Teeny Tiny: Chi Xiao Dou Dang Gui San

It’s been a while since we’ve had a teeny tiny formula post. I am writing today about a favorite of mine, one that really packs some power: Chi Xiao Dou Dang Gui San.

This formula is written about in two places in the Jin Gui Yao Lue.

Firstly it is in Chapter 3 on Pulses, Patterns and Treatment of Bai He (Lilly) Disease, Hu Huo Disease and Yin Yang Toxin Disease. Line thirteen says:

“The patient has rapid pulses, no fever, slight vexation, reticent but with a desire to lay down, and sweating. Three or four days after the initial onset, the eyes are red as those of a turtle dove. After seven or eight days, the four corners of the eyes turn dark. If the patient is able to eat, this indicates that pus has developed. Chi Xiao Dou Dang Gui San is indicated.”

Secondly, it is in chapter 16: Pulses, Patterns and Treatment of Fright palpitations, Purgation of Blood, Fullness in the Chest and Static Blood where line 16 says:

“With bleeding in the bowel, first there is bleeding followed by defecation. This is called proximal bleeding. Chi Xiao Dou Dang Gui San is indicated.”

Ah, the Jin Gui text…..it can be difficult to determine how to use a formula in the clinic well with just these lines to go on!

These two flavors are ground into a powder. Take one square inch spoon with millet water three times a day.

Modern method: make into a powder and 3 doses of 6 gm each day in warm water. It can also be made into a decoction.

This formula is also taken in decoction form but can still be taken with millet water. Millet water is the water taken from millet after it has sat in the cold water for five or six days. It begins to smell sour and a foam appears on top.

Because it is a small formula, it is often combine with other herbs and formulas depending on the situation.

This little formula is amazingly useful for a wide variety of difficulites. As Liu Han-Tang wrote in his Clinical Records of Treating Illness with Classical Formulas:

“In modern times, Chi Xiao Dou Dang Gui San is the primary formula to treat hypertrophy of the knee, blood before stool, Bi syndrome, red and white leukorrhea, urticaria, urinary tract infection, vaginal sores and swelling, immune illnesses (Behcet’s syndrome), anal-intestinal illnesses (bleeding hemorrhoids, anal fissures) water swelling (nephritic edema, cardiopulmonary edema, liver ascites, edema of malnutrition, inflammatory edema, idiopathic edema, premenstrual water swelling and closed type soft tissue damage.”

To this list, I would add that it can treat constipation and it is excellent for certain skin diseases. It is an important formula for the treatment of women’s illnesses, treating blocked breast ducts and blocked menstruation.

On January 9th, 2018, I will be giving a one hour online talk about this formula on medigogy. (Note that Medigogy will be on a new site starting at the start of the year so if this link doesn’t work, just search “medigogy.”) The talk starts at 1:00 pm PST (4:00 EST). I hope that through this talk, practitioners will feel that this formula becomes a good clinical friend. To achieve this, it’s crucial that its actions are really understood. This way, you will know exactly what kind of clinical situations it is perfect for.

For now, I will leave you with more of Liu Han-Tang’s words followed by a case study. I really like this case because of how the patients family didn’t trust the formula because it was made up of kitchen foods and only one “real” herb.

From Liu Han-Tang:

“The sage Zhang wrote in his original text that this formula is for Hu Huo illness. Because the damp heat toxin has mixed with static blood, there is transformation into pus. This formula has the effect of clearing heat, resolving toxin, discharging pus and vitalizing blood, dispelling stasis and generating the new. The use is not at all limited to Hu Huo illness. It is suitable for all illnesses in which damp heat is flourishing or when damp heat becomes a toxin and forms pus. This is the essential point of this formula.”

Postpartum Insufficient Breast Milk

Dr. Tong Zong-Jing 仝宗景

Ms. Liang was a 28 year-old peasant who had just given birth. She came for a consultation on June 10, 1986. This patient generally liked to eat hot spicy foods. After giving birth she developed dry knotted stool. There was also abundant blood in her stool. Six days after giving birth her breast milk stopped flowing. I was invited to come for a visit. At the consultation I could see that both breasts were swollen and distended but the breast milk did not move. Her tongue moss was yellow and sticky and her pulses were thin and rapid.

DIAGNOSIS
Constrained damp-heat, damage to the blood collaterals and lack of breast milk flow.

TREATMENT PRINCIPLE
Clear and disinhibit damp-heat, harmonize the blood and moisten dryness. The treatment was the Jin Gui Yao Lue formula Chi Xiao Dou Dang Gui San.

This was decocted in water, one package for one day. The patient’s family was very doubtful because there was only one Chinese herb in the formula. Chi Xiao Dou is a common food. They were surprised when, after only four packages, the patient’s stool was moist and moving and her breast milk was also flowing and abundant.

DISCUSSION
Chi Xiao Dou Dang Gui San is seen twice in the Jin Gui Yao Lue. It is first seen for Hu Huo illness with brewing pus. Then it is seen for blood in the stool. In both illnesses, the disease mechanism is pent-up damp-heat with resulting damage to the blood collaterals. In the Fu Ren Shi Fang, Chi Xiao Dou Dang Gui San is used for “postpartum lack of movement of the vessels of the breast for 70 days in which taking herbs had been ineffective.” After that, many collections of medical prescriptions recommend Chi Xiao Dou Dang Gui San for opening through the breast. Dang Gui nourishes and harmonizes the blood. It is an important herb for postpartum women. The two flavors are used together. Their strength for this special purpose is great. The damp-heat is dispelled and the blood collaterals are harmonized. In this way, the blood in the stool and the lack of breast milk were both cured at the same time.