Yibian
 Shen Yaozi 
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formulaLeft Metal Pill
sourceDisease Specialty Record Entry
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bubble_chart Preparation and Dosage

Coptis Rhizome (Rhizoma Coptidis) 60gm
Evodia Fruit (Fructus Evodiae) 10gm

bubble_chart Efficacy

Clearing liver and stomach fire, downbearing counterflow to stop vomiting.

bubble_chart Indications

Liver fire invading the stomach syndrome. Symptoms include distending pain in the hypochondriac region, acid regurgitation, belching, epigastric discomfort, vomiting, a red tongue, and a wiry, rapid pulse.

bubble_chart Formula Principles

The syndrome in this case is caused by liver fire invading the stomach and the stomach failing to descend and harmonize. The direct approach would be to purge liver fire, but the author, following the principle of the generation and restriction of the five elements/phases, adopts the method of "when there is excess, purge its child." This means not purging liver fire directly but instead purging heart fire, so that when heart fire is purged, lung metal is preserved. When metal is strong, it can restrain wood and thus purge the liver. This is a therapeutic method of "treating one to secure three." The formula heavily employs Coptis Rhizome, which is extremely bitter and cold (Great Cold, the 24th solar term), directly purging the fire of the heart and stomach, thereby clearing and purging liver fire to prevent it from invading the stomach. Evodia Fruit is pungent and hot, rapidly lowering qi, excelling at descending stomach qi to stop vomiting, and also entering the liver channel to disperse liver qi with its pungency. A small amount of Evodia Fruit combined with a large amount of Coptis Rhizome (1:6 ratio) forms a medicinal combination that both soothes the liver and harmonizes the stomach, while using the bitter-cold nature of Coptis Rhizome to ensure cooling without obstruction. Danxi's selection of these two herbs to treat the syndrome of liver fire invading the stomach with vomiting and counterflow is highly precise and appropriate.

bubble_chart Pattern Identification

  1. Epigastric and hypochondriac distending pain.
  2. Belching and acid regurgitation.
  3. Red tongue with yellow coating.
  4. Wiry and rapid pulse.

bubble_chart Formula Modification

  1. Liver depression is evident: add Bupleurum, Cyperus, Submature Bitter Orange.
  2. Abdominal pain is severe: combine with Peony Root Liquorice Root Decoction.
  3. Dampness-heat dysentery: add Aucklandia Root.

bubble_chart Cautions and Contraindications

This prescription is slightly bitter and cold in nature, and is contraindicated for vomiting due to deficiency-cold.

bubble_chart Modern Application

Acute and chronic gastritis, enteritis, hepatitis, hyperacidity.

bubble_chart Other Related Items

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