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Source: Xiǎo ér Yào Zhèng Zhí Jué 小儿药证直诀

Ingredients:

• Shēng dì huáng (生地黄 Rehmanniae Radix Exsiccata seu Recens, dried/fresh rehmannia [root]) 10g
• Mù tōng (木通 Akebiae Trifoliatae Caulis, trifoliate akebia) 10g
• Gān cǎo (甘草 Glycyrrhizae Radix, licorice [root]) 10g
• Zhú yè (竹叶[1] Bambusae Folium, black bamboo leaf)??? 3g

Action: Clears the heart and drains fire; disinhibits urine.

Indication: Exuberant fire in the heart channel with heat vexation, red facial complexion, and thirst with desire for cold drinks, and mouth and tongue sores. In some cases, heart heat may spread to the small intestine, manifesting in short inhibited voidings of reddish urine. Tongue: Red. Pulse: Rapid.

Category: Heat-clearing formulas / Bowel and visceral heat-clearing formula

Method: Grind the three main ingredients to a powder. Boil with the zhuye[1]. Nowadays simply prepared as a decoction.

Rationale: Shēng dì huáng nourishes kidney yīn and clears heart fire. When kidney yīn is abundant, it downbears the heart fire, and when heart fire is cleared, the small intestine fire naturally disappears. Mù tōng disinhibits water and downbears fire; its water-disinhibiting action is prevented from causing damage to yīn by the Shēng dì huáng. Zhuye[1] is cool and sweet in nature and enters the heart. It helps to clear the heart and drain fire. Gān cǎo clears heat and abducts fire, while also freeing strangury and relieving pain.

Variations:

• Heat vexation in the chest: Add Huáng lián (黄连 Coptidis Rhizoma, coptis [root]).
• Ulceration of the mouth: Add Huáng lián (黄连 Coptidis Rhizoma, coptis [root]), Jīn yín huā (金银花 Lonicerae Flos, lonicera [flower]), and Lián qiào (连翘 Forsythiae Fructus, forsythia [fruit]).
• Night crying in infants: Add Zhēn zhū mǔ (珍珠母 Concha Margaritifera , mother-of-pearl) and Gōu téng (钩藤 Uncariae Ramulus cum Uncis, uncaria [stem and thorn]).
• Blood strangury with rough painful urination: Add Mò hàn lián (墨旱莲 Ecliptae Herba, eclipta), 大蓟, Bái máo gēn (白茅根 Imperatae Rhizoma, imperata [rhizome]), Hǔ pò (琥珀 Succinum , amber), and Qú mài (瞿麦 Dianthi Herba, dianthus).
• Acute pyelonephritis: Add Fèng wěi cǎo (凤尾草 Pteridis Multifidi Herba, phoenix-tail fern), Zhēn zhū cǎo (珍珠草 Phyllanthi Urinariae Herba (cum Radice), phyllanthus), and Bái máo gēn (白茅根 Imperatae Rhizoma, imperata [rhizome]).

Notes: The word red in the formula name neatly conveys the idea of heart fire, since in the five phases red is the color associated with fire and the heart is the viscus associated with fire.

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