Notes on This Category

• For wind-heat, herbs from this category are often combined with herbs to clear heat-toxicity, since toxicity commonly results when heat is extreme.
• “Liang E Bing Fu“: Too many acrid, cool herbs will simply suppress wind-heat. They freeze the surface and wind-heat cannot leave the body. Add one or two acrid, warm herbs to formulas for wind-heat (i.e. 80% cool herbs, 20% warm herbs).
• Use caution when there is profuse sweating or injury of body fluids, and with patients with carbuncles, boils, urinary tract infection, or a history of heavy bleeding.
• Since the dispersing effect of some of the more aromatic herbs in this category is dependent on their volatile oils, they are often decocted only for a short time, or they are just infused (not exposed to a heat source, simply allowed to steep in water that has been brought to a boil).

Bo He – Chinese Field Mint

Nature: acrid, cool

Enters: Liver, Lung

Actions: Disperses wind-heat; eases the head, eyes and throat; expresses skin eruptions; promotes Qi circulation on the surface and frees liver Qi.

Indications:
• Wind-heat: headache, fever, slight aversion to cold, sore throat, red eyes, cough, nasal congestion.
• Liver Qi stagnation: distention, pain or pressure in the chest, costal region, or hypochondrium, emotional instability, gynecological problems.
• Wind-heat: slow skin eruption in early-stage measles, or other early-stage rashes.
• Add to a decoction in the last five minutes of cooking.
HF: A San Du, scattering toxin medicinal, typically found in Gu Zheng (Gu parasites) formulas.
Li Dong Yuan: Upbears Yang Qi.
Li: Can be warming in a large dose.
Yoga: Phudina: P, K-; V+ (in excess)
Sattvic herb, very ethereal: soothing, cooling, clarifying, expanding.
• Relieves tension, congestion; mild; harmonizer.
• Pungent/cooling (slightly)/pungent.
• Affects respiratory, nervous, digestive, and circulatory systems.
• Stimulant, diaphoretic, carminative, nervine, analgesic.
• Same indications as TCM plus earache, dysmenorrhea.
MLT: Similar to Lemon Balm and Spearmint (these herbs can be substituted).
• Do not boil. Infuse in the boiled water only after the rest of the decoction is prepared.

Dose: 1.5-6g

JC: on Spearmint (likely pretty similar to Bo he):
• Diaphoretic (gentle), diuretic (lithotriptic), stimulant, carminative, antispasmodic, aromatic, nervine (sedative), condiment, nephritic, anti-emetic.
• Beneficial to the kidneys and bladder as a diuretic, especially for suppressed, painful, or scalding urination, and bladder/kidney inflammation.
• Soothing and quieting to the nerves and stomach.
• Colic, flatulence, dyspepsia, spasms, dropsy, nausea, vomiting, gravel in bladder, hemorrhoids (shallow enema).
• Ginger intensifies and accelerates its action.
• Vomiting and nausea of pregnancy: 14g spearmint, 2 teaspoons cloves (ding xiang), 2 teaspoons cinnamon (rou gui), 2 teaspoons rhubarb (da huang). Infuse in 1 pint boiled water, cover 20 minutes, strain, take 3-4 tablespoons every 30 minutes.
PLB: Peppermint (the most pungent mint) is, overall, stronger/sharper than Spearmint, and is probably less similar to Bo he.
BII: For irritable bowel syndrome, GB disease (studies used enteric coated capsules of peppermint oil).
• Not for heartburn or esophageal reflux as it relaxes the esophageal (cardiac) sphincter (use licorice/DGL instead).

Chai Hu – Bupleurum root – “Kindling of the Barbarians”

Nature: bitter, acrid, slightly cold

Enters: Liver, Gallbladder, San Jiao, Pericardium

Actions: Frees the liver Qi; disperses pathological factors in the half-interior, half-exterior; lifts spleen Yang Qi; reduces fever; can both lift and descend (acrid and bitter).

