Finding A Guiding Herb Makes Easier to Find the Most Efficient Formula ⑦ Huang Lian (黃連)
By Hyunchang Cho, L.Ac., Ph.D ([email protected])
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★Huang Lian Symptom Indicator Score+++ Frequency of Use+++ Main Symptoms ①Huang Lian is used for Yang-natured patients who display insomnia w/ difficulty falling asleep that is triggered/worsened by external stimulus. Upper Heat is often accompanied. – (even if the patient sleeps well under normal circumstances) if there’s an important event the following day, or a change in sleeping place (such as sleeping in a hotel), tension, worry, or stress, the patient will have a hard time falling asleep for at least 1 to 2 hours. – Upper Heat will be triggered/worsened by stress, tension, excitement, heat stimulus, alcohol, and such. Possible Symptoms ② Fire signs such as redness of the face and dermatographia ③ Heart palpitations ④ Heartburn from spicy or irritating food ⑤ Bleeding and such. CAPE ⑥ Huang Lian patients are Yang-natured people who are impatient, dynamic, outgoing, strong-willed, with high self-esteem, and always have to be right. ⑦ Dominant emotions are excitement and anger, along with sensitivity, nervousness, and anxiety. Generally, Huang Lian patients are easily excited, irritated, annoyed, and angered. |
1. Pharmacological Hypothesis of Huang Lian
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Hyperactivity of sympathetic nerve functions & hypoactivity of parasympathetic nerve functions → the gap between two systems becomes a wider → main problem is the hyperactivity of sympathetic nerve system → manifests as autonomic dysfunction |
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Huang Lian is used for Yang-natured patients with insomnia w/ difficulty to fall asleep. Upper Heat is also common.
Clinical Expressions *Quick-tempered, active, outgoing, strong-willed, high self-esteem, and not afraid to speak out. *If there are important events the following day, environmental changes (i.e., sleeping in a hotel), anxiety, worries, or stress, Huang Lian patients will have difficulty falling asleep, even if they try. *Upper Heat, or hot flushes, is commonly induced by stress, tension, excitement, heat stimulus, drinking, etc. |
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Dominant emotions are excitement and anger. Secondary emotions are tension, sensitivity, and anxiety. |
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In addition, Fire Signs such as heart palpitations or redness of the face, skin hypersensitivity, and heartburns caused by spicy or pungent food may appear. |
2. Clinical Signs of Huang Lian
The two most widely used Huang Lian formulas are Huang Lian Tang and Xiao Xian Xiong Tang. Huang Lian formulas can be divided into two categories: 1) Huang Lian formulas w/ soft/loose stools or diarrhea, and Huang Lian’s indicator score is high, which means it’s widely used all the time for various illnesses. It is often used for psychological disorders but other disorders as well. Also, to correctly use Huang Lian, you must master the tacit knowledge of CAPE and recognize it in patients.
(1) Main Symptoms
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① Huang Lian is used for Yang-natured patients who display insomnia w/ difficulty falling asleep that is triggered/worsened by external stimulus. Upper Heat is often accompanied. – (even if the patient sleeps well under normal circumstances) if there’s an important event the following day, or a change in sleeping place (such as sleeping in a hotel), tension, worry, or stress, the patient will have a hard time falling asleep for at least 1 to 2 hours. – Upper Heat will be triggered/worsened by stress, tension, excitement, heat stimulus, alcohol, and such. |
1) Huang Lian’s insomnia manifests as difficulty falling asleep in situations that make you nervous or anxious. Patients would have difficulty falling asleep, tossing, and tumbling for hours. Stress, anxiety, tension, too much thinking, worry, a change in sleeping place (such as sleeping at a hotel or a friend’s house), an upcoming event (especially in the following morning), sound, and light will lead to sleep disturbance. They will stay awake for at least 1 to 2 hours, sometimes even for 2-3 hours, before finally getting some sleep. Sometimes they won’t get any sleep at all. In other words, patients will experience severe forms of sleep disorder, mainly manifested as difficulty to fall asleep, in almost every condition that can interfere with sound sleep. Many other forms of sleep disorders may also appear.
Huang Lian’s insomnia is the most important Main Symptom almost always present. In Shang Han Lun and Jin Kui Yao Lue, Huang Lian’s insomnia is almost always present in all Huang Lian formulas, except Wu Mei Wan and Huang Lian Fen. Below is a passage from recordings of my past lecture about Huang Lian’s insomnia.
Huang Lian’s insomnia is caused by emotional instability (mainly excited emotions) due to sympathetic hyperactivity. Huang Lian’s insomnia is the combined result of anger as the main emotion with other emotions of excitement, rage, tension, sensitivity, anxiety, overthinking, and such. Shortly, Huang Lian patients cannot sleep well because they’re emotionally disturbed and anxious. As such, sleep is a reflection of a person’s mental state. Sleep is the first thing I would check in my protocol for psychological disorders. But sleep is important in other disorders as well, as it is almost always closely related to the chief and minor complaints of the patients. Therefore, we must treat sleep disorders in order to relieve patients’ problems.
Difficulty to fall asleep and other sleep disorders are also present in Fu Ling, ‘Xiang Chi + Zhi Zi,’ and sometimes Long Gu and Mu Li. Therefore, we must remember that when sleep disorders with difficulty falling asleep are present, we can consider guiding herbs of ① Huang Lian, ② Fu Ling, ③ ‘Xiang Chi + Zhi Zi’ sometimes ④ Long Gu and Mu Li.
2) We can be certain of Huang Lian’s insomnia w/difficulty to fall asleep in patients with ① Yang Personality ② who show signs of Upper Heat. Upper Heat is caused by sympathetic hyperactivity. Other symptoms such as redness of the face and heart palpitations may also occur.
