse is related to liver gallbladder The gallbladder pulse move on both sides and this is why there is rib side pain going to the back Although Taiyin abdominal pain is not commonly seen in the clinic a case like this is quite serious Could this be due to the lack of free flow and inhibition of the liver gallbladder qi mechanism so that the rising and falling of the 6 Fu were unregulated Dr Liu examined this carefully and thought it over fully and decided to treat the liver and spleen together He first used the Shang Han Lun s Chai Hu Gui Zhi Gan Jiang Tang Chai Hu 16 gm Gui Zhi 10 gm Gan Jiang 12 gm Gua Lou Gen 10 gm Huang Qin 4 gm Mu Li 30 gm Zhi Gan Cao 10 gm Translated and Compiled by Sharon Weizenbaum 2021

23 Tian Hua Fen Ebook After taking one package the night time abdominal pain was decreased by half After 3 more packages the pain was completely gone The diarrhea also had stopped Discussion When considering chronic liver gallbladder disease that is hepatitis B the long term use of bitter cold heat clearing medicines can over time lead to a deficient cold condition of the spleen Qi It is then that this formula can be used to disinhibit the liver gallbladder and simultaneously warm the deficient cold pattern of the Taiyin The amount of Huang Qin in this formula is low and the Gan Jiang is slightly high When the urination is scanty add Fu Ling If the body is deficient add 8 Dr Liu often uses this formula to treat hepatitis B Case 2 Stomach Duct Pain Stomach prolapse Dr Gong Mingli Ms Qi was age 61 and came for her consultation on May 26 1983 She had suffered from stomach duct pain for more than a year In the hospital she was diagnosed with stomach prolapse In the previous month the pain had become severe This was accompanied by mental Translated and Compiled by Sharon Weizenbaum 2021

24 Tian Hua Fen Ebook weakness and fatigue Her appetite was poor and she had bad breath and thirst Other symptoms were stomach area water sounds heart palpitations occasional watery stool red sides to the tongue with thin white tongue moss Her pulse was soft and without strength This was heat constraint in the liver gallbladder spleen Qi deficiency fatigue with no power in the movement and transportation and water stoppage in the stomach The treatment needed to clear and disinhibit the liver gallbladder warm the spleen and transform water Modified Chai Hu Gui Zhi Gan Jiang Tang was used Chai Hu 10 gm Gui Zhi 6 gm Gan Jiang 6 gm Gua Lou Gen 12 gm Huang Qin 6 gm Mu Li 12 gm Zhi Gan Cao 6 gm Fu Ling 10 gm Translated and Compiled by Sharon Weizenbaum 2021

25 Tian Hua Fen Ebook Altogether 3 packages were given and the stomach pain decreased The bad breath was also better There were still loud sounds in the abdomen This was the sound of the constraint gradually starting to flow The spleen Qi was already moving She was given the above formula with 12 gm of Huang Qi added After 10 packages there was a cure 3 Discussion The symptoms of bad breath dry mouth heart palpitations and red sides to the tongue were all signs that there was heat in the liver gallbladder The fatigue poor appetite sticky stool and thin pulse without strength were due to spleen cold The gallbladder heat spleen cold inhibited Qi mechanism and congealed fluids being unable to moisten all caused stomach pain In addition there were water sounds The treatment was to clear and disinhibit the liver gallbladder while warming the spleen and transforming fluids This pattern matches this formula Fu Ling was added to strengthen the function of transforming fluids and disinhibiting dampness Case 3 Cough Chronic Bronchitis 4 Dr Yang Shoujun 3 1985 12 11 4 1986 9 46 Translated and Compiled by Sharon Weizenbaum 2021

26 Tian Hua Fen Ebook Mr Zhu was age 59 and came for his consultation on February 15 1984 The patient reported that he had developed bronchitis three years previously Recently due to emotional issues the cough got more severe He went to several doctors for treatment to no avail So he decided to come for a consultation with Dr Yang There was a cough with abundant phlegm chest and rib side fullness and oppression belching poor appetite pale red tongue with thin greasy slightly yellow moss and a wiry pulse This was after careful consideration obviously wood tension and constraint The function of orderly reaching was not occurring as it should Although this was liver illness the liver had passed it onto the spleen Furthermore the spleen is the source of the phlegm The phlegm followed the liver Qi in its rebellion upward to invade the lung This was the cause of the belching and cough The treatment needed to help the liver flow smoothly and fortify the spleen while transforming phlegm and stopping cough Modified Chai Hu Gui Zhi Gan Jiang Tang was used Chai Hu 9 gm Gui Zhi 9 gm Gan Jiang 4 5 gm Gua Lou Ren 9 gm broken Translated and Compiled by Sharon Weizenbaum 2021

27 Tian Hua Fen Ebook Huang Qin 6 gm Mu Li broken 12 gm Zhi Gan Cao 6 gm Tian Hua Fen 9 gm Ban Xia 9 gm Zhi Ke 9 gm Three packages decocted in water He came for a return visit three days later on February 18 The cough had very much decreased as had the chest and rib side fullness and oppression His tongue moss was white and slightly sickey and his pulse was slippery The herbs treat the disease mechanism so he was given the above formula with Tian Hua Fen removed and Chen Pi 9 gm added He took 3 packages and came back on the 21st of February for his third visit His appetite had increased He had a slight cough with scanty phlegm and all other pathology was gone He was then given Xiang Xia Liu Jun Zi Wan and Jian Hua He Dong San to consolidate the treatment A year later there was no relapse Discussion In this case the 3 Zang liver spleen and lung were troubled Nonetheless the root was in the liver spleen and the branch was the lung Translated and Compiled by Sharon Weizenbaum 2021

28 Tian Hua Fen Ebook Chai Hu Gui Zhi Gan Jiang Tang was used to treat this This made the liver constraint open up and the spleen damp was transformed The lung Qi could then return to its clearing The cough was cured Case 4 Heart Palpitations Sinus type Tachycardia 5 Dr Chen Jinsheng Mr Kang was age 20 and came for a consult on November 13 1984 He was very thin with red cheeks and dry lips He said that for half a year he had had chest oppression When it was extreme he felt movement under his left breast that moved his clothing He would become cold and shiver at night Then after around 11 00 to 1 00 he would sweat and his body became hot and the cold resolved During the day his temperature was normal This was accompanied by glomus and poor appetite and dry mouth The pulse was wiry thin and rapid His tongue was red and the tongue body was slightly fat with thin white moss The electrocardiogram showed tachycardia Modified Chai Hu Gui Zhi Gan Jiang Tang was used Chai Hu 25 gm Gui Zhi 10 gm 5 1989 2 28 Translated and Compiled by Sharon Weizenbaum 2021

29 Tian Hua Fen Ebook Gan Jiang 10 gm Tian Hua Fen 15 gm Huang Qin 10 gm Mu Li 25 gm Long Gu 25 gm Wu Wei Zi 12 gm Zhi Gan Cao 10 gm He returned 3 days later on November 16 The night time cold and heat had stopped The chest oppression and heart palpitations greatly decreased and his appetite improved His pule became harmonious He was give 3 more packages of the above formula with the dosages decreased by half and there was a cure Discussion Zhong Jing says that this formula can treat heart vexation Dr Chen has the clinical experience of using this formula to treat sinus type tachycardia This is especially effective for those who have resting type pre ventricular contraction abnormal heart rhythm Shaoyang syndroms In this case of heart palpitations there was alternating hot and cold at Translated and Compiled by Sharon Weizenbaum 2021

