Pamela Alt
Medical Chinese 3
2/24/04

Long Dan Xie Gan Tang

From Wen Bing Ming Fang ( case studies book by Chu, Ming, et.al)

Long Dan Xie Gan Tang, which  can be used for both Liver and Gallbladder Excess Fire harassing the Upper Jiao  AND Damp Heat pouring downwards, originally comes from the Yi fang ji jie ( Analytic Collection of Medical Formulas) source text.  This discussion of the formula here points out the importance of modifying dosage and ingredients according to the individual patient, and one’s observation of their symptoms.  Because the herbs in this formula are mainly bitter and cold medicinals, it is important to realize that, with heat in the liver channel, the body is already in danger of damage to  Yin and blood.  Because of the bitter and cold nature of the herbs in the formula, people with Spleen and Stomach deficiency cannot take large doses  or take the formula long term.   Wen Bing Ming Fang  lists the ingredients and gives dosage ( not specified in the source text)  and points out specific information to make it a more effective and , in some ways, less intense formula( for instance, noting that  Long Dan Cao, Zhi Zi, Dang Gui and Sheng di Huang are usually fried in wine to drain and disperse and direct the herbs to the appropriate channels; and dry frying Huang Qin).

Case studies follow, including one which I translated  suggesting the usage of the formula for a 47-year-old woman who had a stroke with sub-arachnoid hemorrhage.  Modified Long Dan Xie Gan Tang ( Long Dan Cao 10g, Chao Huang Qin 12 g, Hei Shan Zi 10g, Sheng di Huang 12g, Dang Gui 10g, Chai Hu 6 g, Che Qian Zi 12g, Ling Shi Ci 30g, Lu Hui 10g, Mu Tong 10g, Sheng Gan Cao 6g) was prescribed to treat Liver Fire flaming upwards with interior heat obstruction.  Strong, fire-draining herbs ( Lu Hui, Da Huang etc.) are here added, in what some might interpret as a drastic measure, to course the channels and address the deficiency heat and substantive internal obstruction which must be drained through the bowels in order to comprehensively treat the condition.