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Jin Gui

Yao Lue -

Essential Prescriptions of the Golden Cabinet


Chapter 3
Bai He, Hu Huo, and Yin Yang Du Disease
Pulses, Patterns, and Treatment of Bai He,
Hu Huo, and Yin Yang Toxin Disease
This chapter discusses pattern identification and
treatment of Bai He, Hu Huo, and Yin Yang Toxin
disease.
Although each condition displays distinctive
characteristics, all cases are related to contraction
of evil heat. They also share a number of common
manifestations, and are therefore grouped together
here for discussion.
Bai He disease
Hundred-union disease
Bai He disease often results from the normal
progression of febrile disease where residual heat
continues to damage yin, but it an also result from
emotional frustration that leads to internal fire
scorching LU and HT yin.
Essential signs include abstraction of the spirit-mind,
bitterness of the mouth, reddish urine, and faint
rapid pulses.
Bai He disease
Hundred-union disease
It is a literal translation of the Chinese Bai H Bng.
Three reasons have been posited for this disease name.
The first is that hundred-union means the the hundred
vessels, in reference to the locus of the disease.

The disease is characterized by HT-LU vacuity heat. As


we know, the HT governs the blood and vessels, while
the LU assembles the hundred vessels. Thus, the disease
involves the vessels in their relationship to the HT and
LU. This interpretation is supported by the opening line
of the chapter: It is said that hundred union disease [is
so-called because] the hundred vessels [share] one [and
the same] ancestors and all cause the disease.
Bai He disease
Hundred-union disease
A second explanation of the name rests on the fact
that hundred-union or Bai H is also the Chinese
name for the lily bulb, the medicinal that is primarily
used to treat this disease. The lily bulb is called
hundred-union in allusion to its being composed of
manifold converging layers.

A third is that hundred-union refers to the


complexity of the disease.
Hu Huo disease
Fox-Creeper Disease
Hu Huo refers to the specific locations of
pathological manifestation.
Hu refers to the yin region of the body, and
involves ulceration of the genitals. Huo refers to the
yang region, associated with ulceration of the throat.
Hu Huo disease can result from patterns of damp-
heat and also from worm poisoning.
Symptoms and signs include redness of the eyes,
ulceration of the throat, and ulceration of the
anterior and posterior yin organs.
Yin Yang Toxin Disease
Yn Yng D Disease
Regarding Yin Yang Toxin, the term Du is translated
as toxin, and yin yang refers generally to both yin
and yang types.
Du-toxin belongs to the category of acute heat
disease, with manifestations resulting from the
contraction of epidemic disease. It is caused by
contraction of epidemic toxin that invades the
blood.
The main symptoms include maculopapular
eruptions and a sore throat.
SCHEMATIC OVERVIEW
Ba He Disease-Hundred Union Disease

1. Causes:
a) The signs may appear before any cold damage
febrile disease (excessive emotional stimulus), or
b) four or five days after the onset of disease, or
c) gradually over twenty days or a month after the
onset of disease. Each case is treated according
to the signs.
Ba He Disease-Hundred Union Disease

2. Pathomechanism:
The hundred vessels have a single ancestor, which
can cause disease everywhere
(HT-LU Yin vacuity with internal heat depriving the
hundred vessels of nourishment)
3. Signs:
a)The disease manifests in desire but inability to eat; frequent
taciturnity; desire but inability to sleep; desire but inability to
walk; desire to eat and drink yet finding some foods delicious
and others not even tolerable to smell; [signs] resembling a cold
condition but without cold; [signs] resembling a heat condition but
without heat; bitter taste in the mouth; and red urine. None of the
various medicines can treat it. Taking medicine results in violent
vomiting and diarrhea, as if the patient were possessed by a
spirit. The physical form seems to be in harmony and the pulse is
slightly rapid.

b)Bitter taste in the mouth and red urine.


