Hey, this is Nicholas. Let's talk about the category herbs that clear heat. This is a large category with several subcategories.
We have herbs that drain fire, herbs that cool the blood, herbs that clear heat and dry dampness, herbs that clear heat and resolve toxicity, and herbs that clear heat from deficiency. So with all of these categories, we're dealing with some kind of interior heat. What that means is these herbs are going to be cold in temperature, because cold herbs clear heat, and they're going to be Bitter in flavor, because bitter herbs clear heat and drain fire.
In our last category, cool acrid herbs that release the exterior, we were dealing with exterior heat. So there, our strategy was to use acrid herbs to promote sweating and push the pathogen out. But here, since the heat is at a deeper level, that's no longer an option. Here, our strategy is to use bitter herbs that clear heat and drain fire. And then what's interesting is...
we'll see that many of these herbs are also sweet in flavor, referring to their ability to tonify yin and moisten dryness. And this is really convenient, because one of the consequences of heat is that it can damage the yin and dry out the fluids. So these herbs are not only bitter to clear heat, but they can also be sweet in flavor to tonify yin, moisten dryness, and alleviate thirst. As far as cautions and contraindications go, we'll want to be careful about the cold, bitter nature of these herbs. damaging the spleen or causing middle jowl problems.
Remember, the spleen favors warmth and has an aversion to cold. So just like we tell our patients with spleen qi deficiency to avoid cold foods like salads and ice cream, we'll also want to avoid giving these patients cold bitter herbs. And even if the patient has a strong spleen, we'll still want to be careful about using these herbs long term, as over time the cold bitter properties of these herbs may damage the spleen.
So let's talk about the first subcategory of herbs that clear heat, which is herbs that drain fire. But before we do that, it might be useful to review Shang Han Lun and Wen Bing theory. Remember, when we talk about febrile diseases, there are two schools of thought, the cold damage school and the warm disease school. The cold damage school is based on the Shang Han Lun by Zhang Zhongjing.
The idea here is cold pathogens enter the body through the skin and muscle layer and work their way inward through the six channels, taiyang, yangming, xiaoyang, taiyin, xiaoyin, juiyin. The warm disease school is based on the Wenzhe Lun by Yitian Shi. Here we have heat pathogens entering the body through the nose and mouth and penetrating through the four levels, wei level, qi level, ying level, and shui level.
Since we're in the category herbs that clear heat, We're naturally going to focus our attention more on the warm disease school, or Wenbing theory, for this category. When a warm pathogen attacks the body from the exterior, its first stop is going to be the way level. So way level heat is just another name for an exterior attack of wind heat, presenting with symptoms like fever and chills, sore throat, and a floating pulse. With way level heat, we use cool, acrid herbs that release the exterior, like bohe, to vent the heat out.
But if the heat pathogen gets past the whey level and penetrates deeper, its next stop is the chi level. Chi level heat is characterized by the four bigs. Big fever, big sweat, big thirst, and big pulse.
So with whey level heat, when the pathogen was at the exterior, we saw fever and chills. But with chi level heat, we have big fever with no chills. We have a big sweat because the heat is making you sweat.
And when we say big thirst, we actually mean great thirst and vexation. The idea here is heat is damaging the normal fluids of the body, so you feel thirsty. And vexation just means irritability. So the heat is disturbing the shen, causing irritability. When we say big pulse, we mean a rapid surging pulse, indicating excess heat at the interior level.
And like we said, at this stage, since the heat is at a deeper level, we can no longer vent it outwards through the surface. So instead, we use herbs that drain fire to get rid of the heat. And we should also point out that at this stage, there's actually some overlap between Shanghan Lun and Wenbing theory. So Qi-level heat in Wenbing theory is the same as Yangming channel heat in the Shanghan Lun. So for now, we can use these terms interchangeably.
Qi-level heat or Yangming channel heat. So herbs in the category... herbs that drain fire are used for qi level heat or yangming channel heat characterized by the si da. The four big or four great symptoms.