30 Tian Hua Fen Ebook night This indicated the Shaoyang syndrome So he was given Chai Hu Gui Zhi Gan Jiang Tang and there was a cure without a hitch Case 5 Dizziness6 Dr Chen Jinsheng Ms Heng was age 65 and came for her first visit on June 4 1987 She reported feeling dizzy already for several years At times it was light and other times it was heavy When it was extreme she had to lay down When it was moderate though she could sit walking around was difficult This was accompanied by an aversion to cold without sweat red face chest oppression vexation and agitation insomnia and fatigue Her tongue was slightly red with thin white moss In the center of her tongue there was no moss The pulse was wiry thin and rapid Three packages of Chai Hu Gui Zhi Gan Jiang Tang was given with Gan Mai Da Zao Tang She came back for a return visit 2 days later on June 7 The above formula did not have an effect The pattern was as before so Dr Chen considered carefully He again gave Chai Hu Gui Zhi Gan Jiang Tang complying with the original formula s dosages Chai Hu 25 gm Gui Zhi 10 gm 6 1989 2 28 Translated and Compiled by Sharon Weizenbaum 2021

31 Tian Hua Fen Ebook Gan Jiang 10 gm Tian Hua Fen 12 gm Huang Qin 10 gm Mu Li 6 gm Zhi Gan Cao 3 gm 3 packages After the first package the dizziness stopped She concluded after 3 packages Her appetite and sleep were good and her spirit had changed for the better She could walk about smoothly She still had slight chest oppression so she took another 10 packages and was fine thereafter Discussion The Japanese doctor Shu Daoming in his considers this formula to be a Qi and water formula It can treat many kinds of patterns that are due to lack of regulation of Qi and water In this case the dizziness was primarily due to a lack of regulation of Qi and water pattern Clinically it is seen that this type of dizziness is often induced by emotions Alternatively it could come on with menopause Chai Hu Gui Zhi Gan Jiang Tang has the function of regulating and harmonizing Yin and Yang resolving constrain and scattering fluid It is very effective for this type of dizziness Translated and Compiled by Sharon Weizenbaum 2021

32 Tian Hua Fen Ebook Case 6 Rheumatic Fever7 Dr Fu Youfeng Ms Li was age 24 She was an inpatient in the hospital Her consultation was March 26 1979 She had a high fever and body pain Her chest and rib side were inhibited She didn t dare breathe deeply On March 12 she went to the hospital as as ab outpatient She took Gan Mao Shui and had an anti biotic injection but these were not effective Her body temperature was 39 C when high but would go down to 38 C Because she bathed once again her body temperature became high Mid day on March 21 it went up to 39 6 Her family urgently brought her to the hospital The check up showed she had bleeding from her left nostril and throat as well as a stuffy nose Her blood pressure was 140 70 without abnormality She entered the hospital and had blood tests White blood cells 22800 mm3 Neutrophils 89 Sed rate 55mm hour Negative for strep There were many other tests that were all negative The electrocardiogram test show a T wave change The diagnosis was rheumatic fever She went into the hospital and received intravenous antibiotics and medicines to bring down the fever and stop pain Yet the body temperature could not be controlled This is when she came to Dr Fu for a consultation The condition was as described above She reported herself that she had fever and chills body pain and pain in both 7 1993 3 25 Translated and Compiled by Sharon Weizenbaum 2021

33 Tian Hua Fen Ebook knees for two weeks The fever was high in the afternoon She would feel frequent palpitations in front of her left side chest and soon her body temperature would rise At times she felt chest and rib side fullness and oppression dizziness heart vexation dry throat bitter mouth no vomiting but thirst slightly yellow and inhibited urination When she had the fever she would sweat but just on her head Her pulse was wiry and rapid and her tongue moss was white and slightly yellow in the center The sides of her tongue were red and the top had scanty moisture This illness was in the exterior and interior The exterior was not resolved and fluids were knotted on the interior He again gave Chai Hu Gui Zhi Gan Jiang Tang Chai Hu 10 gm Gui Zhi 3 gm Gan Jiang 2 gm Tian Hua Fen 5 gm Huang Qin 4 gm Mu Li 3 gm Sheng Gan Cao 2 gm Two packages Translated and Compiled by Sharon Weizenbaum 2021

34 Tian Hua Fen Ebook The patient took the herbs that afternoon at 5 00 This was just when the aversion to cold and fever would arise After she took the herbs she felt a slight vexation After that there was a slight sweat and the fever resolved The next day she felt her body pain had decreased That afternoon her temperature was 37 5 C She only had the feeling of cold in her arms chest oppression stuffy nose and her family noticed that her lips appeared purplish and contracted That afternoon according to the precedent she got 2 more packages of the same formula That evening at 11 00 she suddenly felt an aversion to cold and then she began to shiver Her body temperature went up to 40 5 C Then she had a big sweat with thirst She sweat profusely all the way until dawn Her body that had felt cold began to feel warm and her lips turned red She was tired and wanted to sleep Her body temperature was 37 2 The flourishing heat had resolved The electrocardiogram and blood tests also became normal She would only occasionally feel a stuffy nose and slight chest oppression She was given several packages of the above formula with 10 gm of Gua Lou Pi and 6 gm of Yu Jin and there was a complete cure Discussion This case began with receiving an evil and getting a fever Yet there was also the chest oppression palpitations due to a water knotting on the interior pattern The doctor however used herbs to clear heat He used cold ingredients like Shi Gao and Xuan Shen Although the heat was deferred the fluid evil had not been dispelled Because she Translated and Compiled by Sharon Weizenbaum 2021

35 Tian Hua Fen Ebook took a bath and got damp the heat caught like a prairie fire with body pain chills and fever Days went by without resolution Based on the symptoms of chest and rib side fullness inhibited urination thirst without vomiting head sweating and chills and fever Chai Hu Gui Zhi Gan Jiang Tang was given The pattern corresponded to the disease mechanism and so there was a cure after 2 packages Shivering and sweating indicates that the internal evil has taken the common route to the outside Ye Tianshi said if there is an evil that is completely in the Qi level and reluctant to leave one can hope that a shivering sweat will out thrust the evil In this case there is a lot of meaning in the fact that the symptoms occur just at the time of night when Yin uses up the Yang movement Master Fu has many cases in which he uses this formula for fevers that show up after a course in time He stresses the importance of dosage In addition to Chai Hu he uses an extremely light dose for the other herbs as well He first takes into account whether the patient has inner heat with fluid damage Secondly he takes into account Zhang Zhong Jing s original formula as the clinical reference Case 7 Inhibited Urination Urinary Infection 8 Dr Chen Jinsheng 8 1989 2 28 Translated and Compiled by Sharon Weizenbaum 2021