Indications:
Shaoyang syndrome: alternating fever and chills, distended chest and hypochondrium, bitter taste in the mouth, flank pain, irritability, vomiting, dry throat, dizziness.
• Liver Qi stagnation: distended hypochondrium, costal pain, headache, irregular menses, dysmenorrhea, dizziness, vertigo, stifling sensation in the chest, flank pain, emotional instability.
• Spleen Qi sinking: prolapsed rectum or uterus, diarrhea, hemorrhoids, shortness of breath.
• Spleen/liver disharmony: epigastric and flank pain, stifling sensation in the chest, abdominal bloating, nausea, indigestion, bloating.
• Some say Chai hu damages the Yin, since it is bitter and drying (often combined with Bai shao to counteract its drying nature).
• Contraindicated in liver Yang rising due to liver/kidney Yin deficiency.
• Antipyretic; some antibiotic/bacteriostatic effects; tranquilizer; anti-tussive.
• Used to treat malarial disorders.
• Occasionally can cause nausea or vomiting (should use a small dose in this case).
Chinensis species (hard, Northern) (Bei/Ying chai hu): better for harmonizing the Shaoyang and clearing heat and wind-heat.
Scorzoneraefolium species (soft, Southern) (Nan/Ruan chai hu): better for spreading liver Qi, resolving depression, and relieving constraint.
Jin: Safe in pregnancy in moderate dose (to 4.5g).
MLT: Some patients are sensitive to Chai hu. Some believe it “consumes the Yin.” Despite its recommendation in the Shan Han Lun, many doctors avoid this herb.
• With blood deficiency, always combine it with Dang gui and/or Gou qi zi.
PFGC: Can purge heat in the uterus; can resolve blood heat; disperses exuberant gallbladder fire.
• Should be used to ascend Shaoyang pathogens to push them over and beyond the diaphragm, forcing them up and out.
• In large doses, it is diaphoretic, but this results in out-of-hand momentum and weakening of its uplifting force.
• Can facilitate smooth bowel movements and can foster proper urination – because uninhibited urination is linked to proper function of the san jiao – Qi dynamics of the san jiao are such that Qi descends only if it is allowed to rise first.
• Use in pre- and post-partum disorders, eruption of macules in children, consumptive fevers, carbuncles, furuncles, all malaria.
• Food accumulation: can move wood Qi to course earth.
• Alternating hot and cold are not a necessary symptom to prescribe Chai hu – it is enough to know the patient has an exterior affliction with nausea or vomiting or frequently spitting sticky saliva – this is sufficient evidence that the disease is in the Shaoyang.
HF: An important herb in anti-Gu therapy to move Qi (Xing Qi) and break accumulation (Po Ji).
DY: Drains the liver and resolves depression; harmonizes the Shaoyang; harmonizes the liver and spleen; abates heat; upbears clear Yang; frees the flow of Qi on the left side of the body.
• With Bai shao to drain the liver without damaging liver Yin, nourish the liver without causing liver depression Qi stagnation, regulate the spleen, stop pain effectively, harmonize the interior and exterior, and constrain Yin while upbearing Yang. For such indications as:
– 1. Liver depression Qi stagnation causing disharmony between Qi and blood.
– 2. Vertigo, unclear vision, chest and lateral costal oppression, pain, and distention due to liver depression Qi stagnation or to disharmony between the exterior and interior.
– 3. Menstrual irregularities, dysmenorrhea, breast distention, low-grade fever during the menses, premenstrual syndrome, and fibrocystic breasts, all caused by liver depression Qi stagnation or disharmony between the liver and spleen.
• The combination of Bai shao and Chai hu is effective for the treatment of liver and digestive problems caused by liver depression Qi stagnation or liver-spleen or liver-stomach disharmony, such as subacute or chronic hepatitis, hepatomegaly, cholecystitis, gallstones, enteritis, and colitis.
• With Huang qin to harmonize the interior with the exterior, the Shaoyang, and liver and gallbladder. Together, they also clear the liver and resolve depression as well as clear and eliminate dampness and heat, particularly in the liver and gallbladder. Chai hu dispels evils (heat) limited to the superficial part of the Shaoyang while Huang qin drains evil heat limited to the internal part of the Shaoyang. For indications such as:
– 1. Alternating fever and chills, a bitter taste in the mouth, dry throat, pain and fullness in the chest and lateral costal regions, nausea, and lack of appetite due to a Shaoyang pattern. (Xiao Chai Hu Tang)
– 2. Malaria due to a Shaoyang pattern.
– 3. Liver depression transforming into fire.
– This combination is remarkably effective for hepato-biliary disorders, such as acute or chronic hepatitis, biliary lithiasis, cholecystitis, and hepatomegaly due to liver-gallbladder heat.
• With Sheng ma for mutual reinforcement, to upbear liver, stomach, and spleen Yang Qi. These two herbs alone don’t raise the Qi efficiently. They must be combined with Ren shen, Huang qi, and Bai zhu to be really effective for this purpose, because one cannot raise what is lacking. Huang qi does appear to upbear the Qi, but not for long. When Chai hu, Sheng ma, and Huang qi are combined, they raise the Qi effectively, and for long periods of time.
For indications such as:
– 1. Uterine prolapse, rectal prolapse, gastric ptosis due to central Qi fall. (Bu Zong Yi Qi Tang)
– 2. Metrorrhagia and abnormal vaginal discharge due to central Qi fall.
– 3. Chronic diarrhea or chronic dysentery due to central Qi fall. (Bu Zhong Yi Qi Tang)
– 4. Shortness of breath and dyspnea with feeling of oppression and downward falling of Lungs due to Qi fall. (Sheng Xian Tang)
– For all the above indications, Sheng ma should be honey mix-fried and Chai hu should be stir-fried until scorched.
– In all the above cases, a small dosage of the two herbs is sufficient (i.e. 3-5g). However, a larger dose of Sheng ma (9-15g) can be used if one wants to simultaneously clear Yin fire due to spleen deficiency from the head and face.
Chai hu is a messenger herb which guides the action of other medicinal substances toward the liver and gallbladder channels, toward the upper part of the body (head and face), along the liver channel pathway (internally) and the gallbladder channel pathway (externally), and toward the lateral costal region.
Chai hu in high dosage (10-18g) resolves the exterior, abates heat, and harmonizes the Shaoyang. In small dosage (2-4g), it upbears Yang Qi. In an average dosage (6-8g), it courses the liver, rectifies the Qi, and resolves depression.
• When pain is predominant, vinegar mix-fried Chai hu is best.
• In cases of liver-spleen disharmony, stir-fried Chai hu should be used.

Dose: 3-12g

Chan Tui – Cicada Molt (skin)

Nature: sweet, cold

Enters: Lung, Liver

Actions: Disperses wind-heat; expresses skin eruptions; promotes vision by removing nebulas; relieves convulsions by subduing liver wind (large dose); strongly clears heat from the nose, eyes, and throat.

Indications:
• Wind-heat: loss of voice, sore throat, cough, hoarseness, or fever, headache.
• Wind-heat or early measles: incomplete expression of skin rash.
• Liver wind-heat: red eyes, tears, nebulas, conjunctivitis, painful eyes, blurry vision.
• Liver wind-heat: childhood febrile disease, morbid night crying in babies, spasms, convulsions, delirium, night terrors; tetanus.
• Doctrine of signatures: skin treats skin; big eyes indicate affinity for eyes/liver; cicadas are silent at night – for calming children at night.
Hsu: Anticonvulsant; decreases muscle tremors caused by nicotine.
DY: Disinhibits the throat; diffuses the portals of the Lungs and increases the voice.
• One of few herbs in the materia medica which calms the liver and settles convulsions and is also non-toxic, even at high doses of up to 30g/day (unlike scorpion and centipede). For this reason, it is good for children.
• Vexation, agitation, insomnia, night crying, night fears, nightmares, clonic convulsions, epilepsy.
• With Shi chang pu to effectively rouse the spirit and open the portals. For vertigo, tinnitus, and deafness due to obstruction of the portals.

