Warm Gall Bladder Soup is a famous formula in the “Prepared Urgent Thousand Gold Essentials”, mainly used to treat “deficiency and sleeplessness after a major illness”. The original formula consisted of six herbs, namely, bamboo rhizome, citrus aurantium, hemp, ginger, Chen Pi, and licorice. In the Song Dynasty, in the “Three Causes and One Disease Evidence Formula” written by Chen Wuzhe, Fu Ling and Dazao were added to the original formula of Warm Gall Bladder Soup, but Dazao is generally not used in clinical practice.
However, this formula can be used clinically to treat many illnesses, so it is necessary to study it again.
(1) Name of the formula
From the composition of the medicine of Warm Gallbladder Soup, this formula belongs to the formula of resolving phlegm and clearing heat, harmonizing the liver and gallbladder, eliminating false annoyance and fixing panic and palpitation. Why is this formula not called “Clear Gallbladder Soup”, but “Warm Gallbladder Soup” instead?
Chinese medicine believes that the liver is a virile organ, which likes to be organized but not depressed, and the gall bladder likes to be quiet but not disturbed. The “Prepared for Emergency Thousand Gold Essentials” says: “The gall bladder is the main organ of the liver. The liver is in harmony with the gallbladder, and the gallbladder is in the clear internal organs”, which shows that the liver and gallbladder are in communication with each other physiologically. As the liver and gallbladder qi has the characteristics of raw and ascending, and is smooth and smooth, the ancient people compared the liver and gallbladder qi to the mildness of spring qi, and the warmth of the gallbladder qi is able to flow. If phlegm and heat are present in the liver and gallbladder, the liver and gallbladder will lose its mildness and develop. In order to restore its nature, the phlegm-heat must be removed first, and when the phlegm-heat is removed, the bile qi will be warm and harmonious.
(2) Etiology and pathogenesis
The pathogenesis and mechanism of warm bile soup can be summarized as follows.
1) Emotional and moral factors: all the seven emotions, such as anger, depression and indecision, can affect the liver and gallbladder and make the qi unfavorable, unable to follow the nature of its growth and development, so that the wood qi is depressed and the earth qi does not reach, the earth qi does not reach, it is easy to produce phlegm and dampness; qi depression over time will turn into heat, phlegm and heat due to qi depression and obstruction, then internal disturbance of the liver and gallbladder as a problem.
(2) Internal injury by diet: such as eating fatty and sweet food, drinking too much wine and tea, resulting in the congestion of phlegm and dampness in the body, which will turn into heat over time and cause disease in the liver and gallbladder.
(3) Injury by external evil: such as external dampness and heat, or injury by summer dampness, or after a serious illness, phlegm and drinks have not been eliminated, the residual heat has not been exhausted, and phlegm and heat disturb the liver and gallbladder and cause the disease.
In short, phlegm congestion and qi depression, the liver and gallbladder are not able to drain, and heat is generated for a long time, so that phlegm, qi and fire are mixed and depressed, forming the evidence of “warm gallbladder soup”.
(3) Main symptoms
Wen Bile Tang is widely used clinically and involves a variety of symptoms, but according to clinical evidence, its main symptoms are: dizziness or pain in the head and eyes, insomnia, heart trouble, nausea, vomiting, palpitations, fullness or pain in the chest and hypochondrium, and timidity and easy fright. The tongue is red and vivid, with a fat body, yellowish white and greasy coating, and a smooth or counted pulse.
The main evidence is analyzed as follows: liver and gallbladder wind and fire incite each other, carrying phlegm and heat upward to disturb the position of clear yang, so the head and eyes are dizzy or painful; liver and gallbladder qi depression and loss of decision, the soul has no master, so palpitations and good fright; phlegm and heat internal disturbance of the mind and spirit will be restless, insomnia and dreamy and restless; wood depression and earth congestion, the spleen and stomach elevation is not normal, often appearing panic and vomiting, dullness; liver and gallbladder qi depression, so that its meridians and veins are not conducive, then the chest is distended or painful.
In addition, phlegm is the mother of all diseases, and fire is rampant, the disease is in Shao Yang, the pivot is unfavorable, the elevation and flow of qi is out of order, and various kinds of concurrent evidence are more common, such as damp-heat, food stagnation, hyperactivity, or wind and yang entering the luo.
(4) Clinical application characteristics
All use of warm gall bladder soup, must master the basic rules of its addition and subtraction changes, which is the key to the clinical use of this formula to treat a variety of evidence and get results.
(1) Chai and Scutellaria warm gallbladder soup: treatment of Shao Yang qi depression into fire, the adverse meridian gas is more serious, such as chest and hypochondrium bitter fullness or pain, mouth bitter, eyes red, migraine headache or qi fleeing pain, etc., add Chai Hu, Scutellaria baicalensis, Bu da Shao Yang qi depression, hair over Shao Yang fire depression, and can benefit Shao Yang cardinal. If the hypochondrium is hard, add raw oyster and neem; if the chest pain leads to back pain, add ginger yellow and southern safflower.
