逍遥散

nullPrescriptions for Regulating the Liver and SpleenPrescriptions for Regulating the Liver and Spleen The formulas in this section are used when there is an imbalance between the functions of the liver and spleen, which may result from either of two processes. When the liver qi is constrained, it can move transversely and violate the spleen and stomach. Conversely, when the spleen qi is deficiency, its transporting function is diminisied, this in turn constrains the spreading of the liver qi. It is important to remember that these formulas are not intended primarily for conditions of deficiency; if they are used in those circumstances, the patient will become fatigued. It the internal disharmony is related to emotional or psychological problems, the best results will be achieved if the patient receives counseling in addition to herbal therapy.xiao yao sanxiao yao sanRambling Powder Source: Imperial Grace Formulary of the Tai Ping Era (Tai ping hui min he ji ju fang)nullRadix Bupleuri (chai hu) 30g Radix Angelicae Sinensis (dang gui) 30g Radix Paeoniae Lactiflorae (bai shao) 30g Rhizoma Atractylodis Macrocephalae(bai zhu) 30g(9g) Sclerotium Poriae Cocos (fu ling) 30g Honey-fried Radix Glycyrrhizae Uralensis(zhi gan cao) 15g (6g) Weijiang a little Bohe a littleIngredientsPreparation Preparation Grind the ingredients into powder and take as a draft in 6-9g doses with 6g of wei jiang and 3g of bo he. May also be prepared as a decoction. Available in prepared form.nullActions Soothing the liver, relieving qi stagnation, nourishing blood and invigorating the spleen.nullIndicationsSyndrome of stagnation of liver qi, deficiency of blood and the spleen.nullhypochondriac pain headache, vertigo a bitter taste in the mouth, dry mouth and throat fatigue, reduced appetite Tongue: pale-red tongue Pulse: wiry, deficient pulse There may also be irregular menstruation or distended breasts.Symptomsnull This is Liver constraint with blood deficiency. The relationship between the Liver and Spleen is very close. When the Liver qi is constrained its control over the Spleen becomes excessive, resulting in Spleen deficiency. This is known as transverse rebellion of Liver qi violating the Spleen. Deficiency of the Spleen, whose function is to transform nutrients into blood and qi, often results in blood deficiency. Conversely, blood deficiency (regardless of origin) can lead to Liver constraint. The Liver, a yin organ which stores blood, depends upon the yang to carry out its spreading function. But if the supply of Liver blood is insufficient, a surplus of qi may ensue, which is known as constrained Liver qi.null Liver qi constraint is indicated by pain along the Liver channel, especially in the hypochondria. In women this can manifest as distended breasts. Liver constraint and blood deficiency causes headache, vertigo, and a dry mouth and throat. Fatigue and reduced appetite are symptoms of Spleen deficiency. The tongue and pulse signs reflect the constrained Liver qi and blood deficiency.ANALYSIS OF FORMULAANALYSIS OF FORMULAChai hu -- soothes the liver to disperse the depressed qi—chief herb Dang gui and shao yao -- nourish the blood and relieve spasm and pain—deputy herbs dang gui affects the qi of the blood, making it an important herb in the treatment of Liver constraint and blood deficiency. nullThe joint use of the three drugs is able to treat the primary cause of stagnation of the liver-qi and deficiency of the blood. They act as main herbs to take care of both the liver structure and function as well as to regulate both Qi and blood. nullBai zhu and fu ling --strengthen the Spleen and thus its transforming and transporting functions zhi gan cao, tonifies the Spleen and, when combined with bai shao, moderates the spasmodic abdominal pain assistant herbsnullwei jiang, an envoy, harmonizes the Stomach and prevents the development of rebellious qi. The other envoy, bo he, when used in small doses enhances the chief herb's ability to relieve Liver constraint, and to disperse the heat due to that constraint.COMMENTARY COMMENTARY This is a variation of Frigid Extremities Powder (si ni san), which is widely used in internal medicine and in the treatment of women's disorders. It may be used for any condition with Liver constraint, blood deficiency, and Spleen deficiency characterized by hypochondriac pain, fatigue, reduced appetite, pale-red tongue, and a wiry, deficient pulse. null Its wide application was noted in the source text, which recommends it for such disorders as blood deficiency with fatigue, painful extremities and trunk, dizziness and heaviness of the head, palpitations, red cheeks, dry mouth and throat, fever, night sweats, reduced appetite, an increased desire to sleep, contention between the blood and heat with irregular menstruation, periumbilical and abdominal pain. It is also recommended for treating "virgin girls with weak blood and yin deficiency." The scope of this formula has been expanded even further in modern China. nullWith the appropriate presentation, this formula may be used in treating such biomedically-defined disorders as hepatitis, pleurisy, chronic gastritis, peptic ulcer, functional uterine bleeding, menopausal syndrome, pelvic inflammatory disease, fibrocystic breasts, neurasthenia, optic nerve atrophy, and central retinitis.MODIFICATIONS MODIFICATIONS For more severe hypochondriac pain with distention, omit bai zhu and add xiang fu. For intense, fixed pain due to blood stasis, add mu dan pi, yu jin and san leng. For pain over the liver with fatigue and reduced appetite, omit wei jiang and bo he, and add xiang fu, fo shou, dan shen and dang shen. For enlarged liver and spleen, add bie jia and mu li.