Dose: 3-12g

Dan Dou Chi – Prepared Soybean

Nature: acrid, sweet, slightly bitter, cold

Enters: Lung, Stomach

Actions: Relieves exterior syndromes; relieves restlessness; clears heat.

Indications:
• Wind-heat or wind-cold: fever, aversion to cold, headache (can be used for either hot or cold invasion, usually for early stage).
• Febrile disease causing stagnant heat in the chest: restlessness, insomnia, irritability, stifling sensation in the chest (Dan dou chi also reaches the heart) – combine with Zhi zi.
• Because of its mild character, is also appropriate for Yin deficiency with a superimposed exterior disorder.
• Is treated either with Ma huang or Zi su ye (more warming effect) or Sang ye or Qing hao (more cooling effect).
MLT: Good for kids (ok taste, nutritive).
• This and all soybeans contain genistein – occupies estrogen binding sites and seems to inhibit development of estrogen-sensitive tumors.
DY: Promotes perspiration; diffuses and out-thrusts external evils from the exterior.
• With Zhi zi, the two herbs unite to form the clearing and diffusing and out-thrusting method to eliminate evils from the exterior and interior. Together, they effectively promote perspiration, drain evils from the exterior, clear and out-thrust heat from the interior, and eliminate vexation due to full heat. For indications such as:
– 1. Vexation and agitation, insomnia, and irritability during or after a warm disease. (Zhi Zi Chi Tang) Use stir-fried Dan dou chi.
– 2. External contraction of wind-heat or a febrile disease.
Qing dou chi is cold, and clears heat and eliminates vexation
Wen dou chi is warm and is superior for resolving the exterior and promoting diaphoresis. Although it is warm in nature, it is used in and preferred for wind-heat affections.

Dose: 9-15g

Fu Ping – Duckweed – Spirodela

Nature: acrid, cold

Enters: Bladder, Lung

Actions: Releases the exterior; unblocks the muscle level; vents rashes; dispels water, reduces swelling.

Indications:
• Exterior heat: head and body aches.
• Hastens full expression of measles and other exanthemas and wind rashes and thereby hastens resolution of the disease.
• Hot, superficial edema, especially when affecting the upper body and when accompanied by urinary difficulty.
• One of few cool herbs that is a strong diaphoretic.
• Doctrine of signatures: The herb is very light, grows on the surface of water. This indicates its affinity for the surface/skin and its ability to release superficial water (edema, sweat).
• Topical: also used as a wash for rashes.
• Often used alone.
MLT: Diuretic, diaphoretic.

Dose: 3-6g (to 9g in severe cases)

Ge Gen – Pueraria lobata root – Kudzu

Nature: acrid, sweet, cold

Enters: Spleen, Stomach

Actions: Relaxes muscles by promoting sweats and expelling EPIs; lifts spleen Qi and Yang; clears heat; generates body fluids; supports detoxification and withdrawal from alcohol.

Indications:
• Wind-heat or wind-cold (lodges in the muscles): stiff neck, occiput, or upper back, fever, headache, no sweating.
• Early-stage measles: slow eruption of skin, fever, aversion to cold.
• Spleen Qi deficiency or damp-heat: diarrhea (when due to deficiency, combine with tonics).
• Injury of body fluids by heat in febrile disease: restlessness and thirst.
• Stomach heat: thirst.
• Lowers BP, treats headache, dizziness, tinnitus, paresthesias due to HTN.
• Also for sudden deafness, ear infections.
• Eases alcohol withdrawal and hangover.
• Lowers blood sugar/treats diabetes.
Guohui Liu: special for tendinitis.
• General analgesic for a variety of pains.
• To lift spleen Qi, roast with wheat bran until the Ge gen turns yellow. This form is less cooling and is superior for diarrhea due to deficiency.
Yoga: Sweet/cooling/sweet; P, V-; K+
• Tonic, diaphoretic, diuretic.
MLT: Demulcent and soothing to the stomach and intestines.
• Has an upward, antispasmodic property.
Hsu: Anticonvulsant, follicular hormone effect, dilates coronary arteries, improves cerebral blood flow in hypertensive patients.
DY: Resolves the muscle aspect; eliminates heat; engenders fluids and stops thirst; tends to reach evils horizontally and, therefore, out-thrusts rashes on the back and the middle part of the body.
• Marked vasodilatory effect, used for hypertension, hypercholesterolemia, coronary disease, angina pectoris, headaches and painful tension in the cervical area due to hypertension.
• With Sheng ma to resolve the exterior and muscle aspect, clear heat, resolve toxins, and out-thrust rashes over the whole body. For indications such as:
– 1. Skin rashes which have difficulty surfacing, accompanied by headache and fever due to an exterior pattern. (Sheng Ma Ge Gen Tang)
– 2. Measles in the initial stage with eruptions which have difficulty surfacing, and fever sometimes accompanied by lack of perspiration or perspiration which has difficulty coming out due to an exterior pattern. (Xuan Fu Jie Bao Tang)
• While Sheng ma is used for all forms of Qi sinking, Ge gen is only used for diarrhea. It treats diarrhea of either the deficient type (i.e. spleen deficiency) or excess type (i.e. damp-heat). For this, roasted Ge gen should be used.

Study: The Chinese Pueraria root extract (Pueraria lobata) ameliorates impaired glucose and lipid metabolism in obese mice.