Ba He Disease-Hundred Union Disease

4. Prognosis:
a) If urination is always accompanied by
headache, the patient will recover in sixty days.
b) If urination is never accompanied by headache
but there is aversion to cold as if the patient were
wet, the patient will recover in 40 days.
c) If urination is fast and merely accompanied by
dizziness, the patient will recover in twenty days.
Prognosis
Observing symptomatic reactions affecting the head
during urination can be useful to determine the severity
and prognosis of the disease.
The LU governs management and regulation of the
waterways and also conveys turbid fluids to the
bladder, and the bladder channel ascends to the head
where it is connected with the brain. That explain the
signs of headache, aversion to wind, or dizziness that
occur unration. The numbers of days required for
recovery are approximate figures and should not be
taken literally.
Ba He Disease-Hundred Union Disease
5. Regular Treatment:
If no vomiting, precipitation, or swelling therapy
has been applied and the disease appears the
same as in the beginning.
Bai H D Hung Tang (Lily Bulb and Rehmannia
Decoction) governs.
Bai He : sweet / mild to nourish Yin, moisten LU,
clear deficiency heat in Qi aspect
Sheng Di Huang Zhi: cooling heat in blood aspect
Clinical application:
Neurological disorders
Mental disorders
Menopausal (depression)
Sleep walking (somnambulism)

+ Gan Mai Da Zao Tang (Licorice.wheat and Jujube


Decoction) and Chai Hu Shu Gan San (Bupleurum Liver-
Soothing Powder)
+ Long Gu (Fossil;ia Ossis Mastodi); Mu Li (Concha
Ostreae); Ci Shi (Magnetitum); Bai Zi Ren (Semen
Platycladi), and He Huang Hua (Flos Albiziae)
Ba He Disease-Hundred Union Disease
6. Treatment after adverse treatment:
a) After promotion of sweating: Bai H Zh Mu Tang

(Lily Bulb and Anemarrhena Decoction) to enrich


the LU/ST, to engender liquid, and to downbear
counter flow.
The line discuss Bai He disease following improper
application of sweating method. The treatment method
here is to clear heat and moisten LU.
Zhi Mu: acts to enrich yin and clear heat
Ba He Disease-Hundred Union Disease
6. Treatment after adverse treatment:
b) After precipitation: Hua Shi Dai Zhe Tang (Talcum and
Hermatite Decoction) to nourish yn and clear heat
and to harmonize the ST and downbear counter flow.

This line discuss Bai He disease following improper application of


the purgation method. The signs include aggravated internal heat
and loss of yin-fluids through the stool, manifesting with inhibited
short voiding of reddish urine. The other is damage ST qi leading to
vomiting.
Treatment method: nourish yin, clear heat, downbear counterflow.
Hau Shi: promotion urination, clear heat
Dai Zhe Shi: downbears counterflow, harmonize ST
Ba He Disease-Hundred Union Disease
6. Treatment after adverse treatment:
c)After ejection: Bai He Ji Zi Tang (Lily Bulb and Egg
Yolk Decoction) to nourish the LU and ST, to
engender liquid, and downbear counter flow.

This line discuss Bai He following inappropriate ejection.


When yin becomes more deficiency and vexing heat is
aggravated; the signs include palpitation, deficiency
vexation, and sleeplessness. When ST Qi is disharmony, the
sings will show as dry retching, clamoring ST , abdominal
discomfort.
Ji Zi (egg yolk): enrich yin and clear heat to calm the spirit.
Support MJ and harmonize ST.
Ba He Disease-Hundred Union Disease
7. Treatment of transmuted patterns:
a)Thirst: If the disease persists for a month without resolving
and thirst appears, use Bai He Xi Fang (Lily Bulb Wash) to
nourish yn and engender liquid, as well as Gua Lou Mu Li
Tang (Trichosanthes and Oyster Shell Powder).
Bai He Xi Fang is for external wash. (should take with Bai He
Di Haung Tang internally)
If the sings of thirst remain, than, Gua Lou Mu Li Tang should
be added.
Gou Lou Gen: engender fluids to relieve thirst
Mu Li: alleviate thirst and protect against the scorching of
yin fluids in throat by conducting heat downward
Ba He Disease-Hundred Union Disease
7. Treatment of transmuted patterns:

b)Heat effusion: Bai He Hua Shi San (Lily Bulb and Talcum
Powder) to nourish yn, clear heat, and inhibit urine.
The line discuss the treatment of Bai He disease transmuting
into heat effusion. The signs include tidal fever, vexing heat
in the five hearts, and short rough voiding of scant reddish
urine.
The treatment method is to enrich yin and clear heat.
Bai He: nourish yin
Hua Shi: drain heat downward through urination
Hu Huo disease-Fox-Creeper Disease
Hu Huo disease-Fox-Creeper Disease

