Inside the Brain of an Herb Nerd

Weekends mean chilling hard and catching up on herbal studies.  Today I’ll share some nerdery to show where I am with theory and talk about how these formulas work.  Later in the post, I’ll also discuss how herbal medicine can treat psychological complaints like anger and depression.

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So this is a pic of a formula that was written by the cardiologist.  I remember this patient because his complaint was straight up insomnia – no hypertension, no dizziness.  Yes, there was some epigastric discomfort as well but the insomnia was serious.  More than two years unable to sleep, getting around max 2-3 hours.

What was the cause?  Anger.

We didn’t psycho-analyze.

Pulses were banging.  Really superficial.  Right on the skin.  Both sides the same.  Wiry.  Tongue was paler than I thought it’d be.  I was expecting a red tongue body from the heat but it wasn’t there.

The diagnosis was Liver Qi and Blood Stasis, which basically means serious stress.

For TCMers out there, here’s the pinyin and quantity of the herbs:

Qing Ban Xia 12g

Huang Qin 10g

Huang Lian 10g

Gan Jiang 6g

Dang Shen 10g

Qing Pi 15g

Chen Pi 15g

Chai Hu 15g

Yu Jin 20g

Fo Shou 10g

Xiang Yuan (Grapefruit) 10g

Chao Zhi Shi 20g

Zhu Ru 10g

Chao Tao Ren 10g

Yuan Zhi 15g

He Huan Pi 30g

Gan Cao 6g

This calming formula is very cardiology-oriented.  Move Blood.  Clear Phlegm.

If you can balance it right, it seems like there’s never any real contraindications to Moving Blood.  Not enough Qi? Add Qi.  Not enough Blood?  Add Blood.  Not enough Yin?  Add Yin.

Calm.  Cool.  Move.  Warm.  Transform.  Break Qi and Blood Stasis.

I remember the tongue being more pale.  Maybe it was that “gray” color he talks about.  Stasis.

All the movers and phlegm clearers really loosen the vessels and detox the body of past shit (interesting to see no drain damp herbs to promote urination – maybe more about the pooping).  Also interesting to see no Di Long and Shui Zhi for the opening the collaterals.  No hypertension and dizziness, so no need, I guess.

The secondary complaint was epigastric discomfort – probably due to Liver Qi Stag.  I don’t know all the details but by the formula, it looks like Stomach Qi Stasis.  Qing Pi, Chen Pi, Zhi Shi, Fou Shou, and Xiang Yuan all treat these symptoms.  They’re mostly warming but balanced by the Huangs as well as the Zhu Ru (so useful).

He was talking about Old School style (老中医) versus his modern style and I’m getting the picture here.  Old School takes longer and uses less herbs but still works.  New School gets quick results with more herb variety and symptomatic treatment.

At the same time – what are the heavier hitters here?

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For me its: Chai Hu 15g, Huang Qin 10g, Ban Xia 12g, Dang Shen 10g, Gan Cao 6g, and Gan Jiang 6g.   It’s Xiao Chai Hu Tang minus Sheng Jiang and Da Zao but subbing in Gan Jiang (it’s also Ban Xia Xie Xin Tang).

That’s the Old School core of the formula from – like, hell yeah – the Shang Han Lun classic.

On top of that there’s Yu Jin 20g and Tao Ren 10g.  These two move blood and are slightly cooling.  Reduce inflammation and relieve long-term stress in the vasculature.  Treat some phlegm too, I bet.  Heavy movers.  Break Stasis.

All the Qi Movers do their thing for the secondary complaints.  Liver Qi Stagnation attacking the Stomach resulting in Stomach Qi Stagnation. New School.  Quick Relief.

Yuan Zhi and He Huan Pi are the insomnia quick relievers.  They’re his go to but he has other power couples as well.

30g He Huan Pi – don’t be afraid, TCMers!  It works!

I love this formula.  Just look at it.  Treating the root! No Suan Zao Ren here.  He knows he’s got to cool down that pulse – I mean, that thing was bumping.  You’d have thought his insides were on fire.  Hypertension.  Stomach Heat.  Something.  But it was all showing up in his sleep.

Mind-Body Medicine

Here’s where you have to wonder about the question of talk therapy.  This guy has some kind of psychological issue.  Anger management.  Actually, he was friendlier than others..  Just some demons in there.

What does the cardiologist do?  Basically, he detoxes the guy.  The patient’s anger or his exposure to anger has, over time, lead to an internal environment that perpetuates this anger.  It’d be very difficult for him to just wake up one day and turn over a new leaf.  It’d be hard for a therapist to quickly talk him out of this anger.

In the end, it’s holistic.  The anger is in his body as much as it is in his mind.  If we clear the inflammation from the body, he can more easily move to the next step in his life.

Beautiful stuff, this medicine.  Hoping to see this patient again in a few weeks.  Will keep you all posted.

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2 Responses to Inside the Brain of an Herb Nerd

  1. Shawne says:

    So dope. Thanks for spreading the educational love. Keep the herbal case studies coming!

    Like

  2. Ken Lau says:

    I heard a tried recently a different Shang Han formula. Si ni san. Chai Hu;Bai shao duo Yao for the liver

    Bai shao holds and astringens the blood and chai spreads and moves upwards the two major functions of the liver. When the liver is happy and relaxed it can do its job well. Apparently and forceful/wiry pulse in all positions is a classic indication for si ni San. Tried it recent. Purge liquid the first dose the solid the second. Was able to let a epigastric tension I had been holding for weeks pass. Food for thought. Miss you and hope to see you shortly.

    Ken Ken

    Ps I graduate in a few weeks!!!

    >

    Liked by 1 person

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