ITM: Pueraria: Source of Important Isoflavones, by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon

Background: the herb and its constituents

Pueraria (gegen), the root of Pueraria lobata, is a commonly used herb in Chinese medicine.  It is perhaps better known by its Japanese name: kudzu.   It is a fast growing vine that can extend a foot in length each day during the warm season.  Its root is also fast growing, typically reaching 50 pounds or more, and can attain a weight of 400 pounds (about 2/3 of it is water).   Aside from the use of pueraria as an ingredient in traditional Chinese medicine formulas, mainly those from the ancient Shanghan Lun, it is the source of a food ingredient widely used in Japan: its starch.  Kudzu starch has a mild taste that doesn’t conflict with delicate and subtle flavors; it creates a smooth consistency; and it crisps well when used as a coating for deep fried foods.  Before isolating the starch (which is 99.6% starch with about 0.4% water), the whole roots also have a small amount of protein and are a reasonably good source of calcium, magnesium, iron, potassium, and zinc when compared to starchy foods such as wheat and sorghum.

Pueraria has one major medicinal active component group: isoflavones that are often simply designated as puerarin, which is its main ingredient (chemical structure, right).  Although several isoflavones have been isolated and characterized, there are five principal ones: puerarin, methylpuerarin, daidzein, daidzin, and daidzein glucopyranoside.  Both daidzein and daidzin are also found in soy beans, which are known for their content of two other isoflavones, genistein and genistin (these isoflavones appear to be primarily responsible for soy’s benefits in alleviating menopausal symptoms; pueraria contains little of these two components).  The total isoflavone content of the dried pueraria root slices generally is typically around 1%, and may reach 2%.   By contrast, the main dietary source of isoflavones, soybeans, usually do not exceed 0.6% isoflavones and more typically contain about 0.3% of this component.  Isoflavones are almost exclusively found in the Fabaceae Family, including the Chinese herbs pueraria, soja (soybeans), astragalus, licorice, sophora, and millettia.

The pueraria isoflavones were intensively researched in China during the 1970’s, and developed into a drug-like product that is used for circulatory disorders.  The tablet or injection (given as IV drip) of concentrated pueraria isoflavones is used to treat dizziness, headaches, neck pain, sudden deafness, glaucoma, diabetic retinopathy and hearing loss, angina, heart attack, myocarditis, and symptoms of hypertension (1,2).  More recently, pueraria isoflavones have been examined for neuroprotective effects; as an example, it was indicated that administration of aspirin plus puerarin after a stroke had improved neurological function (3).  Laboratory animal investigation suggests that puerarin may help reduce glutamate damage to axons (4).  The uses of pueraria and its isoflavones are somewhat like those of ginkgo leaf flavonoids, crataegus flavonoids, and hippophae (sea buckthorn) flavonoids; the first is known for promoting circulation to the brain and the latter two are used for promoting cardiac circulation.

Dosage and Effect
Using the appropriate dosage of the crude herb, as indicated in traditional texts, can be elaborated from work done with isolated active components in a standard dosage form.  As examples of clinical applications (5), pueraria flavones were given in tablets at a dose of 30–40 mg each time, three times daily (total daily dose is 90–120 mg) to 191 patients with coronary heart disease and angina pectoris; in the treatment of hypertension, 50 mg of pueraria flavones given twice per day (total daily dose is 100 mg) for several weeks; similarly, hypertensive patients suffering from angina were given a daily dose of pueraria flavones at 150 mg/day.   From a survey of such applications for the tablets, the maximum daily dose recommended appears to be 300 mg/day.  However, this upper level is apparently not because of toxicity, but simply an amount that was indicated as effective for the particular applications.  Recently, work done with puerarin injection has involved 400 mg for a single injection treating diabetic retinopathy (6) and 500 mg in a single injection for heart attack patients (7).

At a maximum level of 2% isoflavones in the dried pueraria roots, to get a dosage in the range of about 100–500 mg of this component, one would use 5–25 grams in decoction.  However, the level of isoflavones is more typically only about 1%, so that a dose of 10–50 grams would be more suitable.  Since the higher dosages are given by injection for serious and acute conditions, the suggested decoction range for most applications would be 10–30 grams of dried root for a one day supply.   In a report on the treatment of diabetic hearing loss (8), the treatment group received a decoction for which the basic recipe included pueraria at 30 grams per day.

The Materia Medica guides published in China, dosage recommendations range from 5–24 grams in decoction, which is thus on the low side, but when the herb is blended in formulas, as is common, additional flavonoids are usually obtained from one or more of the other ingredients.   The low doses of pueraria root (e.g., 3-9 grams) as used in some large traditional formulas may have limited effect.  It is possible that when combined with licorice root (which is common in these formulations), the isoflavone components of these two herbs work together to alleviate inflammation, thus allowing the low dose of pueraria to contribute to the action of the formula.   A good summary suggestion is found in Oriental Materia Medica (9), where the recommended dosage range for pueraria roots in decoction is 6–24 grams, and the recommended dosage of the pueraria flavonoid is 100–300 mg/day.

The herb has very low toxicity, as demonstrated by the fact that the isoflavone extract of pueraria has even been used as an IV drip without reported adverse effects.   The authors of a report (10) on use of puerarin IV drip for heart disease patients concluded: “Puerarin is a safe and effective drug in treating patients with unstable angina and worth spreading in clinical usage.”  The authors of a review of pueraria flavonoids (11), based on work from several institutes in Beijing and Chengdu, stated that they “recently prepared [puerarin] in an 80+% concentration that shows little toxicity, benefits cardio-cerebro vascular disease, and has good absorption when taken orally.  It has passed pre-clinical examination for new drugs in accordance with criteria established by the Health Ministry of the People’s Republic of China, and is presently in clinical trials.”

Pueraria isoflavones are rapidly absorbed from the GI tract, but are also rapidly eliminated (12).  This high turn-over indicates the need for frequent dosing when using the oral form at moderate dosage, such as three times a day, to maintain significant blood levels for the desired effects on circulation.