1. Cause: Damp-heat arising from worm toxin.


a) Arising after febrile disease, when residual heat
has not been cleared.
b) Arising after measles, when residual heat is still
present

2. Pathomechanism:
Damp-heat and worm toxin causing erosion
Hu Huo disease-Fox-Creeper Disease

3. Principles of treatment:
Clearing heat and disinhibiting dampness; killing worms
and resolving toxin.
4. Signs:
Symptoms resembling cold damage, taciturnity and
desire to sleep, inability to close the eyes and
disquietude whether lying down or being up. If it
erodes the throat, it is called creeper, if it erodes the
yin, it is called fox. It further manifests with no desire to
eat or drink, aversion to the odor of food, and face
and eyes that ae now red, now block, now white.
Hu Huo disease-Fox-Creeper Disease

5. Pattern Identification:
a) Erosion in the upper body (throat): Husky voice.

Gan Cao Xie Xin Tang (Licorice Heart-Draining

Decoction) : clear heat and transform dampness


and to quiet the center and resolve toxin.
Gan Cao Huang Lian
Huang Qin Da Zao
Ren Shen Ban Xia
Gan Jiang
Clinical Application
Stomach ulcers
Herpes
Modification:
Dampness+ Zhu Ling (Polyporus); Fu Ling Pi (Cutis
Poriae)
Inflammation of eyes + Ju Hua ( Flos Chrysanthemi); Gu
Jing Cao (Flos Eriocauli); Mi Meng Hua (Flos Buddlejae)
Mouth ulcers + Bing Peng San (Bornrol and Borax
Powder); Xi Lei San (Tin-Like Powder) externally
Ulceration of genitals and anus + Di Fu Zi (Fructus
Kochiae); Bai Xian Pi (Cortex Dictamni); Huang Bai
(Cortex Phelloderdri Chinensis) and apply Ku Shen
(Flavescent Sophora ) externally.
Hu Huo disease-Fox-Creeper Disease

5. Pattern Identification:

b)Erosion in the lower body.


Anterior Yin: Ulceration of the genitals. Wash with
Ku Shen Tang (Flavescent Sophora Decoction) to
clear heat and eliminate dampness and to kill
worms and resolve toxin.

Posterior Yin: Erosion of the anus. Fumigate with


Xing Hung(realgar) to dry dampness, kill
worms, and resolve toxin.
Hu Huo disease-Fox-Creeper Disease
6. Giving rise to welling-abscesses and suppuration.
a) Signs:
Rapid pulse, absence of heat, slight vexation, taciturnity,
desire only to sleep, and sweating. Initially, when this
condition has lasted for only three to four days, the eyes
become red like those of a turtledove. After seven or eight
days, the four canthi of the eyes turn black. If the patient is
able to eat, this indicated that pus has formed.
b) Treatment:
Chi Xiao Dou Dang Gui San (Rive Bean and Chinese
Angelica Powder) to percolate dampness, clear heat,
quicken the blood and expel pus.
Yin Yang Toxin Disease-Yn Yng D
Yin Yang Toxin Disease-Yn Yng D

1. Causes:
Contraction of epidemic toxin.
2. Pathomechanism:
Epidemic toxin entering the blood aspect:
a) Exuberant heat in blood toxin entering the blood
aspect:
b) Internal putrefaction giving rise to pus: Yang toxin.
c) Static blood congealing and causing obstruction:
Yin toxin.
Yin Yang Toxin Disease-Yn Yng D

3. Pattern Identification:
a) Yng toxin: Face red with patches like brocade,
sore throat, spitting of pus and blood.
b) Yn toxin: Green-blue face and eye,
generalized pain as though having been beaten by
a stick, sore throat.
4. Prognosis:
a) Within the first five days: treatable.
b) By the seventh day: not treatable
Yin Yang Toxin Disease-Yn Yng D