36 Tian Hua Fen Ebook Ms Zhang was age 24 when she came for her consultation on January 25 1985 Her western medical diagnosis was urinary tract infection She took antibiotics as well as Chinese herbs to clear and disinhibit damp heat for one month Still her urination was inhibited frequent and slightly painful She had slight chills and fever and occasional heart palpitations He stool was soft viscous and her appetite was poor Her tongue was slightly red with a scattering of purple spots and a thin white moss Her pulse was wiry and thin Modified Chai Hu Gui Zhi Gan Jiang Tang was used Chai Hu 25 gm Gui Zhi 10 gm Gan Jiang 10 gm Tian Hua Fen 10 gm Huang Qin 10 gm Mu Li 25 gm Zhi Gan Cao 6 gm Wu Wei Zi 10 gm Wu Yao 10 gm 3 packages Translated and Compiled by Sharon Weizenbaum 2021

37 Tian Hua Fen Ebook She drank them all and her urination opened through The heart palpitaitons and chills and fever stopped Her stool also had form Discussion Chai Hu Gui Zhi Gan Jiang Tang has the function for disinhibiting urination and opening through Lin On the basis of a report it can be used when there is a pattern with a urinary tract infection nephritis or urinary block in elderly people accompanied by chills and fever Case 8 Stuttering Dr Yu Yifu The patient claimed to have long lasting stuttering Dr Ye says that when there is long term stuttering one can know that herbs to open through will not be effective The had come especially to see the doctor so he fortunately did not commit this crime Doctor asked if it was the same every day Shi answered no He said that there were times when it was very easy but that when he was upset it became extreme The doctor said okay Only then did he diagnose He was without strength and there was extreme movement in his chest and abdomen He was given Chai Hu Gui Zhi Gan Jiang Tang A many year illness and he completely returned to normal Translated and Compiled by Sharon Weizenbaum 2021

38 Tian Hua Fen Ebook Case 9 Breast Mass9 Dr Qiao Baogou Ms Wang was age 39 She came in March 21 1975 She reported breast distention oppression and discomfort This had gone on for more than a year already and recently she found a lump on her breast Before her menstruation the distention and pain became worse and the lump got clearly getting larger After menstruation the distention and pain lightened and the lump got smaller The lump also got larger when her spirit became depressed This was accompanied by chest and rib side fullness and pain bitter mouth dry throat Her 6 pulses were wiry and slippery and her tongue body tended to be fat with wet moist moss The check up revealed a left upper side breast lump about the size of a walnut It was firm to the touch with slight pain It was also moveable when pushed but the borders were not clear There were several yellow bean sized lumps in the surrounding area The lymph nodes in her armpits were swollen and large This was liver constraint and Qi stasis with congealed knotted phlegm damp The treatment needed to smooth the flow of the liver clear heat while warmly transforming phlegm damp softening hardness and dispersing knotting Chai Hu Gui Zhi Gan Jiang Tang was used 9 1979 1 33 Translated and Compiled by Sharon Weizenbaum 2021

39 Tian Hua Fen Ebook Chai Hu 9 gm Gui Zhi 4 5 gm Gan Jiang 4 5 gm Tian Hua Fen 21 gm Huang Qin 9 gm Mu Li 15 gm Zhi Gan Cao 9 gm 1 package for 1 day decocted in water After 20 packages the two sides of the breast were completely clear of lumps All symptoms had completely cleared There was no recurrence at a check up a year later Discussion Breast lumps are mostly thought of as related to damage to the spleen and coming when there is worry and indignation effecting the liver These cause the liver to become stagnant and for phlegm to congeal This takes the form of a plum or chicken egg or nodes Treatment usually aims to smooth the flow of the liver with Chai Hu Xiao Yao type herbs In this case an inhibited Qi mechanism was the root while phlegm damp congealed and knotted was the branch Therefore Chai Hu Gui Zhi Translated and Compiled by Sharon Weizenbaum 2021

40 Tian Hua Fen Ebook Gan Jiang Tang was used to sooth and disinhibit the liver gallbladder transform phlegm and soften hardness There was a cure Case 10 Hepatitis A 35 year old man named Li with a main complaint of hepatitis He was staying in an infectuous disease hospital His most prominent symptoms were abdominal distention that was worse in the afternoon He was fidgety with no resolution His pulse was wiry moderate and rapid His tongue body was pale and tender with white slippery moss Her bowel movements were sticky and unformed and moved 2 3 times each day Her urination on the contrary was scanty There was also mouth thirst This was differentiated as a Liver and Spleen illness with deficiency cold of the middle warmer This is why the bowels were pasty and to the contrary there was abdominal distention However treating only the Liver and Spleen there was no effect Treatment method was coursing and disinhibiting the Liver and Gallbladder while warming the cold in the Spleen I gave him 5 packages of the following formula Chai Hu 10 gm Huang Qin 6 gm Translated and Compiled by Sharon Weizenbaum 2021

41 Tian Hua Fen Ebook Zhi Gan Cao 6 gm Gan Jiang 6 gm Tian Hua Fen 12 gm Mu Li 12 gm After these 5 packages the abdominal distention was cured His bowels also became normal I then gave him herbs to regulate the liver and harmonize the Stomach Case 11 Epilepsy Feng Shi Lun Case Case Study Hu is a 14 year old male patient who came in on October 18 1965 4 years previously he had developed acute infectuous hepatitis with jaundice He took western drugs and the jaundice receded However his appetite was still poor and his liver function would fluctuate He occasionally had dizziness and for the past year he had an epileptic seizure about once every month Before a seizure he would feel Qi surging up to his throat Then his 4 limbs would spasm and he would get lockjaw He vomited frothy white liquid and was not coherent He took western tranquilizing medication but still had the seizures every two weeks He often felt weak especially after an episode Because he Translated and Compiled by Sharon Weizenbaum 2021

42 Tian Hua Fen Ebook could not eat well he became very thin His tongue was clean and without moss His pulse was wiry and slightly rapid This was an evil constrained half exterior and half interior with cold fluids harassing upward Treatment needed to harmonize the half exterior and half interior and warm and transform cold fluids I used Chai Hu Gui Zhi Gan Jiang Tang and Dang Gui Shao Yao San Chai Hu 12 Huang Qin 10 Tian Hua Fen 12 Gui Zhi 10 Chi Shao 10 Bai Shao 10 Sheng Long Gu 15 Sheng Mu Li 15 Dang Gui 10 Chuan Xiong 10 Translated and Compiled by Sharon Weizenbaum 2021

43 Tian Hua Fen Ebook Sheng Jiang 10 Cang Zhu 10 Fu Ling 10 Ze Xie 15 Gan Cao 9 Outcome After taking 6 packages of the above formula his appetite returned After 6 more packages the dizziness had changed for the better He did not have any epileptic seizures I gave him another week s worth and his strength had improved I still continued with the original formula for another month with slight additions and subtractions After another month there were still no seizures so I gave him another month and then stopped the herbs There were no more outbreaks Translator s musings How do we get to the half exterior and half interior Yin pattern We know it is not Taiyang or Yangming so we use Dr Feng s ruling out method There is dizziness and a wiry pulse but pure Shaoyang would have more heat Here we know it is cold because of the white frothy liquid Translated and Compiled by Sharon Weizenbaum 2021