Conditions determining what form to use:

A limiting factor in use of high dosage pueraria in decoctions is that the starch turns the decoction quite thick, especially if it is allowed to cool.  In China, because of the availability of puerarin in pill form, this herb is not often included in decoctions.  The change in practice may have come also as a result of recognizing the need for higher dosage and the shift of applications from alleviating symptoms of the common cold (as fit some of the early concepts of its use) to treating serious cardiovascular diseases.

In sum, China’s use of pueraria in recent years is tending towards less frequent administration in traditional style decoction formulas (or dried decoctions), relying more heavily on the form of concentrated extracts of the isoflavone fraction taken in daily doses of 100–300 mg puerarin per day orally or by IV drip  with doses up to 500 mg.  The herb can still be utilized in traditional decoction formulas with good effect especially if incorporated at a dose of about 15–18 grams/day (about 3.0-3.6 grams of dried decoction).  The isoflavones are the key ingredient of pueraria roots that influences the determination of proper dosage.

July 2010
REFERENCES

  1. Yue HW and Hu XQ, The medical value of radix pueraria and puerarin in treating diseases of the cardiovascular system, Chinese Journal of Integrated Traditional and Western Medicine 1997; 3(3):234-238.
  2. Lai XL and Tang B, Recent advances in the experimental study and clinical application of Pueraria lobata, China Journal of Chinese Materia Medica 1989; 14(5): 308-311, 277.
  3. Hu HT, Fen F, and Ding MP, Effects of puerarin with aspirin on the markers of damaged vascular endothelial cells in patients with acute cerebral infarction [in Chinese], Journal of Chinese Herb Drugs 2008; 33(23): 2827–2829
  4. Zhou J, et.al., Puerarin attenuates glutamate-induced neurofilament axonal transport impairment, Journal of  Ethnopharmacology 2010 Aug 18. [Epub ahead of print]
  5. Chang HM and But PPH (eds.), Pharmacology and Applications of Chinese Materia Medica, 1986 World Scientific, Singapore.
  6. Ren P, Hu H, and Zhang R, Observation on efficacy of puerarin in treating diabetic retinopathy, Chinese Journal of Integrated Chinese and Western Medicine 2000; 20(8): 574–576.
  7. Xiao LZ, et.al., Study on the effect and mechanism of puerarin on the size of infarction in patients with acute myocardial infarction, Chinese Journal of Integrated Chinese and Western Medicine 2004; 24(9): 790–792.
  8. 8. Li RY, et.al., TCM Treatment of diabetic hearing loss, Journal of Traditional Chinese Medicine   2000; 20(3): 176–179.
  9. Hsu HY, et.al., Oriental Materia Medica: A Concise Guide, 1986 Oriental Healing Arts Institute, Long Beach, CA.
  10. Zhao ZM, et.al., Clinical study of puerarin in treatment of patients with unstable angina, Chinese Journal of Integrated Traditional and Western Medicine 1999; 5(4): 254–256.
  11. Du LJ, et.al., Drug properties of pueraria flavonoid based on pharmacological action, International Journal of Oriental Medicine 2000; 25(2): 95–100.
  12. Penetar DM, et.al., Pharmacokinetic profile of the isoflavone puerarin after acute and repeated administration of a novel kudzu extract to human volunteers, Journal of Alternative and Complementary Medicine 2006; 12(6): 543–548.

Dose: 6-24g

Ju Hua – Chrysanthemum Flower

Nature: acrid, sweet, bitter, slightly cold

Enters: Liver, Lung

Actions: Moves liver Qi, subdues liver Yang rising, clears liver heat; disperses wind and clears heat from the liver and Lungs; eliminates toxicity; promotes vision; can protect the Lungs; nourishes water of the kidneys; said to promote longevity.

Indications:
• Wind-heat: fever, dizziness, headache.
• Liver wind-heat or flaring of liver fire: red, swollen, painful eyes.
• Liver Yang rising leading to stirring of liver wind: headache, dizziness, deafness,
hypertension.
• Liver and kidney Yin deficiency: seeing spots in front of the eyes, blurry vision, dizziness.
• Cook a short time (retain the acridness) to disperse wind-heat, cook longer (boil off the acridness, retain the bitterness) to subdue liver Yang.
• This herb is said to have the energy of autumn – it can protect the Lungs.
• Stronger than Sang ye at clearing liver fire, but weaker at dispersing wind-heat.
• Compared to Mu zei, with regard to the vision: Ju hua nourishes the eyes, but does not remove superficial visual obstruction (as Mu zei does).
Bai ju hua: white variety: stronger than the yellow variety at subduing liver Yang, freeing/nourishing the liver and clearing the eyes; often used for poor vision due to liver/kidney Yin deficiency; better for hypertension.
Huang ju hua: yellow variety: stronger than the white variety at clearing heat and dispersing wind-heat.
HF: A San Du, scattering toxin medicinal, typically found in Gu Zheng (Gu parasites) formulas.
SD: May help antidote lead poisoning.
Yoga: Sevanti – “Service,” gives the energy of devotion, surrender, and service to the Divine.
• Bitter, sweet/cooling/pungent; P, K-; V+ (in excess).
• Affects digestive, respiratory, nervous systems.
• Diaphoretic, antipyretic, alterative, antispasmodic.
• For headache, sore throat, nose bleeds, eye infections, boils, dysmenorrhea, liver diseases.
• Cools and regulates the Pitta that governs vision.
• Calms Pitta emotions: anger, irritability.
• Promotes lactation and menstruation.
• Caution with high Vata.
• Aids in the surrender of the egoistic will (a function of deranged Pitta) to the Divine.
MLT: Drink cool in the summer to protect Yin and blood.
• Good for digestive upset, hypertension, headache, summer-heat.
DY: Light and upbearing in nature.
• With Gou qi zi to effectively nourish and supplement the liver and kidneys, clear heat, calm the liver, and brighten the eyes. For indications such as blurred vision, diminished visual acuity, “moving black spots in front of the eyes,” fire sparks in the eyes, photophobia, dry eyes with distention and headache, and pain in the lower back and knees due to liver-kidney deficiency. For these indications, the combination is present in Qi Ju Di Huang Wan. Bai ju hua should be used. Ju hua carries the action of Gou qi zi toward the eyes.
• For eye problems, hypertension, or headaches with a feeling of distention, use 20-30g of Ju hua daily.
• (Bai) Ju hua yields very good results in hypertensive disorders, especially when accompanied by vertigo and headaches mainly due to liver Yang rising. It is often combined with Shan zha (15-20g), is cases of hypercholesterolemia.
Hsu: Hypotensive: suppresses the motor center controlling blood vessels and is vasodilatory.

