General Introduction to
TCM Formulas
History – Read Bensky Introduction
The Process of Practice of Chinese Herbal Medicine
1. Identify the patients pathodynamic (“differentiation”)
underlying their problem
2. Develop a Strategy of Treatment
3. Identify the formula that incorporates the strategy
4. Customize formula to address patients unique case
(appropriate herbs used to address treatment strategy)
8 therapeutic methods
1)
2)
3)
4)
5)
6)
7)
8)
(See charts Bensky xxvi-xxix)
Diaphoresis/ Promote sweating;
Emesis/ Vomiting;
Purgation / Drain Downward;
Mediation/ Harmonization;
Warming;
Heat reducing/ Clearing;
Elimination
Tonification
Please Note : Bensky chart review / memorization required.
Specific Strategy details taken from chart will be tested.
1.Diaphoresis
• Open Cou Li (pore )
• Regulate Ying and Wei
• Disperse LU qi - expel external pathogenic factors
• Indication: Exterior syndrome caused by external pathogenic
factor attack
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Early Stage measles: rash unable to vent
Early Stage edema: above waist
Early Stage Carbuncles with fever, aversion to cold
Early Stage Diarrhea with fever, aversion to cold
• Strategies
–Release exterior syndrome with acrid warm nature herbs;
-Release exterior syndrome with acrid cool nature herbs
–If weak body constitution: Release exterior syndrome with
tonifying
• Cautions
– Differentiation disease type
– Stop when syndrome controlled
– Combination syndromes
– Generally Decoct Herbs for a short duration
2.Vomiting
• Eliminate Phlegm, food stagnation, toxicity through mouth
• Indication
– Upper location
– Severe acute
– Strong body constitution
– Internal excessive pathogen
• Cautions
– Regulate SP & ST after vomiting (ginger / congee)
– Stop vomiting method
• Not Commonly used in present day
3.Purgation (Draining Downard)
• Purge, drive out food stagnation, dry stools, cold coagulation,
blood stasis, phlegm, water retention in ST and intestines lower
orifices
• Indication: Excessive internal syndrome
– Constipation
– Dry stools stagnation
– Yellow watery fluid in defecation with internal excessive
heat
– Phlegm stagnation
– Blood stagnation
• Strategy
– Purge using cold herbs
– Purge using warm herbs
– Laxative / Moistening
– Drive out excess water
– Purge & tonifying
4.Harmonization
• Harmonize & regulate to treat
– Pathogen in half exterior, half interior
– Disharmony between Zang-Fu organs
– Disharmony between Yin & Yang
– Disharmony between exterior and interior
• Classification
– Harmonize Shaoyang
– Regulate Liv& SP
– Regulate Intestines and ST
5.Warming
• Warm interior to expel cold
• Indication
– Cold generated internally
– External cold direct attack interior
• Treatment principle
– External cold: warm and disperse
– Internal cold: warm and tonify
• Classification
– Warm interior to expel cold
– Revive the yang for resuscitation
– Warm channel to disperse cold
• Cautions
-Strong fire consumes qiwhile slightly warming generates qi”
– Differentiate True Heat Fake Cold
6.Clearing
• Clear heat, purge fire, eliminate toxin, cool blood, clear interior
heat
• Indication: interior heat – Excessive Heat
• Heat toxin
– Combined with qi, blood, blood heat and flesh: red swelling, pus
– Heat attack PC: Shen disorder, coma
• Heat combined with excessive pathogen, blood stasis, phlegm,
water
• Deficient Heat
• Classification
–
–
–
–
–
Clear
Clear
Clear
Clear
Clear
heat in Qistage
heat in Ying stage and cool blood
heat toxin
heat in Zang-Fu organs
deficient heat
• Cautions
– Do not abuse. Protect vital qi
– Careful with True Cold Fake Heat
7.Elimination
• Promote digest, quickens qiand blood, resolve phlegm, drain
water, eliminate parasites slowly eliminate: corporeal
accumulation of qi, blood, phlegm, food, water, parasites, etc
• Caution
– Slow, not in a hurry
• Compare Eliminating and Purgation
8.Tonification
• Tonify : deficiency of qi, blood, Yin, Yang
• Classification
– Tonify qi, Tonify blood, Tonify qi and blood
– Tonifyyin, Tonifyyang, Tonifyyin and yang
• Cautions
– For deficient pattern only. Do not abuse.
– Be good at using Soothing & Tonifying. Do not be frigidly
tonifying
Composition of the Formula
• Key points during composing formula
– Strict compositing structure
– Proficiency herbal compatibility skills
- Herbalist must know all incompatibilities well, tested on
the board and also creates safety in practice.
- Familiarity with synergy provides tools to create more
effective combinations.
• Control direction of herb’s function
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–
–
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Compatibility environment
Dosage
Processing
Cooking and administering
• Aim of Compatibility
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–
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Strengthen effects of a herb
Mutual reinforcement
Control functional direction of a multi-functionherb
Expand treatment range
Control side-effects and toxicity
K-M-A-E Structure
• King (Monarch, Empire ) Herb
– The chief herbs that treat the chief syndrome and/or main
disease differentiation.
•Minister (Deputy) herbs
– Accompany with King herbs to strengthen treatment for chief
disease
– Treat secondary syndrome
• Adjutant (Assistant ) herbs
– Helpful Adjutant: Strengthen effects of King and Minister herbs
and treat combination symptoms
– Corrective Adjutant: Reduce toxicity of King and Minister herbs.
Control harshness of King and Minister herbs
– Opposing Adjutant: Under severe situation, when body reject
herbs, this kind of herbs can be added into the prescription to
prevent the rejection.
• Guiding (Envoy, Messenger) herbs
– Guide: guide herbs to disease location
– Harmonizer: regulate, harmonizing members in formula
• Common channel guiding herbs
– Taiyang: Qiang Huo, Gao Ben
– Shaoyang: BaiZhi, Ge Gen
– Shaoyang: Chai Hu, Huang Qin
– Taiyin: Cang Zhu
– Shaoyin: Xi Xin
– Jueyin: Chuan Xiong, Qing Pi
– Upward: Jie Geng
– Downward: Niu Xi
• Important to Note
– King herbs can’t be missing from a formula. Few ingredients,
large dosage (Not absolute dosage, but relative dosage)
– M, A, G herbs could be missing from a formula. Even one herb
can take 3 roles
– Compound formula composed by several basic formulas, or large
amount ingredients formulas: classify the ingredients according to
herbal function and analyze it according to priority.
Modification
• Why modify?
• How to modify?
– Ingredients
– Dosage
Dosage Form
• Decoction
• Powder
• Pills
Administration
• Cooking
– Utensil
– Water
– Fire
– Procedure
• Ingesting
– Time
– Frequency
– After taking maintenance
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