Great fever, great sweat, great thirst and vexation, and a rapid surging pulse. So our first herb in the category, herbs that drain fire, is shirgao, gypsum fibrosum. Shirgao. The shir in shirgao means stone, so this herb is actually a mineral. It's gypsum, which is what drywall is made of.
And when you look at shirgao, it looks like ice. so that can remind you that it's very cold in temperature. In fact, shi gao is one of the coldest herbs in our Materia Medica.
Shi gao clears heat and drains fire, and it's one of the main herbs for yangming-level heat or qi-level heat, characterized by the four bigs, big fever, big thirst, big sweat, and big pulse. Shi gao clears heat from the lung, for things like a cough with thick, yellow, difficult-to-expect rate phlegm, and shi gao clears blood. blazing stomach fire for things like hunger, thirst, and foul breath, and for things like headache, toothache, swollen gums, and mouth ulcers.
Remember, the foot Yang Ming's stomach channel goes to the face, encircles the lips, and enters the gums. So that's why we see things like toothache and swollen gums. If anything else, number four, shi gao can be used to treat certain skin conditions like eczema, burns, or sores. For this function, it's usually applied topically and we usually use the prepared form called Duan Shigeo or Shu Shigeo. Shigeo is a heavy mineral so its dosage is larger than average, 15 to 60 grams.
So even though Shigeo is very cold and has the potential to damage the spleen, we still use a large dosage when we want to clear heat. The entering channels for Shigeo are the lung and stomach because Shigeo clears heat from the lung and stomach. The taste is sweet implying it has this moistening ability to deal with dryness.
And then, what's a little unusual for this category, shiurgao is also acrid in flavor, but not bitter. The idea here is, rather than simply using its cold nature to overcome the heat, shiurgao disperses cold and dries it out of the body, hence its acrid flavor. So that was herbs that drain fire. Our next category in herbs that clear heat is herbs that cool the blood. So let's go back.
to our Wenbing theory. For Wei-level heat, we used herbs that release the exterior, like Bo He. For Qi-level heat, we used herbs that drain fire, like Shi Gao.
But the next level is the Ying-level, which can be translated as the nutritive level or the construction aspect. At this level, there's a lot of heat. Fever that worsens at night, irritability, restlessness, and insomnia, indicating that heat is harassing the heart and disturbing the shen. and faint or indistinct rashes.
And at this level we'll start to see changes in the tongue. With Wei level heat or Qi level heat, we might see changes in the pulse, but we usually don't see changes in the tongue because the heat is still relatively superficial. But when heat gets to the Ying level, the heat is deep enough and intense enough that it starts to manifest in the tongue. So we'll see a red or crimson tongue that's usually dry.
And last is the Xue level or blood level. This is similar to yin level heat, just more severe. Instead of possible faint rashes, we'll see distinct purple maculopapular rashes. The tongue will be scarlet, possibly with prickles or thorns. And the major thing we're looking for here is bleeding.
Nosebleed, coughing up blood, blood in the urine, or blood in the stool. The idea here is heat causes things to speed up. When heat enters the shui level, the blood speeds up and begins to move.
recklessly or frenetically outside of the vessels, causing bleeding. So in terms of symptoms, ying level heat and shui level heat are similar in their presentation, but they differ in their severity. And it turns out, for both of these levels, we're going to use herbs from this category, herbs that cool the blood.
Really, the treatment strategy for these two levels is slightly different, and it's going to depend on how we combine the herbs. For ying level heat, we also use herbs that vent the pathogen. back up to the qi level.
But that's a little bit complicated, so don't worry about that for now. For now, we can just say that herbs from this category, herbs that cool the blood, are used for both ying level and shui level heat. So the herb we learn is sheng di huang, ramani erratics, sheng di huang.
Sheng di huang clears heat and cools the blood for heat in the ying and shui levels. Our formula for ying level heat is qing ying tang, or Clear the nutritive decoction, and Shengdi Huang is one of the main ingredients. Our formula for Shui level heat is Xi Jiao Di Huang Tang, and again, Shengdi Huang is one of the main ingredients.