Dose: 4.5-15g

Man Jing Zi – Vitex fruit

Nature: acrid, bitter, neutral

Enters: Bladder, Liver, Stomach

Actions: Disperses wind-heat; eases eyes and headaches; drains dampness; expels wind; traditionally said to promote beard growth in men.

Indications:
• Wind-heat: dizziness, headaches, migraines.
• Upper attack of wind-heat: blurry vision, red, painful, swollen eyes, lots of tears, spots in front of the eyes.
• Wind-dampness in the limbs/joints: stiffness, numbness, cramping, heaviness.
Jin: Particularly good for the pain of wind-damp Bi.
Li: Good for Shaoyang headaches behind the eyes.
HL: From Li Shi Zhen’s Ben Cao Gang Mu [provided by John Black]:
Main Uses: Treatment of heat and cold between tendons and bones, damp Bi type cramps, brightens the eyes, and strengthens the teeth. Regulates the nine orifices and expels “bai chong” (the Chinese character indicates some kind of worm, bug, parasite, etc.). Prolonged use of this herb can prevent aging. Can treat headache caused by wind, ringing in the head, lacrimation; benefits the Qi. It can enliven and brighten the spirit, and has been said to be able to expel pathogenic Qi and help the hair to grow. It has also been said to be able to free up the joints, treat epilepsy, red eyes, and Taiyang type headache. It can treat heaviness in the head (and implies some state bordering on unconsciousness), disperse pathogenic wind, cool menstrual blood, treat aching eyes, soothe liver wind, treat headache caused by wind, darken head hair and treats mastitis in the early stages. Through its effect on enhancing beard growth and the hormonal effects attributed to its Western cousin, I believe this herb is a tonic to the Chong Mai.
A final note though. It is contraindicated for those with deficient stomach Qi. The effect of Man Jing Zi in my experience is similar to He Shou Wu in that it can cause bloating, loose stools, sometimes explosive bowels with those people with a digestive insufficiency. Bai Zhu seems to counteract this well.

Dose: 6-12g
On the Western species: Vitex agnus-castus – Chaste berry:
It has not been clearly established as to whether the Chinese species shares all properties of the Western species.
NAH: For menstrual and menopausal disorders; probably an anaphrodisiac – lowers sex drive.
• Increases production of luteinizing hormone and prolactin; stimulates the flow of milk.
• Regulates menses when they are too frequent or too heavy.
• Seems to stimulate progesterone synthesis and regulate estrogen: for PMS and menopause.
• For fibroids and inflammation of the womb lining.
• Re-establishes normal ovulation and menses after discontinuance of the pill.
K&R: Sympatholytic, antispasmodic, estrogen antagonist, FSH inhibitor, luteotropic, galactagogue.
• Sweet-cooling; fire excess, wood excess.
Fire: nervousness, genital excitation, dysmenorrhea, acne; anti-FSH; sympatholytic; stops excess bleeding, corrects a shortened menstrual cycle.
Wood: neurotonia, globus hystericus, liver depression, palpitations, tachycardia, dysmenorrhea, uterine fibroids, hemorrhage, acne, genital excitation, mastosis and breast tenderness, male impotence from excessive sexual excitation, epigastric tightness, PMS, amenorrhea, menorrhagia, irregular menstrual cycle, menstrual and pre-menstrual edema, normalizes milk production (either too much or too little), cystic breasts-normalizes ratio of estrogen to progesterone; anti-FSH, sympatholytic.
RW: Increases LH production and inhibits release of FSH, leading to a shift in the ratio of estrogens to gestagens, in favor of gestagens, and hence a corpus luteum hormone effect.
• Menstrual disorders due to corpus luteum insufficiency (hyper or polymenorrhea and PMS based on hyperfolliculinism).
• Also for acne; pre-menstrual oral herpes; pre-menstrual water retention.
• Lactagogue (slow effect).

Mu Zei – Equisetum hiemale – Horsetail – Scouring Rush – “Wood Thief”

Nature: sweet, bitter, neutral

Enters: Lung, Liver

Actions: Mildly disperses wind-heat; promotes vision, dispels nebulas; stops bleeding; clears heat.