44 Tian Hua Fen Ebook Case 12 Amenorrhea Ms Chen was 23 years old and came in January 20 1990 She had not menstruated for 5 months She had profuse leucorrhea and showed no signs of pregnancy For the last 7 days she had a bitter taste in her mouth chest and rib side fullness and a poor appetite The previous day first her whole body felt pain and she had back pain The her menstruation come and the color was dark red There was a fishy smell and it was scanty Her urination was inhibited and she felt a cutting pain when she urinated Her lips were dry she was slightly thirsty and liked to drink warm beverages She was agitated and at night she sweat from her head Her back was sore and her abdomen was painful Her tongue was pale with thin moss Her pulse was wiry and rapid I gave her the following formula Bei Chai Hu 15 Gui Zhi 10 Tan Jiang 6 Tian Hua Fen 12 Huang qin 10 Translated and Compiled by Sharon Weizenbaum 2021

45 Tian Hua Fen Ebook Zhi Gan Cao 6 Mu Li 12 cook ahead Gan Di Huang 10 Chi Shao 10 Chuan Xiong 3 Dang Gui 10 Second visit the bitter taste in the mouth the back soreness and abdominal pain had greatly decreased The thirst agitation and chest oppression had all cleared The leucorrhea also decreased but the menstruation had still not arrived I gave her 2 more packages and all was normal Discussion In this case she began with scanty menstruation The Shaoyang was then damaged Chai Hu and Huang Qi harmonize the Shaoyang Gui Zhi Gan Cao and Gan Jiang assist the Yang in scattering cold as well as in warming and transforming water fluids Tian Hua Fen clears heat generates fluid and stops thirst Mu Li scatters knotting and dispels fullness Di Huang Chi Shao Dang Gui and Chuan Xiong constitute Si Wu Tang They nourish the blood and vitalize the blood Translated and Compiled by Sharon Weizenbaum 2021

46 Tian Hua Fen Ebook Combined altogether these herbs harmonize Yin and Yang and disinhibit the Qi and blood Gua Lou Bai He Shu Xiong Tang By Lu Yong Bing Gua Lou Shi 20 gm Bai He 20 gm Sheng Di Huang 12 gm He Huan Hua 12 gm Function To broaden the chest scatter knotting clear the heart dispel agitation generate fluids and moisten the lungs Primary application cardio pulmonary disease coronary heart disease depression with constraint and stuffiness of the chest vexation heat Bi pain emotional discomfort being trance like insomnia with many dreams heart palpitations lack of taste of food and drink dry mouth without thirst red tongue with scanty moss slightly rapid or wiry pulse Method of use Every day take one package Boil two times The first time boil in 800 ml down to 150 ml The second time boil in 500 ml Translated and Compiled by Sharon Weizenbaum 2021

47 Tian Hua Fen Ebook down to 100 ml Combine the two liquids and divide into two doses to take warm Formula explanation The chief herb in this formula is Gua Lou Shi Gua Lou Shi includes Gua Lou Shi Gua Lou Ren and Gua Lou Pi These three herbs all have the function to expand the chest and scatter knotting They clear the lung and transform phlegm as well Gua Lou Ren also functions to moisten the intestine and open through the bowel Gua Lou Pi also functions to disinhibit Qi and expand the chest This formula uses the function of the fruit the seed and the peel together Herbal research shows that Gua Lou Shi can expand the coronary artery and increase the blood flow function of the artery It also shows that it increases the ability to endure lack of oxygen The clinical manifestation is lung and heart phlegm fire constraint and knotting in the chest area with the symptoms of chest oppression chest pain For this there are excellent results The formula includes Bai He and Sheng Di as ministers These two herbs constitute Bai He Di Huang Tang Bai He and Sheng Di mainly enter the channels of the heart and lungs They are able to clear the heart and moisten the lungs This is the famous formula for treating lily disease The cause of lily disease are constraint of the seven emotions The clinical picture is of emotional disruption withdrawn with scarce speech a desire to sleep but unable to sleep wanting to move but unable to move wanting to eat but unable to eat feeling cold but not being cold feeling hot but not being hot The symptoms resemble what Translated and Compiled by Sharon Weizenbaum 2021

48 Tian Hua Fen Ebook is called depression in modern times The formula is assisted by He Huan Hua which can rectify Qi and resolve constraint nourish the heart calm the spirit harmonize the Luo vessels and stop pain The four flavor of this formula are all relatively neutral and harmonious All of them enter the heart and lung channels When there is heart and lung Yin deficiency with deficiency heat constrained and knotted in the chest area this causes symptoms of chest oppression and discomfort and emotional upset By means of these four herbs combined together the chest area will open and flow and all of the symptoms will resolve This is why this formula has the name of Shu Xiong Tang Flowing in the Chest Decoction There are many patients now a days who suffer from depression When this formula is used combined with counseling there is a clear effect Modifications With cough with sticky phlegm or yellow phlegm add 15 gm Sang Bai Pi and 10 gm Zhi Mu With obvious oppression and pain in the chest and rib side area add 10 gm each of Yu Jin and Dan Shen With poor sleep quality add 30 gm Suan Zao Ren and 50 gm Han Xiu Cao With poor appetite add 15 gm each of Shan Zha and Mai Ya Translated and Compiled by Sharon Weizenbaum 2021

49 Tian Hua Fen Ebook For dry knotted stool with abdominal distention add switch Gua Lou Shi to 30 gm Gua Lou Ren And add 10 gm Zhi Qiao For dizziness add 15 gm Bai Hang Ju and Bai Shao For tinnitus add 30 gm each of Mu Li and Zhen Zhu Mu For weakness of the whole body add 30 gm Sang Ji Sheng and 15 gm of Xi Yang Shen For afternoon tidal fevers and spontaneous sweating add 12 gm Di Gu Pi and 30 gm Fu Xiao Mai For Heart palpitations with lack of calmness add 10 gm each of Xi Yang Shen separately cooked and Wu Wei Zi and 12 gm Mai Dong Gua Lou Gui Zhi Tang Gua Lou Gen 2 liang 6g Gui Zhi 3 liang 9g Shao Yao 3 liang 9g Gan Cao 2 liang 6g Sheng Jiang 3 liang 9g Da Zao 12 dates 4 dates Translated and Compiled by Sharon Weizenbaum 2021

50 Tian Hua Fen Ebook Original text Jin Gui Yao Lue Chapter 2 on Convulsions Dampness and Heat Stroke Diseases Line 7 There has already been a Taiyang disease and now there is diffuse body stiffness feverishness with deep slow pulses This is convulsion syndrome Gua Lou Gui Zhi Tang governs From Experience with Classic Formulas from Renowned Physicians collected by Liu Du Zhou Case 1 Soft Spasms10 Mr Ding was a 6 month old child Symptoms At the beginning of summer in 1931 he developed a whole body fever with sweating mouth thirst deviated eye neck tightness opisthotonos tetany of the arms and legs cold finger tips inflated and purple fingerprints yellow thin tongue moss Diagnosis Wind and damp damage attacking and entering the Taiyang Wei level Exterior deficiency with fluid damage so that the tendons and vessels were without nourishment Treatment method Regulate and harmonize Yin and Yang Enrich and nourish the Ying fluids with Gui Zhi Gua Lou Tang 10 1 1965 2 Translated and Compiled by Sharon Weizenbaum 2021

51 Tian Hua Fen Ebook Gua Lou Gen 6g Gui Zhi 3g Bai Shao 3g Gan Cao 2 4 g Sheng Jiang 2 slices Da Zao 2 dates This was decocted in water After 3 packages the presentation had diminished Dang Gui 3g Chuan Bei 3g Qin Jiao 3g Sheng Di 6g Bai Shao 6g Translated and Compiled by Sharon Weizenbaum 2021

