The Dynamics of Shang Han Lun ⑤ Example of Symptoms and ‘Sign Symptoms’ in a Formula

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By Jubong Kang, K.M.D.

‘Danggui Shaoyao Powder(當歸芍藥散)’ is one of good example of using a formula to observe symptoms and sign symptoms compared with related textual prescriptions.

Clause (1) when a woman was in a state of pregnancy, if there is cramp in the abdomen, then Danggui Shaoyao Powder governs.1) 

Clause (2) if a woman has many kinds of illnesses (with pain)2) in her abdomen, then Danggui Shaoyao Powder governs.3)

In the first sentence, sign symptom of this formula is abdominal cram of a pregnant woman, and it means that abdominal cramps of a pregnant woman can be relieved by taking Danggui Shaoyao Powder.

The world cramp is a more severe state than abdominal hypertonicity and the following five articles will explain the process how cramp and hypertonicity can be resolves by Danggui Shaoyao Powder.

In the second sentence, there is no specific ‘sign symptom’ except ‘many kind of abdominal illnesses of a woman. If we cross-reference with the added word ‘with pain’ from “Gui LinGu Ben” 2), then the meaning of this sentence becomes clear that ‘sign symptom’ of this formula is also ‘abdominal pain’.

There are six ingredients in this formula, ‘Dangui’, ‘Chuanxiong’, Shayao’, ‘Baizhu’, ‘Fuling’, and ‘Zhexie’.

If we think about several kind of functions of ‘Dangui Shaoyao Powder’ according to methods of the combination of the component herbs, then it would be of help to understand the relationship between herbs, symptoms, and ‘sign symptoms’.

 

In the view of ‘herb property theory’, it can be said as following:

<1> Danggui and Chuanxiong increase the volume of the blood in the vessels. Because of their mobilizing character as pungent taste and warm property, they promote the movement of the stored blood in the liver into the vessels of the body.

At this time, the viscosity of released blood from the liver is very dense, so Danggui and Chuanxiong mixes with lymph liquid to get a normal density through mobilizing property.

Shaoyao vasodilates the capillaries of skeletal muscles and smooth muscles to increase blood flow into the capillaries of muscles. Then heat and energy will be supplied to both kinds of muscles, therefore, ‘hypertonicity’ of abdominal muscles or intestinal muscles can be relaxed.

 

<2> Shaoyao expands smooth muscle through vasodilation, and Chuanxiong and Danggui also increase the diameter of veins to promote the peristaltic movement of the vessels in the intestines.

Danggui and Chuanxiong strengthen the ‘heart beating’ to vitalize the vessels network shrunken from blood deficiency, and to augment blood to vigorously circulate within the blood vessels.

 

<3> Danggui and Chuanxiong transform stagnated blood by their fragrant and mobilizing character so that accumulated blood masses come to be dispersed and dissolved.

 

<4> Baizhu, Fuling, Zhexie drain out water-dampness from cell tissues or muscle tissues which causes edema, muscle pain, joint pain vertigo, headache, palpitations, vexation, and insomnia.

These herbs expel productions such as uric acid and dissolved by products of lactic acid, and condense the soggy blood to increase the efficiency of the circulation so that symtoms raised by water-dampness can be removed.

 

<5> Herb properties and taste of Danggui and Chuanxiong, pungent and warm, make blood travel towards extremities. The property of Shaoyao, a slightly bitter and sour, makes blood flow towards the direction of the abdomen: therefore, the blood circulating in the body finds balance between exterior and interior aspects.

In practice, if a patient is complaining of abdominal pain with abdominal hypertonicity, especially on the left side below the umbilicus, then this is the matching sign symptom for this formula.

When abdominal hypertonicity is palpated, a few other sign symptoms related to the component herbs of this formula, such as palpitations below the heart, or palpitations on the umbilicus, general swelling, vertigo, and extremities coldness 4) are shown, then Danggui Shaoyao Powder can be prescribed with grate results.

This is an example of how a patient’s abdominal pain can be treated by Danggui Shaoyao Powder whose sign symptom is abdominal hypertonicity.


1) in 『Jin Gui Yao Lue(金匱要略)』; the Essential of Golden Cabinet-Line 20-05, translated in English from Chinese Letter by Kang.)

2) in the version of 『Gui Lin Gu Ben(桂林古本)』, a version found recent days in China.

3) in 『Jin Gui Yao Lue(金匱要略)』 Line 22-17.

4) One of Sign symptoms except main sign symptom in a formula are called side sign symptom.

 

 

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