Indications:

• Wind-heat affecting the eyes: red eyes, excessive tearing, pain, swelling, cloudiness, blurred vision, pterygium.
• Heat in the blood: bleeding hemorrhoids, hemafecia (usually used as an auxiliary herb).
• Pulmonary disease: silicosis (improves symptoms).
• Also used externally as a powder.
• Compared to Ju hua, with regard to the vision, Mu zei is best for removing membranes from the conjunctiva (which Ju hua cannot do).
• Doctrine of signatures: the herb is a hollow tube – useful for clearing the tubes of the body – urinary tract, bile duct, air passages, vessels (not widely in this sense in TCM).
SD: May help antidote lead poisoning.
Yoga: Bitter, sweet/cooling/pungent; P, K-; V+
• Affects urinary, respiratory systems.
• Diuretic, lithotriptic, diaphoretic, alterative, hemostatic.
• Strong stone-removing action for the kidneys, bladder, gallbladder.
• Somewhat irritant, should not be taken for a long duration.
• Promotes healing of bones.
• Similar to Niu bang zi: as a paste/wash for inflammation.
• Clears Pitta and fiery emotions from the nerves and mind.
• For edema, nephritis, burning urethra, kidney stones, gall stones, stomach ulcers, broken bones, menorrhagia, venereal disease.
• Caution with patients with high Vata, constipation, dry skin; good for high Pitta.
NAH: Major source of silica – for lungs damaged by tuberculosis.
• Contains many minerals – good for anemia, debility, broken nails, lifeless hair, white spots on nails.
• Silicon encourages calcium absorption and helps guard against fatty deposits in the arteries.
• Astringent action stops bleeding, good for stomach ulcers.
• Mild diuretic, but its astringency makes it useful for children’s bed wetting.
• Also for inflamed/enlarged prostate, cystitis, urinary stones.
K&R: Remineralizing agent.
• Water deficiency, wood excess, water excess, metal deficiency, earth deficiency.
Water: edema, oliguria, ascites, glomerulonephritis, cystitis, nephrotic syndromes, osteoporosis, demineralization, pathological calcification, Paget’s disease, amenorrhea, diabetes.
Wood: hemorrhage, metrorraghia, epistaxis, hematuria, spasmophilia, tetany
Metal: immune deficiency, scrofula.
Earth: diabetes, chronic rheumatism, conjunctivitis, eyelid swelling.
MW: 35+% silica: its uses include almost the entire portrait of homeopathic Silicea: loss of nerve, nervousness to the point of nail-biting, hair-pulling, picking at the body or objects, slightly chilly constitution, problems with the hard sheaths and tissues of the body (strengthens tissue), thin, split hair, weak nails, lack of “grit” to the personality, no confidence to plunge into life, allergic to all sorts of things, chronic cystitis
• For all bleeding, ulcers.
• Brings matters to the surface, releases corrupted material.
• Doctrine of signatures: [see above on tubes] plus stem’s striking joints – for joints.
MLT: Cider vinegar extract of Mu zei: use topically for all fungus.
TS: Cleansing agent for the stomach.
• Reduces the suffering from gravel. For all bladder and kidney difficulties, especially stones in the bladder
• Painful urination.
• Hemorrhaging, hematemesis, epistaxis.
• As a compress for foul-smelling sores with pus.
Hsu: Appetite stimulant; diuretic; screening test shows it is effective against stomach, tongue, and liver cancers.

Dose: 3-9g

Niu Bang Zi – Arctium seed – Burdock seed

Nature: acrid, bitter, cool

Enters: Lung, Stomach

Actions: Disperses wind-heat; eliminates toxicity; expresses skin eruptions; eases the throat; relieves swelling; moistens the intestines for wind-heat constipation.

• Wind-heat: cough with difficult-to-expectorate sputum, swollen, red, and painful throat, fever.
• Wind-heat: slow skin eruption in early-stage measles or other incomplete skin rash.
• Heat and toxicity: red swellings, carbuncles, erythemas, mumps, acute febrile maculopapular rashes.
• Wind-heat: constipation.
• Good for constipation with sore, swollen throat.
• Prostatitis
• Weaker than Bo he at dispersing wind-heat and inducing sweating, but much stronger than Bo he at clearing heat and toxicity.
• Stronger at clearing heat than dispersing wind-heat, but much weaker at clearing heat and toxicity than the herbs in that category.
MLT: Should be crushed.
• Good for skin disease, cancer.
JC: Diuretic; alterative; tonic; nervine; diaphoretic.
• For edema, inflamed kidneys and bladder; scalding urine; mucus discharge from the bladder; difficult skin problems; eczema; boils; carbuncles; psoriasis.
• Topical: powder for abrasions, burns, wounds, ulcerations.
• Apply infusion topically to swollen glands and joints.
Yoga: (seeds and root) Bitter, pungent, astringent/cooling/pungent
• P, K-; V+ (in excess)
• Affects respiratory, urinary, circulatory, lymphatic systems.
• Alterative, diaphoretic, diuretic, antipyretic.
• Tonic and rejuvenative for Pitta.
• Same indications as above sources plus: lymphatic clogging, nephritis, edema, kidney inflammation, hypertension, cough.
K&R: Specific for all kidney afflictions; parotitis with constipation; eczema; cough; suppurative inflammation.
• Contracts the uterus.
IBIS: Alterative, demulcent, diaphoretic, diuretic, tonic.
• [Western] dosage: root tincture: 2 – 8 mL; seed tincture: 0.5 – 2 mL.
• Therapy: aphthous and catarrhal ulcerations of stomach membranes; irritable coughs; psoriasis; chronic cutaneous eruptions; chronic glandular enlargements; syphilitic, scrofulous, and gouty conditions (Ellingwood, p. 378); skin conditions, especially with dry and scaly skin; eczema; acne; boils; styes; carbuncles; arthritis; rheumatism (Anderson Geller)
• Handling fresh leaves may cause contact dermatitis (Duke; Muenscher)

Dose: 3-9g

Sang Ye – White Mulberry leaf – Morus alba

Nature: acrid, sweet, bitter, cold

Enters: Lung, Liver

Actions: Disperses wind and clears heat from the Lungs; clears heat from the liver to promote vision; cools the blood, stops bleeding (charred).