So Shengdi Huang is useful for clearing heat in both the Yin and Xue levels. Besides clearing heat, Shengdi Huang also tonifies Yin and generates body fluids, treating things like dry mouth, thirst, and constipation. So in terms of taste, Shengdi Huang is bitter because it clears heat, and it's sweet because it tonifies and moistens. Shengdi Huang enters the liver channel because it cools the blood and stops bleeding. Basically, Anytime an herb has anything to do with the blood, whether it's tonifying blood, invigorating blood, or stopping bleeding, it tends to enter the liver channel because the liver stores blood.
Shengdi Huang also enters the heart channel because it can be used for shen problems due to heat harassing the heart. And it enters the kidney channel because it tonifies kidney yin. Maybe you can remember that Shengdi Huang is black in color, and black is the color of the water phase and the kidney.
The dosage is larger than normal just because it's a thick, dense root. What we want to be cautious about, though, is sheng di huang is very sweet, sticky, and cloying, so it can easily cause digestive problems. So it's common to combine sheng di huang with aromatic or moving herbs to prevent stagnation.
And lastly, maybe we can point out that the reason we say sheng di huang is because this is the raw version of Ramania root. Later, we'll learn shu di huang, which is the... prepared version. Remember, sheng means raw and shu means prepared. So that was herbs that cool the blood.
And with that, we're done with Wenbing theory. So our remaining categories still have something to do with clearing heat, but these are conditions of internally generated heat. So these categories are not related to the four levels of Wenbing theory. So let's move on to herbs that clear heat and dry dampness.
These are herbs that treat the condition of damp heat. So what is damp heat? Well, simply put, it's dampness that has combined with heat. And this can be very difficult to treat since dampness is a yin pathogen while heat is a yang pathogen.
To treat dampness, we would usually use warm aromatic herbs to dry it out. But here, that would just exacerbate the heat. For heat, we would use cold herbs to clear the heat. But that coldness might just lead to the formation of more dampness, so we're a little bit stuck. Luckily, we have this group of herbs that can do both simultaneously, clear heat and dry dampness.
So what does damp heat look like? Well, it depends on where it is in the body. With middle jowl damp heat, we'll see digestive problems like abdominal pain or distension. If heat is more predominant, we might see constipation.
If dampness is more predominant, we'll see diarrhea. And that diarrhea is going to be sticky or sloppy with a strong foul odor. And then another weird symptom you might see pop up is Thirst with no desire to drink. Thirst because of the heat and no desire to drink because of the dampness. With liver gallbladder damp heat, we might see jaundice or rib side pain.
With damp heat in the large intestine, we'll again see foul smelling diarrhea, tenesmus, a burning sensation around the anus upon defecation, or even dysentery. In some books, you might see the term red and white dysentery. And this just means diarrhea with blood and pus.
The red is the blood. and the white is the pus. Damp heat in the bladder will obstruct the smooth flow of urine, causing urination problems, or Lynn syndrome, with symptoms like frequent, urgent, painful urination. Basically like a UTI, the urine will be dark or reddish in color, possibly with blood in the urine. Damp heat in the lower jowl can also cause vaginal discharge.
That discharge is going to be thick, yellow, sticky, with a foul smell. And there might be itchiness around the genitals as well. And damp heat can also cause skin problems like sores, frunkles, or itchy skin.
In all of these cases, the pulse is going to be rapid and slippery or even soggy. Rapid because of the heat and slippery because of the dampness. The tongue is going to be red with a thick, yellow, greasy coat. Red with a yellow coat indicates heat.
The thick and greasy coat indicates dampness. As for the properties of these herbs, These herbs are of course going to be cold in temperature and bitter in flavor, because a bitter flavor clears heat and dries dampness. In formulas, it's going to be very common to see these herbs combined with herbs from the categories herbs that drain fire or herbs that clear heat and resolve toxicity, because a lot of these conditions overlap.
So let's talk about the individual herbs. Our first three herbs form a group called the three Huangs, or the three yellows, because they all have Huang in the name. Huang Qin.
