Lonicera and Forsythia Combination

Lonicera and Forsythia Combination, Yin Qiao San 銀翹散 is a formula from the Detailed Analysis of Warm Diseases, Wen Bing Tiao Ben 溫病條辨 used to treat a warm disease pattern of pathogenic wind-warmth invading the upper burner to attack the lungs at the exterior. It is also used to treat summer-heat damaging the lung network vessels and, with appropriate modifications, latent summer-heat when both the exterior and interior or both defensive and constructive are afflicted.

Pathogenic wind-warmth may invade the body, usually through the nose and mouth, and attack the lungs. Because of the proximity of the lungs at the surface where the defense qi homes, the wind-warmth pathogenic pattern exhibits exterior signs and symptoms. An attack can occur more easily when the climate is changing from cold to warm during spring and when there is an unusually warm spell during winter; Wu Kun An explained, “If the weather is fine and dry, and the warm wind is too warm, attacks by its qi are called pathogenic wind-warmth.” Pathogenic wind-warmth can also more easily attack people with compromised health or weakened immunity that inhibits them from fostering resistance.

To help identify the pathogenic wind-warmth pattern one should look for the key characteristic signs and symptoms of fever, aversion to wind, cough, thirst, and a floating pulse. The illness will typically occur during spring when the weather is warming following the cold winter.

The classic signs of wind-warmth attacking the exterior and lung in the upper burner include fever, mild aversion to wind, sore throat, headache, slight sweating, or no sweating, cough, oppression or pain in the chest, mild thirst, thin white tongue coat, red tongue tip, and a floating rapid pulse.

The therapeutic approach used in Traditional Chinese Medicine to treat this condition is to resolve the exterior, diffuse the lungs, and discharge the heat by using acrid-cooling herbs

Traditional Formula Composition:

30gm Lonicera Jin Yin Hua 金銀花

30gm Forsythia Lian Qiao 連翹

18gm Platycodon Jie Geng 桔梗

18gm Arctium Niu Bang Zi 牛蒡子

18gm Mentha Bo He 薄荷

15gm Soja Dan Dou Chi 淡豆豉

12gm Schizonepeta Jing Jie 荊芥

12gm Lophatherum Dan Zhu Ye 淡竹葉

15-30gm Phragmites Lu Gen 蘆根

15gm Licorice Gan Cao 甘草

Yin Qiao San’s therapeutic functions:

• Disperses wind-heat
• Clears heat
• Resolves toxicity

The herbs used in this formula are light so they have an effect in the upper burner.

• Lonicera, Jin Yin Hua 金銀花 and Forsythia, Lian Qiao 連翹 have an acrid flavor, a cool property, and a fragrant quality. They release the exterior, clear lung heat, and resolve toxins.
• Platycodon, Jie Geng 桔梗 and Arctium, Niu Bang Zi 牛蒡子 improve the throat and clear the lungs.
• Mentha, Bo He 薄荷, Soja, Dan Dou Chi 淡豆豉, and Schizonepeta, Jing Jie 荊芥 promote sweating and release exterior heat.
• Lophatherum, Dan Zhu Ye 淡竹葉, Phragmites, Lu Gen 蘆根, and Licorice, Gan Cao 甘草 clear heat, generate fluids, and alleviate thirst.

Examples of Modern Applications:

Common cold, influenza, bronchitis, pneumonia, tonsillitis, measles, mumps, meningitis, encephalitis B.

When Chinese herbs are applied to a disease or pattern of illness, whether traditionally or bio-medically referenced, formulas and herbs should only be used when the Chinese medical pattern of illness deems it appropriate. This is essential for safe and efficacious herbal therapy.

Common Formula Modifications:

• Oppression and distention of the chest and diaphragm due to turbidity, add:
• Agastache, Huo Xiang 藿香
• Tumeric, Yu Jin 鬱金
• Severe thirst caused by heat damaging fluids, add:
• Trichosanthes Root, Tian Hua Fen 天花粉 (Gua Lou Gen, 瓜蔞根)
• Sore swollen throat caused by warm toxins, add:
• Puffball, Ma Bo 馬勃
• Scrophularia, Xuan Shen 玄參
• Coughing caused by stifled lung qi, add:
• Apricot Seed, Xing Ren 杏仁
• Bloody nose caused by heat damaging the network vessels, add:
• Imperata, Bai Mao Gen 白茅根
• Biota, Ce Bai Ye 側柏葉
• Gardenia, Zhi Zi 梔子
• remove*:
• Soja, Dan Dou Chi 淡豆豉
• Schizonepeta, Jing Jie 荊芥
• Irritability and vexation caused by the pathogenic heat progressing into the nutritive layer, identified by a dark red tongue, add:
• Raw Rehmannia, Sheng Di Huang 生地黃
• Ophiopogon, Mai Men Dong 麥門冬
• Scanty dark urine caused by damaging fluids, add:
• Anamarrhena, Zhi Mu 知母
• Scute, Huang Qin 黃芩
• Gardenia, Zhi Zi 梔子
• Raw Rehmannia, Sheng Di Huang 生地黃
• Ophiopogon, Mai Men Dong 麥門冬
• Early-stage measles, add:
• Cicada Molting, Chan Tui 蟬蛻
• Duckweed, Fu Ping 浮萍
• Early-stage carbuncles, add
• Dandelion, Pu Gong Ying 蒲公英
• Isatis, Da Qing Ye 大青葉
• Acute endometriosis, add:
• Gardenia, Zhi Zi 梔子
• Siler, Fang Feng 防風
• Raw Rehmannia, Sheng Di Huang 生地黃
• subtract*:
• Licorice, Gan Cao 甘草
• Lophatherum, Dan Zhu Ye 淡竹葉
• Diarrhea and a yellow tongue coating, combine with:
• Pueraria, Coptis and Scute Combination, Ge Gen Huang Qin Huang Lian Tang 葛根黃芩黃蓮湯

* One cannot remove herbal ingredients from a finished granule product such as Lonicera and Forsythia Combination; however, one can compound the formula with the desired modifications by compounded the formula with single herb granule ingredients.

If the finished granule extract formula is not available, it is easy to mix the single herbal granule extracts in a proportional ratio to produce the formula. It is also easy and convenient to make modifications by adding additional herb granule extracts or formula granule extracts according to the needs of the individual case.

References

Scheid, V., Bensky, D., Ellis, A., Barolet, R., 2009. Chinese Herbal Medicine: Formulas and Strategies 2nd Edition. Eastland Press, 36-39 pp.

Bensky, D., Clavey, S., Stoger, E., Andrew, G. 2004. Chinese Herbal Medicine: Materia Medica 3rd. Edition. Eastland Press, Inc.

Wen, JM., Seifert, G., 2000. Warm Disease Theory: Wen Bing Xue. Paradigm Publications. 103-108 pp.

Wiseman, N., Feng, Y., 1998. A Practical Dictionary of Chinese Medicine. Paradigm Publications.