52 Tian Hua Fen Ebook Gua Lou Gen 6g Ren Dong Teng 6g Decocted in water After 4 packages there was a cure Case 2 Pediatric Soft Spasm11 Surprise attack on a child A wind evil came from the outside and damaged the interior There was sweating red face and head tremor This changed and became soft spasm The neck and back were rigid and his eyes were fixed with his head face upward His pulse was deep and slow This was due to wind cold The deep pulse showed the root of the spasming vessels and the slow pulse indicated cold This was on the Taiyang channel and looked like cold damage but actually was not The formula to use was Gui Zhi Tang to harmonize the Ying and Wei and dispel the wind cold evil Gua Lou Gen was added to clear the Qi level heat so that the Taiyang channel Qi would be regulated When the channel Qi is open through and flowing smoothly the wind evil is spontaneously resolved 11 t 1 1986 3 Translated and Compiled by Sharon Weizenbaum 2021

53 Tian Hua Fen Ebook Hua Fen 9g Gui Zhi 4 5 g Sheng Bai Shao 9g Zhi Gan Cao 3g Sheng Jiang 3g Hong Zao 4 dates I also have a case involving a woman who had sudden lockjaw opisthotonos deviated eyes and inability to speak I said that this was soft spasm and gave Gua Lou Gui Zhi Tang The effect was seen after one package After three packages there was a cure Over the years there have been many cases like this Many practitioners mistakenly give Zi Ling Dan Case 3 Postpartum convulsions 12 Ms Qin age 20 Autumn 1948 She was postpartum 7 8 days when she became dizzy with flowery vision and an inability to sit up When she was in the clinic she suddenly began to have spasms in her fingers She 12 1 1978 Translated and Compiled by Sharon Weizenbaum 2021

54 Tian Hua Fen Ebook yawned one after the other opening her mouth wider and wider to the point that the corners of her mouth split and began to bleed We had to force it shut but it went on Her facial color was pale white Her eyes were staring and she drooled Occasionally she had a cold sweat She was comatose Her pulse was wiry moderate and without strength Differentiation of the pattern The recent birth involved blood loss and damage to the Yin Sweating damages the Yang In addition she received and external contraction and the wind entered the channels and gave rise to spasms This was a forceful presentation of Yin exhaustion and Yang breaking away Treatment method Return the Yang and consolidate the breaking away dispel wind and calm spasms Formula and herbs 15 g Korean Ren Shen as urgently boiled and given to her After half an hour there was a change for the better I continued with Gua Lou Gui Zhi Tang with added flavors Gua Lou Gen 12 g Zhi Gan Cao 9g Sheng Jiang 9g Da Zao 5 dates Korean Ren Shen 9g Translated and Compiled by Sharon Weizenbaum 2021

55 Tian Hua Fen Ebook Zhi Huang Qi 30 g Gui Zhi 6g Hang Shao 9g Fu Pian 4 5 This was decocted in water After 1 package the sweating diminished and after 2 packages the spasms resolved She still felt dizzy and tired The exterior was consolidated and the Yang had returned but the Yin and blood were depleted I wanted to nourish the blood and calm spasming supplementing both the Qi and blood I gave her Gua Lou Gui Zhi Tang plus Si Wu Tang modified Gua Lou Gen 9g Zhi Gan Cao 6g Dang Gui 9g Chuan Xiong 4 5 g Korean Ren Shen 9g Translated and Compiled by Sharon Weizenbaum 2021

56 Tian Hua Fen Ebook Zhi Huang Qi 30 g Gui Zhi 4 5 g Hang Shao 9g Sheng Di Huang 15 g Gou Teng 9g After 2 more packages the dizziness decreased and her spirit was recovering with each passing day Discussion Zhang Zhong Jing said In Taiyang illness with fever and sweating and no aversion to cold this is called soft tetany As for the cause of soft tetany it is excessive wind on the outside crosses over to damage the interior What is seen is body rigidity and stretching with a deep slow pulse This Ji Ji refers to the back being rigid all the way to the neck where one cannot lift the head As for the pulse being deep and slow the deep pulse means that the spasming is based in the vessels and the slow pulse means that the fluids are insufficient so that the movement of the Ying and Wei is inhibited Gua Lou Gen is the principle herb of Gua Lou Gui Zhi Tang It enriches and nourishes the fluids to Translated and Compiled by Sharon Weizenbaum 2021

57 Tian Hua Fen Ebook enable relaxation to the tendons and vessels Gui Zhi Tang dispels the wind evil resolves the muscles and harmonizes the Ying and Wei It makes the channel Qi flow and open through in a united way In this way the wind evil is spontaneously resolved The tendons soften and the tetany is cured In case 1 the patient was a 6 month old baby There was a fever with sweating This damaged the moisture and plundered the fluids This caused deviated eyes and neck rigidity opisthotonos and spasming of the fingers After taking Gua Lou Gui Zhi Tang all the pathology diminished To deal with the aftermath after that herbs were given to nourish the blood and generate moisture while clearing heat and opening though The wind evil spontaneously resolved Case 2 involved a child with spontaneous sweating red face head tremor neck and back rigidity opisthotonos upward facing head and a deep slow pulse This corresponds to the Jin Gui soft tetany presentation and calls for Gua Lou Gui Zhi Tang He also had a woman patient with lockjaw opisthotonos eyes staring straight ahead Dr Fan decided that this was soft tetany and also gave her Gua Lou Gui Zhi Tang Since the formula probably matched the presentation the patient must have had sweating and a deep slow pulse Otherwise it would not be right to give Translated and Compiled by Sharon Weizenbaum 2021

58 Tian Hua Fen Ebook this formula One must be careful not to mistake soft tetany for warm illness with flourishing heat and moving wind in which you would give Zhen Ling Dan If the differentiation is not clear and cold and heat are mixed up certainly the effect will not be good In case 3 Dr Qin saw a newly partuent woman Hemorrhage had damaged her fluids Profuse sweating also damaged her Yang Then she received an external evil Wind excess on the exterior caused tetany He urgently boiled some Korean Ren Shen Tang to supplement fluids and generate fluids Then he continued treatment by using Gua Lou Gui Zhi Tang to relax the tendons and vessels and to dispel the wind evils He added Shen Qi and Fu Zi to boost the Qi and return the Yang consolidate the exterior and stop sweating He waited for the sweating to become scanty and for the tetany to moderate and then he again gave Gua Lou Gui Zhi Tang but this time with Si Wu Tang and other modifications This embodies the saying that During the postpartum time one should greatly supplement Modern doctors use this formula to treat focal type encephalitis that has been differentiated as soft tetany Gua Lou Gui Zhi Tang VS Gui Zhi Jia Ge Gen Tang Below is a case in which the patient had Rigid Human Syndrome After reading this case I wondered why the doctor used Gui Zhi Jia Ge Gen Tang and not Gua Lou Gui Zhi Tang Here is the case from Dr Zh ng Zh nd ng Translated and Compiled by Sharon Weizenbaum 2021

