abstracted & translated by
Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)
On page 94 of issue #6, 2007 of Xin Zhong Yi (New Chinese Medicine), Wang Qiu-ping published an article titled “The Treatment of Chronic Fatigue Syndrome Via Three Steps Based on Knowledge Gained from Experience.” In this article, Dr. Wang outlines a three-step treatment protocol for this condition. A summary of his experiences is presented below.
1. Level the liver and extinguish wind; quickly treat the tips [or branches]
Dr. Wang’s first step of treating patients with CFS is based on his experience that these patients commonly present with dizziness, headache, sore neck, heart palpitations and fearful throbbing, vexation, agitation, restlessness, insomnia, profuse dreams, a dry mouth with a bitter taste, thin, yellow tongue fur, and a vacuous, agitated pulse. These symptoms correspond to a pattern of ascendant liver yang hyperactivity with internal wind harassing above. The liver’s main physiologic functions are its governance of the storage of blood and its governance over coursing and discharge. Its body is yin, but its function is yang. The liver is categorized as wood in terms of the five phases. Therefore, it governs stirring and upbearing. It is the liver’s ability to store the blood that controls and restrains ascendant liver yang hyperactivity. The nature of CFS is that it is a long-term condition that exhausts and consumes the body’s yin and blood internally. As Wang Bing said:
The liver stores the blood, [while] the heart moves it. Stirring leads to the blood’s movement within all the channels. [However, when] a person [is] still, this leads to blood returning to the liver viscus.
If liver blood is consumed internally, it is not able to control and restrain liver yang. Yin is vacuous and yang becomes hyperactive. Thus vacuity wind harasses the clear orifices above, leading to dizziness and headache. This harassment also stirs the heart spirit which leads to heart palpitations and fearful throbbing, vexation, agitation, and restlessness. The liver stores the ethereal soul, and the ethereal soul is nothing other than a manifestation of the spirit. Blood is the main material basis of both the spirit and the ethereal soul. Therefore, it is said, “The liver stores the blood [and] the blood is the abode of the ethereal soul.” If liver blood is insufficient, the spirit has no abode in which to lodge. The clinical manifestations of this are susceptibility to fright, profuse dreams, and restless sleep. Agitation and stirring of wind and yang consume and damage fluids and humors, thus leading to a dry mouth with a bitter taste as well as thin, yellow tongue fur and a vacuous, agitated pulse.
Based on the above, Dr. Wang says that one first should level the liver and extinguish wind using the following formula:
Sheng Di Huang (uncooked Radix Rehmanniae), 40g
Ci Ji Li (Fructus Tribuli)
uncooked Mai Ya (Fructus Germinatus Hordei)
Yin Chen Hao (Herba Artemisiae Scopariae), 6g each
Gou Teng (Ramulus Uncariae Cum Uncis)
He Huan Pi (Cortex Albiziae)
Yu Jin (Tuber Curcumae), 10g each
Ye Jiao Teng (Caulis Polygoni Multiflori)
Fu Shen (Sclerotium Pararadicis Poriae), 30g each
Dang Shen (Radix Codonopsis)
Shi Jue Ming (Concha Haliotidis)
Dan Shen (Radix Salviae Miltiorrhizae), 15g each
Within this formula, a heavy dose of Sheng Di Huang enriches and nourishes the liver and kidneys, cools the blood and moistens dryness. Gou Teng levels the liver and extinguishes wind. It also has the function of settling and stilling. Shi Jue Ming levles the liver and subdues yang. Ci Ji Li courses the liver and dispels wind, levels the liver and regulates the liver qi. A small amount of Yin Chen Hao clears heat from the liver and gallbladder as well as rectifies liver-gallbladder depression. Hence heat is dispersed and depression is upborne. This is assisted by uncooked Mai Ya which is also effuses and upbears the qi. Its nature is to regulate the flow of the liver qi’s spreading and extending. Ye Jiao Teng and He Huan Pi nourish the blood and resolve depression, quicken the blood and free the flow of the network vessels, quiet the spirit and stabilize the mind. Dang Shen fortifies the spleen and supplements the qi, while Fu Shen disinhibits water and seeps dampness, thus preventing the accumulation of dampness from producing phlegm. It also calms the heart and quiets the spirit. The use of these two medicinals is based on the saying, “[If] one sees liver disease, know that the liver transmits to the spleen [and] so one must first replete the spleen.” Yu Jin and Dan Shen soothe and ease the flow of the qi mechanism, free the flow and out-thrust stasis and stagnation. Therefore, they free and ease the flow of both the qi and the blood.
