Bai He – Lily bulb – “Hundred Meetings”

Nature: sweet, slightly cold

Enters: Lung, Heart

Actions: Moistens the Lungs, generates body fluids, stops coughing; clears heat from the Lungs and heart; calms the Shen.

Indications:
• Lung heat and/or dryness: cough, including with bleeding, sore throat.
• Heart heat with Shen disturbance: palpitations, insomnia with lots of dreams, restlessness, irritability, intractable low-grade fever.
• Can be used alone for insomnia due to Lung Yin deficiency.
• Not as strong as Mai men dong at nourishing Lung Yin.
Dui Yao: The Art of Combining Chinese Medicinals: Nourishes heart Yin.
• Sweet and cold, but moistens without being slimy.
• With Zhi mu to moisten the Lungs and clear heat, nourish the heart and quiet the spirit. For such indications as:
– 1. Vexation and agitation, insomnia, vertigo, thirst related to a warm disease which has damaged Yin or due to Yin deficiency with deficiency heat.
– 2. Dry cough, vexation and agitation after a warm disease.
– 3. Lily disease.
Bai He Syndrome – “Lily disease,” named for the major herb that treats it, is a form of mental depression with depressed emotions, anxiety, taciturnity, a desire to sleep without being able to, a desire to walk without being able to, and a subjective feeling of cold or hot. It follows either a warm disease, in which case it is of sudden and recent onset, or emotional problems which have damaged heart Yin, in which case it is enduring and progressive in nature.
Bai he is also effective for numerous psychological and cardiac imbalances related to heart Yin deficiency: palpitations, deep cardiac pain with a feeling of emptiness in the cardiac region, insomnia, profuse dreams, vexation, agitation, neurasthenia.
• When dry cough is predominant, honey mix-fried Bai he should be used.
• If vexation and agitation or insomnia is predominant, uncooked Bai he should be prescribed.
Heiner Fruehauf: An An Shen (spirit calming) herb, important in Gu Zheng (Gu parasite) formulas (because of emotional disturbance common in patients with Gu).
Journal of Chinese Medicine: [BAI HE SYNDROME by Professor Gu Yue Hua, Transcribed by Arne Kausland. Number 40, Sep 1992] The name ‘Bai He’ has two meanings: i. ‘Bai’ means ‘hundred’ and ‘He’ means meeting/communicating’. There is a saying “All the hundred branches (i.e. the channels and collaterals) originate in the Heart and meet in the Lung”. Thus the syndrome mainly relates to the Lung; ii. Bai He is the name of the herb (Bulbus Lilii) in the Chinese pharmacopoeia which nourishes Lung-Yin and Heart-Yin and pacifies Heart-Fire, and is used to treat this syndrome.
The main symptoms of Bai He syndrome are absentmindedness (being in a ‘trance’), abnormal appetite and behaviour, a bitter taste in the mouth, and a slightly rapid pulse. The main zang involved are the Lung and Heart and sometimes also the Spleen. It is generally caused by injury due to excess of the seven emotions, and often begins with depression which damages the Heart and Lung Yin. Sometimes Bai He syndrome develops after a febrile disease that damages the Yin of the Heart and Lung leading to emotional problems.
The Heart stores the Shen; when the Heart is injured, the Shen is disturbed. The ‘intellectual function’ of the Lung is to store the Po. When the Po is disturbed, the patient is usually absent-minded and, because the Po belongs to the Lungs, easily suffers from sadness and grief; when the Po is uneasy the patient suffers from hallucinations. The general treatment principle for Bai He syndrome is to treat the Heart and Lung, concentrating on whichever of these two zang most predominates.