59 Tian Hua Fen Ebook Ms Wang was age 52 She had a tendency to perspire In October of 1985 she felt her lower limbs tighten up with pain Gradually this moved to her neck Her lower limbs became stiff and convulsed She was unable to work in the field This was accompanied by difficulty breathing that sometimes became stifling In the hospital she was diagnose with Rigid Human Syndrome At the time of her consultation her head and neck were rigid and she could not move about or turn easily Her whole body was thin and weak Her facial color was sallow her speech was unclear and her spirit was aloof Both eyes were constrained and bounded Her chest was locked and her breasts stuck out Her abdominal muscles were tense and the muscles of her four limbs were stretched tight Her reflexes were hyperactive Her toes were cramped so that they were adhered toward the soles of her feet Her whole body was moist with sweat Her tongue was red with thin white moss Her pulses were thin and wiry This was in the category of Ying Wei disharmony in which sweating had damaged the fluids so that the tendons and vessels lost their nourishment She was given 30 packages of the following formula Ge Gen 30 gm Gui Zhi 10 gm Sheng Jiang 10 gm Translated and Compiled by Sharon Weizenbaum 2021

60 Tian Hua Fen Ebook Bai Shao 10 gm Gan Cao 5 gm Da Zao 5 dates Her sweating stopped and her whole body had a soft harmonious feeling 3 gm of Quan Xie as given powdered to be taken as a draft and she was given 30 more packages After that she could work in the fields and walk When looking at this case I first notice that the patient was over 50 had a sallow complexion and an emaciated body This body type was in the category of Yin and blood deficiency Then I saw that this was This was in the category of Ying Wei disharmony in which sweating had damaged the fluids so that the tendons and vessels lost their nourishment This should indicate Gua Lou Gui Zhi Tang Although Ge Gen is similar to Gua Lou Gen in that it clears heat generates fluid and enriches the moisture in the channels and vessels Ge Gen also resolves the muscles by diaphoresis in a relatively strong way This could further damage the fluids Gua Lou Gen is relatively strong at clearing heat and resolving the muscles and its ability to supplement deficiency is stronger than that of Ge Gen Dr H X sh refers to Gua Lou Gen being very strong in its function to supplement deficiency Translated and Compiled by Sharon Weizenbaum 2021

61 Tian Hua Fen Ebook However I thought about this later and could see that the reason Ge Gen was used was based on rational theory After careful pondering I saw that this patient s pulse was wiry and thin and that this was the real crux of the issue If the pulse had been deep slow and without strength that would have shown that clearly the fluids had been severely damaged In the end the degree to which the pulse is without strength in its beating is how one can know that Ge Gen is not suitable The wiry thin pulse indicates that that there is fluid damage but that nevertheless the channels and vessels are also constricted Moreover the latter is the principle contradiction the doctor wanted to resolve It is because of wanting to resolve this question that the doctor used Ge Gen s ability to resolve the muscles relax that channels and generate fluids Perhaps this is exactly why the doctor used the original formula Gui Zhi Jia Ge Gen Tang A senior once said the difficulty with Chinese medicine is in selecting and distinguishing and when differentiation formula patterns is the pinnacle of Chinese medicine s differentiation of patterns The more one differentiates the formula pattern with meticulous care and flawless accuracy the more one can master the herbs in the formula with high proficiency In examining and studying this case I am able to understand these similar formulas and these two similar herbs with slight differences Again I take a deep sigh when I realize the greatness of Zhongjing And now I have shared this consideration and experience with all of you Translated and Compiled by Sharon Weizenbaum 2021