Huang Lian and Huang Bai. And we say that each of these three herbs has a specialty in one of the three burners. Huang Qin clears heat from the upper jiao.
Huang Lian clears heat from the middle jiao. And Huang Bai clears heat from the lower jiao. And maybe you can remember them this way because they're in reverse alphabetical order, qin, lian, bai, and they go to the upper, middle, and lower jiao.
So let's take a look at each one in more detail. First is huang qin, scutellaria radix, huang qin. Huang qin is skullcap root. It clears heat and dries dampness, and its specialty is clearing heat from the upper jiao.
So huang qin is good for clearing heat from the lung for things like fever, irritability and thirst, and for cough with thick, yellow, difficult-to-expectorate phlegm. Remember, when heat enters the lung, it cooks down the fluids and causes them to thicken, giving us phlegm that's thick, yellow, sticky, and difficult to expectorate. But even though we say its specialty is clearing heat from the upper jowl, Huangqin clears heat from a lot of other places as well.
Huangqin clears damp heat from the stomach and intestines for diarrhea or dysentery. Huangqin clears damp heat from the lower jowl, treating Lin syndrome. Huangqin clears heat to stop bleeding, for things like nosebleed, coughing up blood, vomiting blood, or blood in the stool. To enhance Huangqin's ability to stop bleeding, it should be charred, called Huangqin Tan. Huangqin clears liver heat and liver yang rising, for headache, irritability, and red eyes.
Huangqin can also be used for skin problems due to damp heat. such as sores and abscesses. For this, Huangqin can also be applied topically. And finally, Huangqin calms restless fetus. When heat enters the uterus, this can upset the fetus and cause excessive movement and kicking.
And our worry here is that this may result in a miscarriage. So Huangqin calms restless fetus movements to prevent miscarriage. For this purpose, it's best to use Huangqin in its dry-fried form, called Chao Huangqin. as this preparation will moderate some of Huangqing's cold properties. So that's a lot of things.
But again, the specialty of Huangqing is clearing heat from the upper jiao. It just also clears heat from a lot of other places as well. So that was herbs that clear heat and dry dampness. Next is herbs that clear heat and resolve toxicity.
The word toxin, or du in Chinese medicine, can mean a few different things. So in this category, when we say these herbs resolve toxicity, we're usually talking about extreme heat accumulation that occurs with infectious disease. So one of the main things we're treating here is skin infection, abscesses, sores, and swellings. This can include boils and carbuncles. This can include painful sores and swellings, especially when there's pus involved.
This can include mastitis and breast abscess. This can also include internal abscesses like lung abscess, large intestine abscess, or appendicitis. And just to clarify, the word abscess just means a swollen area containing an accumulation of pus.
Heat toxicity can also include diarrhea or dysentery, especially if there's blood and pus in the stool. Certain epidemic or viral infections can fall under the category of heat toxicity, such as mumps or acute encephalitis. In fact, modern research has shown that some of the herbs in this category have antibacterial and antiviral properties as well.
The word du can also refer to real toxins like poison or venom. So some of the herbs in this category treat painful sores and swellings from animal bites like snake bite, spider bite, or scorpion sting. So the herb we learn here is jinyinhua, lawn acera floss.
Jin-yin-hua. As for the name, jin means gold, yin means silver, and hua means flower. So jinyinhua is Golden silver flower.
This is honeysuckle flower. Jin yin hua clears heat toxicity to treat abscesses, sores, and swellings. This could be painful sores and swellings on the breast, throat, or eye. This could also be intestinal abscess. And for these types of sores and swellings, jin yin hua can be taken internally in a decoction or applied externally as a poultice or wash.
Besides clearing heat toxicity, Jinyinhua also has an important function of releasing exterior wind heat invasion. One of our main formulas for an external attack of wind heat is called Yinchaosan. The yin in Yinchaosan means jinyinhua.
So in this formula, jinyinhua is being used alongside other exterior releasing herbs, like the one we learned, bohe. Jinyinhua also clears damp heat from the lower jiao for things like painful urinary dribbling or diarrhea. due to damp heat. And then we can also use jinyinhua in its charred form to stop bleeding.
