I Can Hear the Heart's Voice of Traditional Chinese Medicine

Chapter 546 - 233: Angelica Sini Decoction with Evodia rutaecarpa and Ginger (2)

In Traditional Chinese Medicine (TCM), it is believed that warmth facilitates movement, whereas cold tends to cause stagnation.

This coldness doesn’t just refer to low temperatures; in TCM, it also represents a state of stagnation and obstruction.

For instance, conditions like uterine fibroids and endometriosis that cause menstrual pain are often considered to result from severe uterine cold. We often say that pain results from obstruction, and without obstruction, there is no pain. Obstruction-induced pain is caused by cold, which impedes blood flow.

At this time, the body sends a pain signal, a reminder for us that it’s time to muster more yang energy and resources to help discharge the menstrual blood.

This may be hard to understand for many people. Simply put, it’s like when we’re driving on the road, and someone doesn’t follow the traffic rules, causing a traffic jam. Then, calling the traffic department results in the dispatch of traffic police to clear it.

The pain acts as a signal of the traffic jam, dispatching yang energy to help clear the congestion, akin to traffic police being dispatched to redirect the energy. Once it’s cleared, the pain naturally subsides."

"Unobstructed means pain-free, and pain equals obstruction. I’ve heard this before," the young woman quickly added.

Lu Xuan smiled slightly, unsurprised.

This saying is widespread; even those not familiar with TCM have likely heard it.

"So, how can we achieve unobstruction?"

Lu Xuan posed another question.

Diagnosis is crucial, and similarly, prescribing the right formula is equally important.

Accurate diagnosis matters, but if the prescribed medicine is incorrect, it won’t be effective and may even exacerbate the condition, much like incorrect diagnosis would.

Once the diagnosis is accurate, the next step is treatment.

Pain results from obstruction.

To alleviate pain, we need to achieve unobstruction first.

How to achieve unobstruction becomes the most urgent task.

With these thoughts, facing the inquisitive gaze of the young woman, Lu Xuan continued, "Since it’s obstruction caused by deficiency-cold, we certainly need to address both the deficiency and the cold symptoms, which simply means warming and tonifying.

Zhang Zhongjing’s classical prescriptions work quite well; for menstrual pain, there’s the Angelica Sini Decoction with Evodia rutaecarpa and Ginger. You can find it documented in detail in the Treatise on Cold Pathogenic and Miscellaneous Diseases. However, the usual dosage is not the same as in the original text. The original says for those with persistent internal cold, use Angelica Sini Decoction with Evodia rutaecarpa and Ginger. This decoction is inherently warming. Adding Evodia rutaecarpa and Ginger enhances its cold-dispelling strength.

We say this formula is essentially Cinnamon Soup. Those who have read the Treatise on Cold Pathogenic and Warm Pathogenic Diseases know it’s the ancestor of many formulas, with its influences visible in countless classical prescriptions, sometimes with modifications.

For example, in the Cinnamon Soup, components like Cinnamon, Ginger, Chinese Dates, Licorice, Danggui, Tongcao, Asarum, and Evodia rutaecarpa are added.

In this formula, Danggui is spicy, sweet, and warm. Its main role is to nourish and invigorate the blood, replenishing the liver Qi where our essence-blood derives from. Paired with Peony for blood deficiency, Peony is a yin herb, while in Cinnamon Soup, Cinnamon is yang, and Peony is yin. Cinnamon along with Asarum, both yang herbs, are sweet and warm, dispersing cold and warming the meridians, pushing out coldness like clearing traffic jams, primarily taking the responsibility to warm and improve circulation.

Licorice and Chinese Dates primarily replenish Qi and strengthen the spleen. Since we know it’s a deficiency-cold-induced congestion, we need to resolve both the congestion and deficiency.

Improving spleen and stomach functionality, strengthening it helps in replenishing blood, and when the spleen functions well, the circulatory system improves, enhancing the blood-nourishing effect.

This formula contains one crucial herb, Tongcao.

