Nourishing and Clearing Formulae
The formulae in the nourishing and clearing category are designed to address some of the most common conditions encountered in clinical practice. The overwhelming majority of cases present a complex condition in which the body’s Qi is deficient and a pathogenic factor obstructs the normal functioning of Qi and Blood and the flow of Qi in the channels.
In the early stages of a pathology, the condition of the patient is usually characterised by fullness of a pathogenic factor. If this factor is not expelled it will obstruct the proper movement and transformation of Qi eventually leading to a deficiency. As the pathogenic factor is still retained, the condition is characterised by both Fullness (of a pathogenic factor) and Emptiness (of the body’s Qi).
This often starts a vicious cycle whereby the pathogenic factor continues to obstruct the movement and transformation of Qi, thus leading to a deficiency of the body’s Qi while this in turn contributes to the accumulation of the pathogenic factor; for example, Dampness obstructs the Spleen and this induces a deficiency of Spleen-Qi which then leads to the formation of more Dampness.
How should we choose when to tonify/nourish only and when to nourish and clear simultaneously? The pulse and tongue are important gauges as to when to tonify and when to nourish and clear at the same time. If the pulse is predominantly deficient (such as weak, empty, fine, choppy, or minute) and the tongue does not have a thick coating (or has no coating at all), then it is probably advisable to tonify. If the pulse is of the full type (e.g. full, wiry, slippery, overflowing, tight) and the tongue is swollen and has a thick coating, it is probably advisable to clear pathogenic factors.
If the pulse is of the deficient type (e.g. fine) but also has a quality which indicates the presence of a pathogenic factor (e.g. slippery), it is probably advisable to tonify the body’s Qi and clear the pathogenic factors simultaneously. Similarly, if the tongue shows some deficiency (e.g. pale) but is swollen and has a thick coating, to tonify and clear at the same time is desirable.
Formula in a Nutshell: Prostate problems from Damp Heat, Blood stasis, Toxic Heat against a background of Qi and Yin deficiency.
Pattern: Qi and Yin deficiency, Damp-Heat in the Lower Burner, Blood stasis, Toxic-Heat.
Action: Tonify Qi, nourish Kidney-Yin, drain Damp-Heat, move Blood, separate the clear from the turbid, soften hardness (masses), resolve Toxic Heat.
Tongue: Red (possibly without coating), sticky-yellow coating on the root with red spots.
Pulse: Fine-rapid or Floating-Empty; the left rear position might feel Slippery on rolling the finger proximally (this is the prostate position).
Formula in a Nutshell: Long-term Liver-Qi stagnation which has given rise to Heat.
Pattern: Liver-Qi stagnation, Liver-Heat (deriving from long-term Qi stagnation), Blood deficiency, Spleen-Qi deficiency.
Action: Move Qi, pacify the Liver, nourish Blood, tonify Spleen-Qi, clear Liver-Heat, calm the Mind, settle the Hun.
Tongue: Red sides.
Pulse: Wiry, rapid.
Formula in a Nutshell: Chronic Bi Syndrome of the elderly with underlying Kidney-Yin deficiency.
Pattern: Chronic Bi Syndrome of lower part of body with underlying deficiency of Kidney-Yin and Liver-Yin.
Action: Nourishes Kidney-Yin and Liver-Yin, expels Wind-Dampness from the joints.
Tongue: Without coating; red, if there is Empty Heat.
Pulse: Weak on both Rear (chi) positions or Floating-Empty.