62 Tian Hua Fen Ebook Gua Lou Mu Li San Gua Lou Mu Li San Tian Hua Fen 20 30 gm Mu Li 20 30 gm Grind the above herbs into powder and take 3 6 gm 3X day Take in rice water Alternately this can be decocted in water and should be taken slowly Original Text Jin Gui Yao Lue Chapter 3 line 7 In Lily Disease if thirst is not cured the following formula is indicated Gua Lou Mu Li San Discussion13 Function Boost Yin and submerge Yang moisten dryness and stop thirst Principle Presentation Lilly disease Yin deficiency with inner heat deficiency Yang floating upward thirst dry mouth slightly rapid pulse Principle Illness wandering mind heart vexation Principle actions 13 From the 1983 cs 351 Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 63 Principle Presentation Lilly disease Yin deficiency with inner heat deficient Yang floating to the surface mouth thirst dry mouth rapid and minute pulse Adjunctive Presentation Obscured consciousness and heart vexation Clinical Modifications 1 Yuan Zhi Gui Ban Shi Hu and Sheng Di can be added to treat Lilly Disease when the Yin is extremely deficient 2 Bai He Zhi Mu Yuan Zhi Tai Zi Shen and Sheng Di can be added to treat neurosis 3 When this formula is used as a decoction it is also very effective 4 In regard to the cooking and administration method A decoction made from the powder is recommended Generally the boiled powder is taken 3 4 times This way it will be easy to assimilate One should avoid taking a large dosage as it could stimulate the digestion Taken as a decoction 1 3 to 1 6th can be taken once every 4 hours This method is similar to the western medical concept of half life This can be quite effective Application method for boiled powder The herbs should be coarsely ground and 20 30 gm can be given 2 3 times a day for an Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 64 adult This can be increased when the condition is more serious After soaking the powder in cold water bring to a boil while stirring Then simmer 3 6 minutes stirring vigorously Gu L u Q M i W n Fu Zi 1 piece 6 gm Shan Yao 3 liang 9 gm Fu Ling 3 liang 9 gm Qu Mai 1 liang 3 gm Tian Hua Fen 2 liang 6 gm Grind all the ingredients and blend with honey to form pills the size of firmiana seeds Take three pills with fluid three times a day If no effect is noticed increase the dosage to seven or eight pills Disinhibition of urine and warmth in the stomach can be taken as indicators that the formula is working Single dose is 1 8 or 4 5 gm Daily dose is 5 4 gm or 13 5 gm Original Text Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 65 Jin Gui Yao Lue Chapter Dispersion Thirst Inhibited Urination Strangury Line 10 Inhibited urination means that there is water Qi and that the patient suffers from thirst Gua Lou Qu Mai Wan governs Discussion When there is lower Ji o Yang deficiency there is a loss of command over the q transformation This leads to unbeneficial urination with interior water q stoppage The water fluids are not steamed up and therefore the person suffers from thirst The appropriate treatment is to warm the yang transform qi benefit water and moisten dryness This will address the root as well as the symptoms simultaneously Gu L u Q M i W n contains Gu L u and Sh Y to moisten dryness and stop thirst F L ng and Q M i seep drainage and benefit water P o F Z warms the yang and transforms qi When the flame floats upward enriching will inevitably extinguish fire When there is accumulation below warming will most certainly disperse When water is pooled up benefitting will of course dispel In this formula there is cool moistening pungent moistening and seeping disinhibiting used together These methods are not mutually exclusive Take the construction of Shen Qi Wan as an example This is truly an effective formula In the clause for this formula Zhang Zhongjing adds the following note When the urination starts to flow normally the lower abdomen will become harmoniously Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 66 warm We can see from this that the patient in addition to having unbeneficial urination also have symptoms of cold in the abdomen Using this formula stimulates the lesser fire ministerial fire which is the Yang Qi The abdomen then naturally warms up 14 What is the function and application of Qu Mai The name is similar to a grain like plant but it would be a grave error to think of it this way Qu Mai is actually a wide ranging and profound herb among herbs in our China Qu Mai blooms in the summer and is a pale red or white color It can be planted in pots or grown as a border or in a rock garden It is beautiful to look at As a medicinal herb its application and use is quite broad What is its use and application It is bitter and cold discharging downward It can clear the heart and small intestine fire It has the function of conducting heat downward It can also benefit urination Generally it is used for lin diseases being especially good for heat lin It is often combined with Bian Xu Mu Tong and Che Qian Zi Together these herbs treat lin droplets that contain blood While it benefits urination it also can vitalize blood and open through menstruation Therefore it is very often used to treat idiopathic amenorrhea It is very appropriate for blood stasis amenorrhea It is a very good herb to regulate menstruation If the cycle is long it can be taken as a tea This From Appraising Jin Gui Formulas through One Hundred Cases and Discussion compiled and written by H R n Zh ng Zh m n and Li n Ji nw i Zhe Jiang science and technology press September 1991 pg 232 14 Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 67 is a simple way of taking it Although Qu Mai is a wonderful herb it is by no means appropriate for pregnant women or newly partuent women 15 Case 1 Blocked urination16 Dr Zh Zhu f The patient was named Ch n At the beginning she suffered from a L n pattern Over time though her urination came in droplets and was painful Examining her pulse image the right side was deep and moderate I gave her three packages of Gu L u Q M i W n as follows Fu Pian 15 gm Shan Yao 24 gm Fu Ling 15 gm Qu Mai 9 gm Hua Fen 15 gm Che Qian Niu Xi 15 https www 38xf com 2017 1215 960754 html 16 From 1980 3 Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 68 Her urination opened through like a spring Discussion This patient had lin syndrome that over time became blocked urination The right side pulses were deep and moderate This indicated kidney Yang deficiency with loss of command over the Qi transformation The original Gu L u Q M i W n warms the Yang and transforms the Qi seeps to drain and benefits water Adding Che Qian and Niu Xi uses the modification of Shen Qi Wan method from the J Sh ng to strengthen the release of the movement downward and benefitting water Case 2 Water swelling Dr W i Ch ngch n The patient was a man age 34 He came for his first consultation on April 18 1959 His kidney Yang was insufficient with loss of Qi transformation Phlegm water was stagnating on the interior Above he was panting and he had swelling His urination was scanty and his stool was dry and knotted He had chest and rib side pain and his face was pale white His left pulses were deep and thin and the right were deep and slippery His tongue was pale red The treatment principle was to warm the kidneys open through the Yang and benefit urination This would be assisted by opening the bowels and urination and dispelling phlegm Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook Qu Mai 9 gm Dan Fu Zi 6 gm Fu Ling 24 gm 69 Tian Hua Fen 9 gm Huai Shan 12 gm Yao Ji o M 1 5 gm Chen Xiang 3 gm Che Qian Zi 9 gm Huai Niu Xi 9 gm K ng Xi n 3 gm D n17 swallowed 3 packages Second visit The original Yang returned The urination increased and the water swelling retreated The chest and rib side pain also diminished Her belly became soft and her appetite increased Her complexion had become good She felt some slight dizziness Her pulses were moderate 17 Is made up of G n Su heart removed D J peel removed and B i Ji Z for strongly removing phlegm fluids Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 70 and her tongue was pale red with thin white moss I gave her sixteen packages of the previous formula with the K ng Xi n D n removed Third visit The disease had recovered Her pulses were moderate and her tongue pale red To consolidate the treatment I warmed the illuminating source Yang Qu Mai 15 gm Dan Fu Zi 6 gm Fu Ling 24 gm Che Qian Zi 9 gm Huai Shan 12 gm Yao Jiao Mu 1 5 gm Huai Niu Xi 9 gm B J R u 9 gm Chuan Duan 9 gm Four packages Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 71 18 Discussion This was a mixed excess and deficiency case The kidney Yang deficiency was the root and the phlegm water contained within was the excess Therefore the treatment method was to use Gu L u Q M i W n with Che Qian Zi and Niu Xi to warm the kidneys open through the Yang and benefit water This was assisted with K ng Xi n D n Ch n Xi ng and Ji o M to open through urination and discharge phlegm The root and branch are worked with together The evil and the correct are both treated When the water swelling retreated the K ng Xi n D n was removed Ba Ji and Chuan Duan were added to strengthen the treatment of the root Case 3 Short scanty urination19 Dr H R n On February 4 1983 I treated a woman named L She presented with mouth thirst short scanty urination and a feeling of cold in the lower abdomen as if there was water there Her menstruation was scanty and pale Her pulses were deep and her tongue moss was white and dry This 18 1 10 1984 19 Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 72 was an upper dryness and lower cold pattern I gave her Gu L u Q M i W n to boil as a soup Qu Mai 6 gm Dan Fu Zi 4 gm Fu Ling 12 gm Tian Hua Fen 9 gm Shan Yao 12 gm After taking five packages the mouth thirst decreased a there was only slight lower abdominal coldness The urination was normal I continued with seven packages of the original formula and there was a cure Differentiating Gua Lou Qu Mai Wan and Wu Ling San20 It can be seen that both of these formulas treat mouth thirst and unbeneficial urination It seems important to then differentiate the two Below are my own student contemplations and I hope those senior to me make corrections and give advice The clauses for Wu Ling San are below 1 Floating pulse unbeneficial urination slight heat dispersion thirs it is appropriate to benefit urination and induce sweat