This is called jinyinhua tan. Tan means charred. This is especially useful for when there's heat toxicity accumulating in the large intestine causing diarrhea with blood in the stool. So jinyinhua tan can clear heat toxicity and stop bleeding.
The dosage, 6 to 20 grams, might look kind of weird. This is just if we're using jinyinhua to release the exterior we might use the smaller dosage, but if we're using jinyinhua to clear heat toxicity we might use the larger dosage. The taste might look kind of weird as well. We say that jinyin hua is sweet in flavor.
It turns out jinyin hua does have an ability to tonify deficiency and alleviate thirst. It's just that this isn't really a function that we emphasize nowadays. But there are people who drink honeysuckle tea on a regular basis because it has these gentle tonifying actions. So jinyin hua was our herb for herbs that clear heat and resolve toxicity. Our last subcategory of herbs that clear heat is herbs that clear heat from deficiency.
These herbs clear heat due to liver and kidney yin deficiency. So what does deficiency heat look like? Well, we might see tidal fever, afternoon fever, or hot flashes. We might see malar flush, which is redness in the face. Or we might see five-center heat, which is heat in the chest, palms, and soles.
We might see night sweats. And then we have something called... steaming bone disorder, or the Weissman term, steaming bone tidal heat effusion disease.
This is a condition where the patient feels heat coming from the bones, but the skin and muscles will not be warm to the touch. So maybe you can remember that the kidney governs the bones, so in cases of severe kidney indeficiency, you might see steaming bone disorder. The pulse is going to be thin and rapid.
Rapid because heat speeds things up. and thin because there's not enough yin substance to fill the vessel. The tongue will be red with little or no coat.
We should also point out that these herbs treat the branch symptoms of heat associated with yin deficiency. They're bitter in flavor, so they clear heat. If we wanted to treat the root cause of the yin deficiency, we would have to combine them with sweet herbs that tonify yin, such as sheng di huang, ramania root, or bie jia, turtle shell. Herbs in this category are also used to treat lingering heat in the aftermath of a febrile disease. So if you have a patient recovering from a severe febrile disease where the fluids have been damaged, herbs that clear heat from deficiency can be used to clear heat that's lingering in the deeper aspects of the body.
So the herb we learn in this category is Qinghao, Artemisia annui herba. Qinghao. This is sweet wormwood. Qinghao. clears all types of heat from the yin levels of the body.
It clears deficiency heat, it clears summer heat, it cools the blood and stops bleeding, and it clears heat and malaria disorders. So Qinghao clears deficiency heat. It's good for fever due to yin deficiency or blood deficiency, it treats steaming bone disorder, and it treats fever due to lingering heat in the aftermath of a febrile disease.
Qinghao clears summer heat, especially when there's fever, headache, dizziness, and a stifling sensation in the chest. Qinghao cools the blood to stop bleeding, especially for purple rashes or nosebleed due to heat in the blood. And Qinghao has become famous as a treatment for malaria. Now, Qinghao has been used by Chinese herbalists to treat malaria for over 2,000 years, but it recently has become more famous because in 2015, Chinese physician Tu Youyou was awarded the Nobel Prize in Medicine for discovering the active ingredient artemisinin.
As part of her research, Tu discovered that this active ingredient is very easily destroyed by heat, so we definitely want to pay attention to this traditional cooking instruction of adding Qinghao towards the end of the cooking process. Qinghao is bitter and acrid, meaning it both drains and disperses heat. Qinghao enters the kidney channel because it clears deficiency heat and treats steaming bones.
And Qinghao enters the liver and gallbladder channels because it cools the blood and stops bleeding. And also because it treats malaria, which is characterized by alternating fever and chills. So it's kind of like Xiaoyang disorder. And remember, add Qinghao at the end of cooking. So that was our category, herbs that clear heat.
It's a large category, so thanks for sticking through all the way to the end. We'll see you in the next video, which is downward draining herbs. You can click on the card or I'll put a link in the description below.
So until then, thanks and see you next time.