The main patterns of Bai He syndrome are:
1. Yin-Xu of Heart and Lung:
Herbal prescription: Bai He Di Huang Tang plus Gan Mai
Da Zao Tang
Bai He (Bulbus Lilii) 30g
Zhi Mu (Radix Anemarrhenae Asphodeloidis) 10g
Sheng Di Huang (Radix Rehmanniae Glutinosae) 30g
He Huan Hua (Flos Albizziae Julibrissin) 10g
Ye Jiao Teng (Caulis Polygoni Multiflori) 12g
Mu Xiang (Radix Saussureae seu Vladimirae) 9g
Da Zao (Fructus Zizyphi Jujubae) 30g (8-10 dates)
2. Internal Disturbance of Phlegm-Heat
Herbal Prescription: Bai He Huan Tan Tang
Bai He (Bulbus Lilii) 30g
Zhi Mu (Radix Anemarrhenae Asphodeloidis) 10g
Sheng Di Huang (Radix Rehmanniae Glutinosae) 30g
Gua Lou (Fructus Trichosanthis) 10g
Xing Ren (Semen Pruni Armeniacae) 9g
Zhi Shi (Fructus Citri seu Ponciri Immaturus) 10g
Chen Pi (Pericarpium Citri Reticulatae) 6g
Ban Xia (Rhizoma Pinelliae Ternatae) 9g
Fu Ling (Sclerotium Poriae Cocos) 12g
Dan Nan Xing (Pulvis Arisaemae cum Felle Bovis) 10g
Huang Qin (Radix Scutellariae Baicalensis) 10g
Gan Cao (Radix Glycyrrhizae Uralensis) 6g
3. Heart-Yin Xu
Herbal prescription:
Bai He (Bulbus Lilii) 30g
Zhi Mu (Radix Anemarrhenae Asphodeloidis) 10g
Sheng Di Huang (Radix Rehmanniae Glutinosae) 12g
Cao Zao Ren (Semen Ziziphi Spinosae Praeparatae) 20g
Bai Zi Ren (Semen Biotae Orientalis) 20g
Zhu Sha (Cinnabaris) 2g [Could probably substitute Hu po or Long chi -PB]
4. Stagnation of Liver-Qi and Yin-Xu
Herbal prescription:
Bai He (Bulbus Lilii) 30g
Sheng Di Huang (Radix Rehmanniae Glutinosae) 12g
Zhi Mu (Radix Anemarrhenae Asphodeloidis) 10g
Qing Pi (Pericarpium Citri Reticulatae Viride) 6g
Chen Pi (Pericarpium Citri Reticulatae) 6g
Zhi Shi (Fructus Citri seu Ponciri Immaturus) 12g
Wa Leng Zi (Concha Arcae) 15g
Mu Xiang Mian (Powdered Radix Saussureae seu Vladimirae) 6g
Fo Shou (Fructus Citri Sarcodactylis) 6g
• In case of Stomach heat add Huang Lian (Rhizoma Coptidis) 7g and Wu Zhu Yu (Fructus Evodiae
Rutaecarpae) 3g.
• When the condition improves, give Xiao Yao Wan to soothe the Liver and regulate the patient’s mental state.
5. Stagnation of Spleen-Qi and Injury to the Lung
Herbal prescription:
Bai He (Bulbus Lilii) 30g
Sheng Di Huang (Radix Rehmanniae Glutinosae) 15g
Zhi Mu (Radix Anemarrhenae Asphodeloidis) 12g
Gui Zhi (Ramulus Cinnamomi Cassiae) 6g
Cang Zhu (Rhizoma Atractylodis) 15g
Sha Ren (Fructus seu Semen Amomi) 9g
Dai Zhe Shi (Haematitum) 15g
Yu Jin (Tuber Curcumae) 9g
Chuan Jiao (Fructus Zanthoxyli Bungeani) 7g
6. Lung and Kidney Yin-Xu
Herbal prescription:
Bai He (Bulbus Lilii) 30g
Zhi Mu (Radix Anemarrhenae Asphodeloidis) 12g
Sheng Di Huang (Radix Rehmanniae Glutinosae) 15g
Di Gu Pi (Cortex Lycii Chinensis Radicis) 15g
He Shou Wu (Radix Polygoni Multiflori) 18g
Bie Jia (Carapax Amydae Sinensis) 10g
7. Disharmony between Heart and Kidney
[no formula given]
The value of understanding the syndrome of Bai He lies in its practical relevance in the analysis and treatment of patients suffering from depression, uneasiness, absentmindedness, lack of concentration, sadness, grief etc. Since the clinical manifestations of patients with emotional disorders do not avail themselves of clear-cut categorisation (whether in Western medicine or TCM), the broader the understanding of the possibilities the better the weaving of a treatment prescription.