Indications:
• Wind-heat: cough, headache, fever, swollen and painful throat.
• Lung dryness: cough and dry mouth.
• Lung heat: thick and yellow sputum.
• Lung yin deficiency: night sweats, feeling hot at night.
• Liver channel heat (full or deficient) or liver wind-heat: red, dry, painful eyes, excessive tearing, spots in front of the eyes (for liver heat, empowers metal to control wood).
• Heat in the blood: mild cases of hematemesis.
• May lower blood sugar.
• Stronger than Ju hua to disperse wind-heat, but weaker to clear liver fire.
• Fry with honey (honey:herb::1:10) to moisten the Lungs for invasion of dryness and treat coughing.
• Doctrine of signatures: (supposedly) looks like a lung.
• Grows in the spring and contains the energy of spring.
• Can be used as an external wash for eye problems.
• This is the food of the silkworm.

Dose: 4.5-15g

Sheng Ma – Cimicifuga (Actea) rhizome – “Ascending Hemp”

Nature: acrid, sweet, slightly cold

Enters: Lung, Spleen, Large Intestine, Stomach

Actions: Guides upward; releases exterior syndromes; expresses skin eruptions; clears heat and eliminates toxicity; lifts Yang Qi.

Indications:
• Wind-heat: headache; slow skin eruption in early-stage measles.
• Heat and toxicity: headache, swollen and painful gums, canker sores, sore teeth, ulcerated lips or gums, painful and swollen throat, sores, blotches (febrile disease).
• Spleen Qi sinking: prolapse (rectum, uterus, etc.), shortness of breath, fatigue.
• Spleen Qi deficiency and failure to control the blood in the vessels: uterine bleeding.
• Stomach heat: toothache (raises Yang and relieves heat toxicity).
• Often used with Ge gen to promote expression of rashes.
• Often used with Chai hu to lift the Yang Qi.
• Stronger than Chai hu at lifting prolapsed organs.
• Note that the herb Serrulata is often substituted for Cimicifuga.
• Guides other herbs upward.
• Fry in honey to lift spleen Qi.
HF: A San Du, scattering toxin medicinal, typically found in Gu Zheng (Gu parasites) formulas.
DY: Upbears Yangming and clear spleen Qi; frees the flow of Qi on the right side of the body.
• In combination with Chai hu for mutual reinforcement, to upbear liver, stomach, and spleen Yang Qi. See Chai hu in this category for indications and notes on this combination.
• With Sheng ma to resolve the exterior and muscle aspect, clear heat, resolve toxins, and out-thrust rashes over the whole body. See Ge gen in this category for specific indications and notes.
Sheng ma is stronger than Ge gen at upbearing Yang. Moreover, Sheng ma is used for all types of Qi fall in the middle burner, such as ptosis of the organs, rectal prolapse, uterine prolapse, shortness of breath with a feeling of collapse in the chest, chronic diarrhea, and persistent metrorrhagia.
• Sheng ma is a messenger medicinal which guides the action of other medicinal substances toward the upper part of the body – the head, face, and upper orifices – and toward the Yangming. Therefore, it is used to treat toothache, oral ulcers, and stomatitis associated with the stomach, and constipation associated with the large intestine [I assume he means by clearing excess from the Yangming].
Hsu: Anti-ulcerative, anticonvulsant, analgesic, antipyretic.

Dose: 1.5-9g

Of the Western species, Cimicifuga racemosa:
It has not been clearly established how much the Chinese and Western species have in common, although they have been shown to contain many of the same chemical constituents. It seems that Black Cohosh possesses Sheng Ma’s exterior releasing and analgesic qualities (and may even be stronger), but Sheng Ma does not necessarily possess the hormone modifying qualities of Black Cohosh. Since Serrulata species are a very common adulterant for Sheng ma, unless you are sure you are getting some kind of Cimicifuga, Sheng ma certainly cannot be counted on for the following actions and indications.
K&R: Antispasmodic (musculotrope and neurotrope), sedative, sympatholytic, vagolytic, LH antagonist. Pungent-cooling; wood yang.
Wood: headaches – migraine, ophthalmic headaches, cluster headaches, hypertension, vertigo, Meniere’s, neuralgia, spasmophilia, menstrual cramps, menopausal complaints incl. depression, anxiety, hot flashes, vaginal dryness and atrophy.
• Also for genital herpes, asthma, pertussis, anxiety, panic attack, facial neuralgia, rheumatic pain, relieves tension in shoulders and occiput along the gall bladdder channel.
• Careful with the use of this herb for a true migraine – can induce vomiting.
JC: Nervine; emmenagogue; antispasmodic; alterative; diuretic; astringent; expectorant; diaphoretic; arterial and nervine sedative; cardiac stimulant-slightly depresses heart rate while increasing force of pulse and equalizing circulation; stomachic-tonic; antiseptic; antivenomous; muscular: for rheumatism, arthritis, neuralgia; tonic to mucus and serous tissues; stimulates secretions of liver, kidneys, and lymphatics.
• Pelvic disturbances, uterine disorders – contracts the uterus, increases menstrual flow.
• Acute chronic pulmonary and bronchial affections.
• Parturition: initiates uterine contractions, checks hemorrhage, allays nervousness and afterpains of delivery.
• Hypertension, palpitations, hemorrhage, uterine contractions: use full dose.
• Smaller dose for insomnia, headache, indigestion, bronchitis…
• Use as a syrup for colic, convulsions, nerve disorders, cough, whooping cough, liver and kidney disorders.
• Overdose can produce nausea and vomiting.
MW: A black, tangled mass of roots: for those caught in state of brooding, dark hopelessness, entangled in a web of coercive forces, against which one fights, but feels cannot ultimately defeat; a sense of entrapment; maybe caught in an abusive relationship or manipulative business pattern.
• For those who need to grab hold of their fears and drives in order to get through the entanglement which surrounds them.
• Gives the confidence to go through the black states of mind.
• Known as the “Herbal Chiropractor” – for spine problems/pain and head pain, especially when worse with menstruation.
Yoga: Bitter, pungent/cooling/ pungent
• Reduces Pitta and Kapha; elevates Vata
• Alterative, emmenagogue, antiseptic.