Dryness Formulas

A central tenet of Chinese meridian theory is that pathogens track with a predictable progression through the body. Different seasons bring varying influences into the body. Autumn is the season of dryness. Below is a discussion of the "dryness" pathogen and its progression as articulated by Wu Ju-tong (1757-1841), one of the most highly regarded herbalists of the Qing Dynasty, heralding from the Warm Disease school, which specialized in seasonal affective disorders.

The purpose of the following article is to acquaint readers who have a passion for Chinese herbalism with Warm Disease perspectives on dryness by discussion the common formula prescriptions.

Formulas:
Sang Xing Tang
Sang Ju Yin
Sha Shen Mai Men Dong
Qiao He Tang
Qing Zao Jiu Fei Tang

Discussion
Sang xing tang and Sang ju yin are both for initial stage dryness. The condition is in the lung and wei levels. Use acrid, cool, clearing, and moistening herbs.

Sha shen mai men dong tang is for dryness that has damaged "yin aspects of the lung and stomach, [presenting] with fever or cough. This is a deeper level of damage than above, therefore the addition of sweet is needed to assist in the production of jin and ye.

Qiao he tang treats dryness transforming into fire and Qing zao jiu fei tang treats pent-up (fen yu) qi.

The interesting thing is that all these formulas treat dryness, specifically heat dryness. Dryness patterns range from conditions resembling wind-heat to yin deficiency, so the texts are adamant about doing proper differentiation. The problem is that differentiation is much easier said than done because constitutional patterns often must be considered in addition to the acute presentation.

The formulas above are characterized by their treating the lung primarily and stomach secondarily. It is interesting to note that the text's commentators place considerable emphasis on the role of earth as mother to metal. Fascinatingly, this also leads to their stunningly obvious but daring conclusion that autumn dryness is actually born from summer dampness. Be that as it may, aromatic damp transformers, so central to all dampness formulas, do not find their way into any of the above formulas.

Since these formulas track the progression of heat through the meridians of the lung, differentiation turns on duration and severity of the condition. By far the most severe presentation belongs to "dryness transformed into fire." In contrast to clear repletion fire formulas however, heavy bitter herbs are not appropriate. Toxicity is cleared through the bitter, slight sweet, and bland of he ye (lotus leaf) and the anti-toxicity of lian qiao (forcythia), an herb that must rank among the lightest of the category. Hallmark signs are tinnitus and red eyes, but accompanying upper jiao symptoms, such has weakness, wheezing, and vomiting, can also be present. Herbs that can be used are fresh ju hua, ku ding cha, xia ku cao, niu bang zi, and huang qin.

Dryness that progresses beyond the initial stage, that which damages the lung and stomach yin calls for Sha shen mai men dong tang. The first two formulas Sang xing tang and sang ju yin are for the initial stages. The latter of these two would be used for initial stage dryness that also presents with a cough.

Initial stage conditions are characterized by lung and wei presentations, whereas deeper stages do not have wei symptoms. This means when differentiating between whether to administer first stage or second stage (so to speak) formulas, it is important to determine whether wei syndromes are still present. Constitutionally speaking, deficient patients-- individuals with lung deficiency, pre-existing dampness, or yin deficiency-- may never present in the clinic with wei patterns because their wei qi, and by extension zheng qi, is already on the deficient side.

We conclude this discussion on dryness with Qing zao jiu fei tang. I have personally found this formula helpful for yin deficiency cough. A strong reminder is served to practitioners about using cold and bitter herbs for dryness for diminishing heat symptoms in the case of lung dryness. This formula focuses on stomach earth as mother of lung metal. Though it is easy to note the spleen lung relationship, this text reminds us that the yang aspect of earth is the focus of dryness conditions. Herbs that clear and moisten (run) are consequently called for.

All of the above formulas are discussed in Bensky with the exception of Qiao he tang, so its ingredients are provided below:

Bo he 1 qian 5 fen
Lian qiao 1 qian 5 fen
Sheng gan cao 1 qian
Black zhi zi 1 qian 5 fen
Jie Geng 3 qian
Lu dou yi 2 qian

Source text: Wen Bing Xue. Meng Shu-jiang ed., Ren min wei sheng chu ban she, 1989 1st edition 1997 3rd printing.