Chapter 1 Formation of a Formula The
formation of a formula is not only simply to pile up herbs with similar functions and
effects but also ¡°to treat the head when the head
aches or treat the foot when the foot hurts¡±. In
TCM, a formula is not only to treat the symptoms but treat the syndrome or the disease
based on the differentiation of syndromes, and then some proper herbs are selected and
organically constituted in the light of the principles of the formula formation.
Section 1 The Principle of
Forming a Formula
By the principle of forming a Formula is mainly meant the
compatible theory of principal, assistant, adjuvant, and guiding herbs in the formula of
TCM. To form a formula in accordance with this theory, it is necessary to make a clear
distinction between the principal herb and the secondary ones and make them supplement and
restrict one an other, thereby, producing the most effective result in the treatment of
diseases.
Principal herb: A principal herb is one which is aimed at
producing the leading effects in treating the cause or the main symptom of a disease. It
holds sway in the whole formula. Assistant herb: An assistant herb is firstly meant the
herb which helps strengthen the effect of the principal herb and is secondly meant the
herb which is aimed at producing the leading effect in the treatment of the accompanying
symptoms.
Adjuvant herb: An adjuvant herb can be divided into three
types: the first type is used to assist the principal and assistant herbs to strengthen
their therapeutic effects or treat less important symptoms by itself, the second used to
reduce or clear away the toxicity of the principal and assistant herbs, the third used to
possess the properties opposite to those of the principal herb.
Guiding herb: A guiding herb can be subdivided into two
types: one is known as the medicinal guide leading the other herbs in the formula to the
affected site, the second is known as a mediating herb coordinating the effects of various
ingredients in the formula.
Section 2 Modification of a
Formula
The formation of a formula is not only based on a definite
principle but should also bc accommodated in. the light of the concrete conditions such as
the state of illness, sex, age, the patient's constitution, the occurring season of a
disease and the circumstances. Especially when a set formula is used, the above-mentioned
conditions should be taken into serious consideration to accommodate the formation of a
formula so as to suit the herbs to the illness and ensure their therapeutic effects. The
modification of a formula is usually seen as follows.
l. Modification of herbs:
It refers to modifying less important herbs in accordance with the difference of
the secondary symptoms or the accompanying symptoms without any change of the main
symptoms and the principal herbs to meet the need of complicated conditions of illness. In
this way, new herbs can be added into a formula or the original herbs may be taken away
from it at the same time. For example, the indication of Cinnamon Twig Decoction is for
the exterior deficiency syndrome due to affection of pathogenic wind-cold marked by fever,
headache, Perspiration, aversion to wind, white and thin fur, floating and slow pulse. If
the patient also has a cough or asthma, magnolia and apricot kernel can be added to lower
the adverse flow of qi and relieve asthma. If the patient has the accompanying symptoms
such as a fullness sensation in the chest and abrupt pulse, which show impairment of the
heart-yang, peony with sour, cold, yin and soft nature should be excluded from the
Formula. If the patient has the symptoms of oppressed sensation in the chest and slight
cold, which indicate that the yang-qi has been impaired seriously, peony should be
excluded from the formula and prepared aconite roots should be added so as to warm the
meridians to ensure the flow yang-qi. It is obvious that the modification of the herbs in
the same formula in accordance with the difference of the accompanying symptoms reflects
the adaptability in forming a formula.
2. Modification of dose:
It refers to increasing or decreasing the dose of an herb in a formula without
any change in its ingredients. ` This method can either change the potency of the original
formula or extend the scope of the treatment, sometimes the dominant and the subordinate
roles of the herbs in a formula may be changed so as to suit them to new indications. For
example, Decoction for Resuscitation and Decoction for promoting blood circulation and
relieving cold are both composed of prepared aconite roots, dried ginger, prepared
licorice. Their functions are to recuperate depleted yang-qi and save the patient from
collapse. The difference between them is that the latter, consisting of a larger dose of
aconite roots and dried ginger than the former, produces a stronger effect of recuperating
depleted yang-qi and can treat more severe causes.
3. Modification of dosage forms:
It means that the same Formula should be used differently just because of its
dosage forms. A Formula can be prepared into various dosage forms each having its own
characteristics. Doctors can select the most suitable dosage form to meet the need of the
Patient's illness and make it convenient for administration so as to raise the curative
effect. For instance, pill or bolus and powder are of slow-acting and lasting effects,
decoction is of speedy and drastic effect, injection produces effect more quickly and is
convenient to use. Let us take Bolus for Regulating the Function of middle-warmer(sanjiao
organ) as an example. It is used to treat insufficiency of the spleen yang, but if the
condition of the illness is mild and chronic, bolus is preferable, if the case is serious
and acute, it is better to take the decoctions instead.
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