Dose: 9-30g

8 comments on “Bai He – Lily bulb – “Hundred Meetings”

  1. Hello my name is Rosanna Vasquez-Gregory, LAc. I am currently finalizing my doctorate program at Pacific College of Oriental Med., San Diego on-line campus. My instructor briefly touched the surface of Lily Disease and found your article. With your permission I would love to incorporate it with a Case Study of this type of disorder from a non documented immigrant. I plan to tie it into resources from NIMA and SAMHSA and Acupuncturist Without Borders/NADA protocol?

  2. Jason Wong says:

    Can you explain the form of the dosage? Is each formula listed as raw herb weight or powdered extract weight? You have dose listed as 9-30g. I assume that is per day? So if that is powdered extract then for example for the prescription for Stagnation of Liver-Qi and Yin-Xu, the total is 113g so would you expect that to last 11 days if they were taking 10g of that formula per day?

    • Peter Borten says:

      Yes, these are bulk, one day doses.
      The translation to powdered extracts (granules) is inexact. A typical bulk formula might work out to 50 to 100 grams a day (for example, typical dosing on Xiao Yao San {tang} might be 9 grams chai hu, 12 grams Bai shao, 9 grams dang gui, 12 grams Bai zhu, 9 grams Fu ling, 6 grams bo he, 3 grams zhi gan cao) … And sometimes 150 or more grams a day. If you were using granules with a concentration of 5:1, then approximating a bulk formula dosed at 60 grams a day would mean using 12 grams of these granules (usually divided as 4g 3x a day). That’s a common and reasonable dose. But if you were prescribing a larger formula that was, say 120 grams in bulk form, you’d need 24 grams of granules to approximate this dose, and you’ll virtually never see this done. Mostly, people prescribe 6 to 15 grams of granules a day, regardless of the size of the formula. Though if you think about it, the larger the formula, the more you’d need to take in order to get a pharmacologic dose of each herb (if you think of herbs that way). Clearly, most people don’t think of granules that way … more like a lower dose for milder conditions, kids, elderly, sensitive people… and higher dose for more severe conditions, bigger people, strong people, etc., without much concern for trying to approximate bulk dose equivalents.

    • Peter Borten says:

      These doses listed are for bulk herb for one day. For instance, you might take 15 grams of bai he, decocted into tea, split into 2 or 3 portions, drunk over the course of the day.

      Dosing powdered extracts is more nuanced. It depends in part on the strength of the extract. A typical formula of, say, 10 herbs, dosed at an average of about 10 grams each, would amount to 100g of bulk herb to be taken each day. If you wanted to approximate this using a 5:1 powdered extract, you’d take 20g over the course of the day (about 7g 3x a day). Often, though, granules are dosed lower, like 3g 3x a day (9g per day) to 5g 3x a day. But it’s not unheard of to use 20g a day or more. It would make sense to dose a larger formula higher and a smaller formula lower, since the relative dose of each herb would be smaller if you took, say, 12g of granules a day of a large formula (say 15 herbs) than if you took the same amount of granules of a small formula (say 4 herbs).

  3. Jason Wong says:

    My local herbal dispensary does not carry Wa Leng Zi (Concha Arcae), can you recommend a good alternative?

    • Peter Borten says:

      There isn’t a great single herb with the same functions as Wa Leng Zi. It’s rather unique. Depending on what functions you’re going for, something like Mu Li, Hai Piao Xiao, Hu Zhang, Si Gua Luo might do the trick. Or you might have to combine two herbs.

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