5. Treatment.
a) Yng toxin: Sheng Ma Bei Jia Tang (Cimicifuga
and Turtle Shell Decoction) to clear heat, resolve
toxin, and disperse stasis.
b) Yn toxin: (-) Xiong Huang (realgar) and Shu
Jiao ( zanthoxylum ) to resolve toxin, quicken the
blood and disperse stasis.
Sheng Ma Bei Jia Tang (Cimicifuga and
Turtle Shell Decoction)
Sheng Ma 2 Liang
Dang Gui 1 Liang
Hua Jiao 1 Liang
Gan Cao 2 Liang
Xiong Huang Liang
Bai Jia finger sized pc
Clinical application:
Lupus
Leukemia
Psoriasis
Modification:
Blood stasis + Dan Shen (Radix Rhizoma Salviae);
Chi Shao (Radix Paeoniae); Mu Dan Pi (Cortex
Moutan)
SUMMARY
Disease Associated Signs and Principles of Formula
Pattern Pathomechanisms Symptoms Treatment

Bai He Yin deficiency with Vexation, Cleat internal heat, Bai He Huang Tang
Disease heat affecting the bitterness in the nourish yin (Lily Bulb and
heart and lung mouth, reddish Rehmannia
urine Decoction)
Yin damage Vexation, dry Cleat heat, nourish Bai He Zhu Mu
resulting from mouth yin, moisten the lung Tang (Lily Bulb and
improper sweating Anemarrhena
Decoction)

Yin-fluid damage Inhibited short Nourish Yin, clear Bai Shi Dai Zhe
and stomach voiding of heat, downbear Tang (Talcum and
disharmony reddish counterflow, Hematite
resulting from urination, disinhibit urine Decoction)
improper purgation vomiting
Disease Associated Signs and Principles of Formula
Pattern Pathomechanisms Symptoms Treatment

Bai He Yin-fluid damage Deficiency Nourish the lung and Bai He Ji Zi Tang
Disease resulting from vexation, stomach, engender (Lily Bulb and Egg
improper ejection palpitation, fluids, and calm the Yolk Decoction)
insomnia, dry spirit
retching
Bai he disease with Thirst, dry Nourish yin, cleat Bai He Xi Fang
predominant thirst, mouth heat (Lily Bulb wash
yin deficiency, formula)
exuberant heat Gua Lou Mu Li San
damaging fluids (Trichosanthes Root
and Oyster Shell
Powder)

Bai he with Tidal heat, Enrich yin, clear heat Bai He Hua Shi San
predominant heat vexing heat in (Lily Bulb and
effusion due to the five hearts, Talcum Powder)
chronic heat rough voiding
constraint and yin of scant
deficiency reddish urine
Disease Associated Signs and Principles of Formula
Pattern Pathomechanisms Symptoms Treatment

Hu Huo Damp-heat Alternating cold Clear heat, dry Gan Cao Xie Xin
Disease brewing internally, and heat, dampness, resolve Tang(Licorice
upright qi insomnia, toxin, support the Heart-Draining
deficiency erosion of the upright Decoction)
flesh, ulceration
Heat toxin brewing Abscesses with Cleat heat, Chi Dou Dang Gui
and binding in the pus formation eliminate damp- San (Rice Bean and
blood aspect ness, dispel stasis, Chinese Angelica
expel pus Powder)

Static damp-heat Genital Clear heat, resolve Ku Shen (Flavescent


toxin in the liver ulceration, dry toxin, eliminate Sophora Decoction)
channel throat dampness

Static damp-heat Anal ulceration, Clear heat, resolve Fumigation with


toxin dry throat toxin Xiong Huang
Disease Associated Signs and Principles of Formula
Pattern Pathomechanisms Symptoms Treatment

Yang Du Blood aspect static Brocade-like Clear heat, resolve Sheng Ma Bie Jia
heat, internal heat red macules on toxin, move blood, Tang (Cimicifuga
scorching the throat the face, sore and dispel stasis and Turtle Shell
throat, spitting Dec-oction)
of purulent
blood
Yin Du Static blood, toxin Blue-green Resolve toxin, dispel Sheng Ma Bie Jia
binding in the complexion stasis Tang (Cimicifuga
throat generalized and Turtle Shell
pain, sore Decoction) minus
throat Xiong huang
(Realgar) and Hua
Jiao (Pericarpoium
Zanthoxyli)