(2) Huang Lian Wen Bile Tang: Treating phlegm-heat disturbing the heart with heavy heat, mainly with heart disturbance or insomnia. If the fire-heat is heavy, then add Scutellaria baicalensis to clear the evil of fire-heat in the biliary organs.
(3) Gao Shao Wen Bile Tang: Treating phlegm-heat in Shaoyang with deficiency of Yin and Blood. The liver is the organ that collects blood, and uses yin and yang. Gas depression into fire, most likely to deplete liver blood, blood deficiency does not glory then see scalp or limb numbness, limb constricted spasm or limb trembling, or perimeter scurrying pain, tongue red vivid less moss or cracked, add angelica, white peony nourish liver blood; if dizziness or headache to menstruation is very, the above then add white Wei, codonopsis; head swelling pain add Xia Ku Cao, top headache add Chuanxiong, Tribulus terrestris, back of the head pain add Gui Zhi; yin deficiency serious and tongue light vivid, can add Sheng Di or Umei.
(4) Longmu warm gall bladder soup: treatment of bile deficiency and weakness, the mind is restless due to panic and restless sleep at night, add dragon bone, oyster can converge the mind and fix the will, while increasing the dose of Fu Ling to strengthen its tranquilizing effect. In severe cases, add nightshade flower, nightshade vine and dragon tooth.
(5) Peach Red and Warm Gallbladder Tang: Treating Shaoyang phlegm-heat with blood stasis and vascular obstruction, with dullness or forgetfulness, with petechiae on the tongue, adding peach kernel and red flower to activate blood stasis and promote blood circulation, and in severe cases, adding Chuanxiong and red peony.
(6) Danjuania Wenzhao Tang: For treatment of phlegm-heat internalized, the phase fire of Shaoyang is depressed, and the heart is troubled or troubled by sweating, add Dampi and Gardenia to drain the phase fire of Shaoyang. If the five hearts are troubled and hot, add Zhi Mu and Huang Bai; for low fever in the afternoon or night sweating, add Artemisia annua and Di Bone Bark.
(7) Yu Pu Wen Biao Tang: For treatment of phlegm and heat in the chest and diaphragm, paralysis and chest pain, add Yu Jin and Acorus calamus to open the phlegm and Qi to open the paralysis. If the heart is chagrined by phlegm and dampness, add Buddha’s hand and incense stick; or if the heart is dull and inarticulate or speech is unfavorable due to phlegm and dampness, add these two flavors to open up the phlegm and open up the orifice.
(8) Cangbai Wenzhao Tang: treating phlegm-heat with damp-heat downward injection, and see pain in the waist and knees, yellow and short unfavorable urine, women with more damp-heat in the lower jiao, add Cangzhu and Huangbai to clear damp-heat in the lower jiao. Yellow filth in the belt plus Fu Ling, Tsubaki root bark; heavy dampness and aversion to greasy food, plus Yin Chen, slippery stone.
(9) Dai Clam and Warm Gall Bladder Soup: For treatment of Shaoyang phlegm-heat, phase fire and disturbance of the heart and lung, with agitation, mania and dreaminess, or cough and phlegm, add Qing Dai and sea clam shells to clear the liver and cool the blood, and cleanse phlegm and resolve knots. Add Guahuo Ren and Loquat Leaf for excessive phlegm; add Hai Fushi for unpleasant spitting.
(10) Antelope Hook Warm Gallbladder Tang: For treatment of Shaoyang phlegm-heat with hyperactivity of Liver Yang, dizziness and tinnitus or fainting, soreness and weakness of the waist and knees, or limb numbness and limb trembling, add Antelope Horns and Hooked Vine to calm Liver Wind.
(11) Silkworm, Scorpion and Warm Gallbladder Tang: For the treatment of phlegm-heat and wind entering the ligaments and seeing numbness in the limbs, strong pain in the neck or constricted spasm in the limbs, add scorpion and silkworm to open the meridians and activate the ligaments.
(12) Nitrocellulose and warm gallbladder soup: treatment of Shaoyang phlegm-heat and hosts the stomach home real stagnation, the symptoms see abdominal distension and fullness, dry stools or unpleasant, plus huang, mannite or wind nitrate to pass the internal organs to drain heat, and stomach gas.
The above 12 kinds of evidence, often accompanied by the main evidence and appear, the main evidence and evidence in the pathogenesis has an intrinsic link, if the above-mentioned rules and characteristics of the treatment of the various evidence memorized in mind, when examining the changes in the pathogenesis, the weight of the disease and the changes in the addition and subtraction of the evidence is not bound to a pattern, then the prescription of the medicine, can be more effective.