Liverspleen disharmony with dampness pouring downward. Liver depression has resulted in depressive heat affecting the functions of the stomach, heart, and lungs, while spleen qi vacuity has resulted in nonconstruction of the heart spirit and failure to upbear the clear. Hence there is disquietude of the spirit and urinary symptoms that are aggravated by stress or emotional upset.
Courses the liver and rectifies the qi, clears heat and eliminates dampness, supplements the qi and quiets the spirit.
A liverspleen disharmony with dampness pouring downward resulting in urinary frequency, urgency, and possible pain. In addition, liver depression has resulted in depressive heat affecting the functions of the stomach, heart, and lungs, while spleen qi vacuity has resulted in nonconstruction of the heart spirit. Hence there is disquietude of the spirit and association and aggravation of the urinary symptoms with psychoemotional stress.
In terms of disease diagnosis, this formula is mainly for the treatment of neurogenic bladder. If the patterns fit, this formula may also be used to treat interstitial cystitis.
The excessive urination is due to a combination of stomach heat and hyperactivity sending downward too many fluids and spleen qi/central qi vacuity failing to send enough clear fluids upward. This is a very commonly seen combination and has nothing to do with kidney vacuity.
This formula is not for damp heat pouring downward cystitis.
THE SIGNS AND SYMPTOMS OF LIVER DEPRESSION QI STAGNATION INCLUDE
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A bowstring pulse
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Possible PMS and/or dysmenorrhea
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Irritability
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A dark tongue
THE SIGNS AND SYMPTOMS OF DEPRESSIVE HEAT AFFECTING THE HEART AND/OR STOMACH INCLUDE
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Easy hunger
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Possible rapid pulse
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Possible swelling of the tongue sides
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Possible redness of the tongue tip and/or sides
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Possible yellow tongue fur
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Restlessness and agitation, possible profuse dreams or poor sleep
THE SIGNS AND SYMPTOMS OF SPLEEN VACUITY WITH DAMPNESS INCLUDE
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Fatigue
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A fine pulse
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A tendency to loose stools
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Lack of strength
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A swollen tongue with teethmarks on its edges
THE SIGNS AND SYMPTOMS OF NONCONSTRUCTION OF THE HEART SPIRIT INCLUDE
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Excessive worry and anxiety
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Poor sleep
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Possible palpitations
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Restlessness
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Confusion and/or impaired memory
Although this formula in Chinese is named after Xiao Chai Hu Tang (Minor Bupleurum Decoction), it is actually a modified combination of Xiao Chai Hu Tang, Xiao Yao San (Rambling Powder), and Bu Zhong Yi Qi Tang (Supplement the Center & Boost the Qi Decoction). In this formula, Chai Hu (Radix Bupleuri), Fang Feng (Radix Saposhnikoviae), Chen Pi (Pericarpium Citri Reticulatae), and Sheng Jiang (uncooked Rhizoma Zingiberis) course the liver and rectify the qi, while Bai Shao (Radix Alba Paeoniae) and Dang Gui (Radix Angelicae Sinensis) nourish the blood and emolliate the liver. Huang Qi (Radix Astragali), Dang Shen (Radix Codonopsis Pilosulae), Fu Ling (Poria), Gan Cao (Radix Glycyrrhizae), and Da Zao (Fructus Zizyphi Jujubae) supplement the spleen and construct the heart spirit. Fu Ling, Ban Xia (processed Rhizoma Pinelliae Ternatae), Chen Pi, and Sheng Jiang seep and transform dampness. Huang Qin (Radix Scutellariae) clears heat from the liver, stomach, and lungs. Depressive heat from the liver drafts upward, affecting the stomach and lungs. In Chinese medicine, it is said that, “The kidneys are the sluicegate of the stomach.” This means that the stomach and kidneys are related in terms of the production of urine. If the stomach is hot and hyperactive, it not only disperses food too quickly downward, it also disperses liquids too quickly downward, thus contributing to urinary frequency and urgency. Similarly, depressive heat from the liver and stomach may accumulate in the lungs, affecting the lungs’ control over the water passageways. Mai Men Dong (Tuber Ophiopogonis) clears heat from the stomach and heart, helps transform dampness and phlegm, and nourishes yin, therefore, preventing the ruling ingredient, Chai Hu (Radix Bupleuri), from plundering yin. Niu Xi (Radix Achyranthis Bidentatae) helps move the blood and thus also heat and fluids downward, while empirically also treating any tendency to low back pain. Yuan Zhi (Radix Polygalae) and Ye Jiao Teng (Caulis Polygoni Multiflori) both quiet the spirit. In addition, Yuan Zhi rectifies the qi and transforms phlegm, while Ye Jiao Teng nourishes the blood and treats both irritability and insomnia.
This formula has achieved a 90.3% total amelioration rate in one study of 31 patients with urinary bladder neck syndrome and neurogenic bladder, with a 61.2% cure rate.
Three capsules two times per day. This formula is made from a 9:1 extract. That means the above dosage is equivalent to not less than 27 grams of bulk herbs. However, because our extraction process is so much more efficient than stovetop decoction, we believe this amount it is actually more like the equivalent to 40-54 grams of bulkdispensed herbs.
If symptoms of spleen qi vacuity or central qi falling downward are more pronounced, this formula may be combined with Bu Zhong Yi Qi Wan (Supplement the Center & Boost the Qi Pills). If stomach heat is marked, it may be combined with Huang Lian Su (Coptis Simple) or Ban Xia Xie Xin Tang (Pinellia Drain the Heart Decoction). If dampness and turbidity are more marked, this formula can be combined with Er Chen Wan (Two Aged [Ingredients] Pills). If heart spirit nonconstruction and malnourishment are more pronounced, it can be combined with Gan Mai Da Zao Wan (Licorice, Wheat & Red Date Pills). If kidney qi not securing complicates the picture, it can be combined with Jin Suo Gu Jing Wan (Golden Lock Secure the Essence Pills). If complicated by blood stasis, this formula can be combined with Shao Fu Zhu Yu Tang Wan (Lower Abdomen Dispel Stasis Decoction Pills).
MY PATIENT DOES HAVE
Liver depression qi stagnation: Yes - No
Spleen vacuity with dampness: Yes - No
Depressive heat (Not absolutely necessary): Yes - No
