Jie Miao Qi Bao Yin

From the Family Collection of Yang’s Formulas

[Composition]

Chang Shan 3 grams, Hou Po, Qing Pi, Chen Pi, Zhi Gan Cao, Bing Lang, Cao Guo Ren each 1.5 grams

[Usage] When brewing the formula, use equal amounts of wine and water; increase the amount of wine for colder conditions, and increase the amount of water for warmer conditions. After brewing, let it sit overnight before consuming on an empty stomach. Modern usage: add a small amount of wine after brewing, and consume two hours before an episode of malaria.

[Indications] Malaria.

[Indications] Often with phlegm and dampness, frequent episodes of malaria, and a pulse that is wiry, slippery, and floating.

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[Functions] Eliminate phlegm and dry dampness.

[Formula Explanation] Ancient texts said, "Without phlegm, there is no malaria," indicating that phlegm and dampness are closely linked to the formation of malaria. Chang Shan, with its ability to eliminate phlegm and dry dampness, is a key ingredient in this formula, making it the primary agent. Cao Guo and Bing Lang promote qi flow and dispel toxins to open the channels blocked by phlegm and dampness, working in tandem with Chang Shan to eliminate phlegm and dry dampness, enhancing the formula’s effectiveness in treating malaria. The source of phlegm and dampness lies in the spleen and stomach; Hou Po, Qing Pi, and Chen Pi all have the effects of strengthening the spleen, drying dampness, and eliminating phlegm, making them complementary treatments. Zhi Gan Cao harmonizes all the herbs, acting as an auxiliary to guide and unify the formula.

[Clinical Additions and Subtractions]

① Remove Hou Po, Qing Pi, and Chen Pi, and add穿山甲, Zhi Mu, and U Mei, creating Jie Miao Chang Shan Yin (from Dan Xi Xin Fa), another formula for treating malaria and eliminating phlegm.

② For severe chills, add Gui Zhi; for severe vomiting, add Banxia and fresh ginger.

[References]

① "Chang Shan can expel old phlegm and accumulated fluid, Bing Lang can help break down food-related phlegm and blockages, Cao Guo can eliminate phlegm from the Taiyin region of grain and rice, Chen Pi promotes qi flow, Hou Po calms the stomach, and Qing Pi clears the liver—each of these herbs is a warming agent that disperses phlegm. Adding Zhi Gan Cao to the stomach helps to expel malaria phlegm." (Collection of Medical Formulas)

② "According to modern pharmacological experiments, alcohol is an excellent solvent; the active ingredients in Chang Shan and other malaria-treating herbs dissolve easily in water when mixed with alcohol." (Shanghai College of Traditional Chinese Medicine: Clinical Handbook of TCM Formulas)

[Commentary] Many of the herbs in this formula are pungent and warm, so they are not suitable for those with a naturally weak spleen and stomach, or those with internal fire.

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Chapter Four: Dual-Method Formulas for Resolving Both Exterior and Interior

For conditions affecting the exterior, use methods that promote sweating; for conditions affecting the interior, employ cleansing, purging, and warming therapies; for conditions affecting the semi-exterior, use methods that harmonize and resolve. When treating conditions that affect both the exterior and interior, which method should be used? In such cases, treating only the exterior will not eliminate the underlying pathology in the interior; treating only the interior will fail to alleviate the exterior symptoms. Thus, physicians developed dual-method formulas that treat both exterior and interior simultaneously. Any formula that possesses the ability to treat both exterior and interior is referred to as a dual-method formula.

Dual-method formulas for resolving both exterior and interior are further divided into three types based on the specific circumstances of the exterior and interior conditions: ① Resolving the exterior and attacking the interior: suitable for exterior symptoms combined with internal heat. ② Resolving the exterior and clearing the interior: suitable for exterior symptoms combined with internal heat. ③ Resolving the exterior and warming the interior: suitable for exterior symptoms combined with internal cold.

When using dual-method formulas, it is important to note: ① Clinically, one must recognize the presence of both exterior and interior conditions. ② Only by clearly distinguishing between the cold, heat, deficiency, and excess in the exterior and interior can one determine which type of dual-method formula to use. ③ Consider the severity—light, moderate, or severe—and the urgency of the exterior and interior conditions, weighing the need to adjust the herbs’ potency and the dosage accordingly.

I. Resolving the Exterior and Attacking the Interior

Suitable for patients with exterior symptoms combined with internal heat; here, semi-exterior and semi-interior conditions are also regarded as exterior symptoms, in contrast to internal heat conditions.