What is Tongcao?

It’s long, thin, and white, reminiscent of thick vermicelli, very lightweight."

Lu Xuan described the appearance of Tongcao, then continued, "We commonly use Tongcao for clearing heat, promoting water metabolism, and facilitating lactation. Many women use Tongcao when facing breastfeeding difficulties.

Here, we use Tongcao primarily for its unblocking effect, promoting circulation routes.

Huang Yuanyu, the author of Four Saints Heart Source, wrote about it in Changsha Medicine Explanation, stating Tongcao can unblock menstruation. Therefore, Angelica Sini Decoction with Evodia rutaecarpa and Ginger has a stronger warming and cold-dispelling effect than Angelica Sini Decoction.

If the cold isn’t severe, and the pain isn’t intense, the Angelica Sini Decoction suffices. But for severe cold, Angelica Sini Decoction with Evodia rutaecarpa and Ginger is more effective for menstrual pain.

Currently, Hanfang Medicine is more widely used in Japan than in our country, and the Japanese tend to place more trust in TCM.

They state in Hanfang prescriptions what Angelica Sini Decoction with Evodia rutaecarpa and Ginger treats.

It treats women’s lower abdominal pain. What is women’s lower abdominal pain?

Mostly menstrual, pregnancy, and childbirth-related conditions.

When congestion is serious, we can pair it with other medicines. For instance, we may use Angelica Sini Decoction with Evodia rutaecarpa and Ginger with Peach Kernel and safflower to enhance its warm meridian and pain-relieving effects."

"Japan also uses TCM?" The young woman seemed surprised to hear this, showing interest.

"Yes, not only do they use it, but they also value it more than we do."

Speaking of Japan, Lu Xuan paused, then said with a smile, "Among our medical texts, Japan favors the Treatise on Cold Pathogenic and Miscellaneous Diseases the most, having researched it for hundreds of years.

Hanfang, like Han characters and the Chinese language, is a distinctive feature of Chinese culture.

Introduced to Japan from the Tang Dynasty, it has evolved on Japanese soil into a unique academic discipline known as Japanese Hanfang. From Yoshimasa Todo to Otsuka Keisetsu, from Asada Shuho to Hosono Shiro, from Tanba Genkan to Mori Riki, a prominent group of Japanese Hanfang scholars have, with their wit and wisdom, collectively built a magnificent Hanfang medical edifice.

They established their own method based on TCM.

For example, Japanese Hanfang is highly practical.

There are two manifestations: First, they emphasize prescriptions.

Yoshimasa Todo precisely stated: the essence of medicine is the prescription.

Compound prescriptions embody the crystallized experience of ancient physicians using natural medicines, representing the wisdom in treating diseases and constituting the core of Hanfang medicine.

Second, they emphasize prescription-based treatment. The goal of clinical medication is highly pragmatic; matching prescriptions with symptoms achieves effective results. They don’t delve into ambiguous general principles but focus on well-defined standard prescriptions, which is where Japanese Hanfang’s practicality lies.

However, it cannot be denied that Japanese Hanfang also has many shortcomings; it only scratches the surface of TCM.

Why do I say this?"

Lu Xuan answered his own question: "First, the inability to easily modify. Since Japanese Hanfang promotes ready-to-use compound formula granules, this limits adjustments to the prescription’s ingredients and dosages, eventually affecting Japanese Hanfang’s research on individual herbs, especially the in-depth study of medicinal prescriptions, potentially leading to the problem of having prescriptions without effective herbs.

In our country, ready-made formulations are also available, but in most cases, when people consult TCM, decoctions of raw herbs are prescribed, and TCM practitioners adjust quantities according to the patient’s physical condition, modifying the herbs based on different symptoms. In contrast, Japanese Hanfang directly uses classical formulas from ancient texts without modification, making it difficult to adapt to current conditions and achieve symptom-specific treatment, which is why I say Japanese Hanfang has significant flaws.

This is something we need to be mindful of as well."