Gentian Liver-Draining Decoction

Gentian Liver-Draining Decoction

Gentianae Radix et Rhizoma (Long Dan Cao wine-fried) 6g, Scutellariae Radix (Huang Qin dry-fried) 9g, Gardeniae Fructus (Zhi Zi wine-fried) 9g, Alismatis Rhizoma (Ze Xie) 12g, Akebiae Caulis (Mu Tong) 6g, Plantaginis Semen (Che Qian Zi) 9g, Angelicae Sinensis Radix (Dang Gui wine-washed) 6g, Rehmanniae Radix (Sheng Di wine-fried) 12g, Bupleuri Radix (Chai Hu) 12g, Glycyrrhizae Radix et Rhizoma (Gan Cao) 6g

Use water to decoct the medicinals. The formula could also be prepared as pills as well. Take one dose (6~9g) with warm water per day at two times.

Clears and drains excessive fire of the liver and gallbladder, and clears damp-heat in the liver channel.

1. Flaming up of excessive fire of the liver and gallbladder, which manifests as headache and red eyes, pain in the rib-side, bitter taste in the mouth, deafness, swelling of the ears, a red tongue with a yellow coating, and a forceful wiry, rapid pulse.

This pattern includes the flaming up of excessive liver and gallbladder fire and the pouring downward of damp-heat in the liver channel. The foot jueyin liver channel goes around exterior genitalia, goes along the rib-side, connects with the eyes, and enters the top of the head. The foot shaoyang gallbladder channel starts at the inner canthus, goes around the ears, and enters the ears. From there, one branch enters the femoribus internus and goes around the exterior genitalia, and the other branch runs along the rib-side. The fire of the liver and gallbladder flames upward along the two channels which causes pain in the head, eyes, and ears; or deafness. Liver and gallbladder fire attacks the rib-side, which causes pain in rib-side and bitter taste in the mouth. Damp-heat in the liver channel pours downward along the channel, which causes vaginal swelling, itching, damp or sweat at the exterior genitalia, painful urination with turbid urine, impotence, and smelly yellow leukorrhea. A red tongue with a greasy yellow coating and a slippery, wiry rapid pulse are signs of intense fire and damp-heat. The characteristic features of this pattern pathogenesis are flaming up of excessive fire of the liver and gallbladder, pouring downward of damp-heat in the liver channel, and a disturbance of the qi movement. Therefore, the therapeutic method is to clear and drain excessive fire of the liver and gallbladder, clear damp-heat in the liver channel, and free the qi movement.

If Long Dan Xie Gan Tang is indicated for the flaming up of excessive fire of the liver and gallbladder, why are nourishing and moistening medicinals like dang gui and sheng di included?

1. Essential pattern differentiation Long Dan Xie Gan Tang is a commonly used formula for treating the flaming up of excessive fire of the liver and gallbladder, or the pouring downward of damp-heat in the liver channel. This clinical pattern is marked by bitter taste in the mouth, dark urine, red tongue with yellow coating, or red tongue with greasy, yellow coating, and a wiry, rapid or slippery pulse 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of flaming up of excessive fire of the liver and gallbladder: resistant brow ache, eczema in the head, hypertension, acute conjunctivitis, iridocyclitis, external auditory boils, and rhinitis; when the patient shows signs of damp-heat in the liver and gallbladder: acute icteric hepatitis, acute cholecystitis, acute posteriorganglionitis, acute mastitis, impotence; or when the patient shows signs of pouring downward of damp-heat in the liver channel: urinary tract inflammation, reproductive system inflammation, acute pyelonephritis, acute cystitis, urethritis, aidoiitis, orchitis, inguinal lymphadenitis, acute pelvic inflammatory disease, and Behcet's disease. 3. Cautions and contraindications Do not use the formula in patients with deficiency-cold of the spleen and stomach, as well as those with yin deficiency and yang hyperactivity, because there are many bitter-cold medicinals that can damage the spleen and stomach.

1. Xie Qing Wan (Green-Draining Pill, 瀉青丸)