Wu Ling San governs 20 http www hhjfsl com bbs forum php mod viewthread tid 26470 highlight Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 73 2 When there is pulsing below the umbilicus vomiting of clear fluids insanity and dizziness in a frail person this is water and Wu Ling San governs 3 When there is thirst with a desire to drink but when water enters there is vomiting with water rebelling every day Wu Ling San governs 4 A sweat has already been promoted and the pulse is floating and rapid and there is vexation and thirst then Wu Ling San governs 5 When in cold damage there is sweating and thirst Wu Ling San governs The clauses for Gua Lou Qu Mai San are below 1 Inhibited urination means that there is water Qi and that the patient suffers from thirst Gua Lou Qu Mai Wan governs From these clauses it can be seen that the symptoms share the common ground of thirst and unbeneficial urination They are dissimilar in that Wu Ling San symptoms include that it is an exterior pattern with cold damage slight heat sweating floating pulse pulsations below the navel vomiting of rheum water reversal mania and vexation Gua Lou Qu Mai Wan has warms in the abdomen From this we can infer that the symptoms would be cold in the abdomen cold limbs superficial yellowing of the complexion water tongue moss and deep pulse Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 74 Analysis of the ingredients for the meaning of the formula and the patho mechanism it addresses Wu Ling San is composed of Fu Ling Zhu Ling Ze Xie Gui Zhi and Bai Zhu It treats the water reservoir and it works as a kind of sluice gate for when the thoroughfare is blocked by a wind cold evil The sluice gate is unable to drain off the water in the lower reaches This creates the unbeneficial urination situation At the same time because the sluice gate mechanism of the reservoir is blocked by the wind cold evil it also can t pump the water to the upper reaches Therefore there is mouth thirst Gui Zhi takes care of opening the blockage from the wind cold so that the water pathways can open through and disinhibit the water ways Ze Xie Fu Ling and Zhu Ling open the sluice gates making it so the water can move downward and go out through the lower reaches One aspect of Bai Zhu is that it makes the earth soil stronger for the water pathways It prevents the dikes and dams that hold the water from collapsing and flooding the flooding is what causes the pulsations below the navel vomiting of rheum and water reversal At the same time it has the action of raising the clear so it activates the water pump mechanism This causes the water to migrate upwards from the water reservoir decreasing the water pressure in the reservoir Therefore the patho mechanism for the Wu Ling San pattern is an external cold evil blocking the Taiyang Fu causing the normal Taiyang cold water to be unable to open through Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 75 Gua Lou Qu Mai Wan is composed of Fu Ling Huai Shan Shan Yao Fu Zi Qu Mai and Gua Lou This is a pattern of water cold ascending upward with the dragon The cold water and the dragon are not stored The dragon flies to the upper reaches and the water will then follow However because the cold water has solidified it does not follow the dragon s movement Therefore the dragon compels itself to the upper Jiao s misty dew to moisten its body This is what causes the person to have thirst Fu Zi arouses a low fire within the cauldron When the fire is sufficient the cold transforms When the cold transforms this causes the water to follow the dragon s movement However the distant water finds it difficult to rescue the nearby fire This is why Gua Lou Gen is used to rescue the upper source of water The flavor and nature of Gua Lou Gen is also bitter and cold It is a root so it burrows right into the earth It can guide the dragon to enter the sea Additionally there is Qu Mai to open through the water pathways It removes obstruction of the ascending and descending of the water pathways Fu Ling is used as a guide It guides the dragon to go along with the direction of the water and return to the palace of the sea god When the dragon is within the palace the abdomen becomes warm When the water Qi is governed like this the urination can exit as well Huai Shan has three functions The first is to consolidate the middle earth The second is to moisten the pathways The third is to benefit the raising of clear water Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 76 Therefore the patho mechanism that Gua Lou Qu Mai Wan matches is upper dryness and lower cold The lower cold is the cause of the upper dryness The Jin Gui Yao L e Xin Dian when flames float upward without juicy moistness they cannot be extinguished When Yin accumulates below without warmth it cannot disperse Neijing Heaven s Qi ascends as clouds Earth s Qi descends as rain Clouds are the issuing out of Earth s Qi Rain is the issuing out of Heaven s Qi Comparing the two formulas Wu Ling San is a Yang exterior pattern while Gua Lou Qu Mai Wan is a Yin interior pattern Mu Li Ze Xie Tang Formula Constituents Equal amounts Mu Li dry fried Ze Xie Shu Qi washed in warm water to remove fishy smell Ting Li Zi dry fried Hai Zao wash salt away Gua Lou Gen Tian Hua Fen Shang Lu Gen Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 77 Using equal amounts of each ingredient Grind them separately and then blend them in a mortar Mix 6 9 gm of powder with rice soup and take three times a day When urination returns to normal stop taking the herbs Original Text Line 395 When there is water Qi below the waist after recovering from a major disease Mu Li Ze Xie Tang governs Discussion This formula treats water swelling below the waist with diminished righteous Qi In the clinic this is seen as lower limb or lower abdominal swelling that does not disperse The bowels and urination are inhibited A special characteristic of this presentation is a deep pulse Mu Li combined with Gua Lou Gen nourishes the Yin and clears heat vitalizes the blood and softens hardness This is aimed at a disease mechanism that arises from the Liver The other 5 ingredients attack and disinhibit evil water These are aimed at the branch which is in the 3 Jiao According to reports it treats liver cirrhosis very effectively Case 1 Water Swelling Ye Tian Shi Case History Male with a rough pulse Each time the Yang Qi moves there is Yi There are gurgling water sounds under the left rib side with water Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 78 descending to the lower belly Evidently this swelling and distention is not due to the Yang pathway being inhibited This is a case of the Yin pathway excess The damp heat of water and grain have not transformed I suggested Mu Li Ze Xie Tang Mu Li Ze Xie Hua Fen Chuan Gui Zhi Mu Fu Ling Zi Hou Po He took it at noon and was cured Discussion Swelling distention with a rough pulse This appears as water fluids knotted together and dropping and descending into the lower abdomen When water knots it tends to go down In this kind of case Mu Li Ze Xie Tang is used to vitalize blood disinhibit water soften hardness and scatter knotting Case 2 Suspended fluids Seeping type pleurisy 21 Dr Li Hao Peng Master Du s older sister was more than 60 years old She had suffered from pulmonary tuberculosis for more than 10 years with repeated relapses Sometimes the condition was mild and sometimes it was serious Three weeks previously she began to feel a cutting pain under her ribs She coughed spittle and felt a drawing pain She had simultaneous chills and fever She was given the western medicines streptomycin and rimifon type anti TB drugs These all helped alleviate 21 From He Nan Zhong Yi 1989 4 14 Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 79 the condition but she still suffered from pain with cough An X Ray revealed exudative pleurisy on the right side Because there was a fear that fluids could penetrate into the pleural cavity she sought a consultation with a Chinese medical doctor Presentation Her facial color was grey She was frowning and made suffering groan sounds She had a cough and was flustered She had to support herself to breath and could not lay down When she coughs she must hold her rib sides and felt pain when she turned She dripped with a cold sweat She felt full and distended with a poor appetite She would go several days with no bowel movement Her urination was short and yellow Her tongue moss was white and dry with scanty fluids This was undoubtedly a case of Suspended Fluids type Qi knotted and fluids blocked For treatment it was appropriate to relieve edema and reduce fluids open knotting and regulate Qi I had to keep in mind that this patient was more than 60 years old with chronic consumption Her Zheng Qi was not strong and so while removing water and dispelling phlegm I also boosted Qi and vitalized blood Duan Mu Li 30 Ze Xie 15 Ting Li Zi 15 Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook Shang Lu Gen 6 Gua Lou Gen 30 Hai Zao 15 Hong Shen 10 Dang Gui 10 Huang Qi 15 1 package day divided into 2 5 packages 80 doses Second visit In the beginning when taking the herbs she felt agitated and oppressive heat with the desire to vomit When she took the second package she heard gurgling noises and then had watery diarrhea with phlegm several times Immediately she felt comfortable in her chest and breath I continued with 20 more packages of this formula and her presentation resolved The X Ray showed that the water was completely cleared I continued with 8 precious and 4 gentleman to consolidate the result Discussion Translated and Compiled by Sharon Weizenbaum 2021

Tian Hua Fen Ebook 81 When evil water knots in the chest and rib side one treats by opening the knotting and scattering fluids using modified Mu Li Ze Xie San The effect is good According to Li Hao Peng s experience when there are alternating fever and chills one can combine Xiao Chai Hu Tang When there is a deficiency presentation he combines Ren Shen and Huang Qi When there is extreme rib side pain he combines Si Ni San When there is water knotting chronically with Qi deficiency and blood stasis He removes out Shu Qi and decrease Shang Lu while adding Ren Shen Hong Hua Tao Ren and Dan Shen When there is Yin damage Yi Wei Tang is combined When there is simultaneous Yang deficiency Fu Zi and Rou Gui will be added Translated and Compiled by Sharon Weizenbaum 2021