2. Enrich and nourish the liver and kidneys, balance yin and yang
After wind and yang have been leveled and extinguished respectively, clinically one sees marked signs of liver-kidney insufficiency as the root of the disease. This is evidenced by unremitting fatigue accompanied by heart palpitations, insomnia, restlessness, and a fine, weak pulse. In this case, the pattern is categorized as liver-kidney essence depletion with blood not nourishing the spirit. If liver blood and kidney essence become insufficient, then the spirit suffers from lassitude and the body from lack of strength. In addition, there are heart palpitations and fearful throbbing. In order to treat this, Dr. Wang says one should supplement and boost the liver and kidneys, enrich, nourish, and quiet the spirit. The formula he suggests is Zuo Gui Yin (Restore the Left Beverage) and Sheng Mai Yin (Engender the Pulse Beverage) plus Suan Zao Ren Tang (Zizyphus Spinosa Decoction) with additions and subtractions:
Suan Zao Ren (Semen Zizyphi Spinosae)
He Huan Pi (Cortex Albiziae)
Shan Zhu Yu (Fructus Corni)
Tu Si Zi (Semen Cuscutae)
Dang Shen (Radix Codonopsis)
Mai Men Dong (Tuber Ophiopogonis), 10g each
Fu Shen (Sclerotium Pararadicis Poriae)
Ye Jiao Teng (Caulis Polygoni Multiflori)
He Shou Wu (Radix Polygoni Multiflori), 30g each
Sheng Di Huang (uncooked Radix Rehmanniae)
Shu Di Huang (cooked Radix Rehmanniae)
Dan Shen (Radix Salviae Miltiorrhizae), 15g each
Gua Lou (Fructus Trichosanthis), 6g
Within this formula, Suan Zao Ren, Ye Jiao Teng, and He Huan Pi nourish the heart and boost the liver, quiet the spirit and stabilize the mind. He Shou Wu astringes the essence and secures the qi, supplements the liver and enriches the kidneys. Sheng Di Huang and Shu Di Huang enrich yin and supplement the kidneys, nourish the blood and boost the essence. Shan Zhu Yu supplements the liver, astringes the essence, and secretes the qi. Tu Si Zi boosts the three yin and strengthens the defensive qi. Dang Shen and Mai Men Dong boost the qi and nourish yin, nourish and clear the heart. Fu Shen, Dan Shen, and Gua Lou transform phlegm and dispel stasis, move the blood and quiet the spirit. When all these medicinals are used together, they supplement and boost the liver and kidneys, enrich, nourish, and quiet the spirit. When the essence is engendered and the blood is sufficient, fatigue and lack of strength are improved and ameliorated.
3. Fortify the spleen and nourish the heart, improve and ameliorate the physical body
According to the authors of the Su Wen (Simple Questions):
The spleen and stomach, large intestine, small intestine, three burners, and the bladder are the root of the storehouse of endowment and the abode of the constructive... They are of the category of utmost yin and communicate with the earth qi.
Earth is the origin of the tens of thousands of things. Thus it is said, “The spleen is the latter heaven root.” Liver blood and kidney essence both come from this source, and supplementing and filling the spleen qi enriches, engenders, and transforms this source. Therefore, if the spleen qi is fortified and moving, the finest essence of food and drink is full and sufficient. This then leads to the engenderment and transformation of the liver and kidney essence and blood having a source. This promotes and ameliorates the physical body and secures the therapeutic effects already gained. The formula Dr. Wang recommends for this purpose is Gui Pi Tang (Restore the Spleen Decoction) with additions and subtractions:
Huang Qi (Radix Astragali)
Dang Gui (Radix Angelicae Sinensis)
Suan Zao Ren (Semen Zizyphi Spinosae)
Yuan Zhi (Radix Polygalae)
Mai Men Dong (Tuber Ophiopogonis)
Mu Xiang (Radix Auklandiae)
Dang Shen (Radix Codonopsis), 10g each
Fu Shen (Sclerotium Pararadicis Poriae)
Ye Jiao Teng (Caulis Polygoni Multiflori)
Bai Shao (Radix Alba Paeoniae)
Dan Shen (Radix Salviae Miltiorrhizae), 15g each
Wu Wei Zi (Fructus Schisandrae)
Gan Cao (Radix Glycyrrhizae), 3g each
Within this formula, Huang Qi, Dang Shen, and Gan Cao supplement the spleen and boost the qi. When the spleen qi is strong, it is able to engender and contain the blood. Fu Shen, Yuan Zhi, Suan Zao Ren, and Ye Jiao Teng supplement the heart and boost the spleen. When heart yin recovers, it is able to engender the blood and construct the spleen. Dang Gui and Dan Shen nourish the blood and construct the heart. Mu Xiang moves the qi and soothes the spleen. Mai Men Dong and Wu Wei Zi promote the boosting of the lungs and kidneys. Bai Shao restrains the liver and enriches the kidneys. When all these medicinals are used together, they promote the sufficiency of heart blood, the strength of the spleen qi, and fortification of both the mother and child. Hence all the symptoms of fatigue and lassitude are eliminated.
In the representative case history Dr. Wang provides as an example of this approach, he prescribed formula No. 1 for one week. At the end of that week, the patient’s heart palpitations and agitation had remitted. Then Dr. Wang prescribed formula No. 2 for 20 days based on the fact that the patient was still fatigued and had a sore neck and that these were worse after activity. After this, he prescribed formula No. 3 in order to regulate and rectify and generally improve the patient’s condition. Although he does not say how long the patient took formula No. 3, he does say that this regime was very effective.
Copyright © Blue Poppy Press, 2007. All rights reserved.
