Calm Dragon Formula: Chai Hu Jia Long Gu Mu Li Tang
Calm Dragon Formula (Chai Hu Jia Long Gu Mu Li Tang), is a potent herbal from traditional East Asian medicine, first detailed in the classic Shang Han Lun by Zhang Zhong-Jing. This formula is a modification of Minor Bupleurum Decoction (Xiao Chai Hu Tang), enhanced with Dragon Bone (Long Gu) and Oyster Shell (Mu Li) to intensify its grounding and calming effects. It's designed to address patterns of disharmony where all three burners (San Jiao) have become constrained due to an initial shaoyang-stage pathology.
This constraint manifests with symptoms such as palpitations, restlessness, or insomnia, often due to an uprising of Ming Men Fire–an essential living impulse coursed by Liver Qi, housed by the Gallbladder, and fanned by the Triple Burner.
Although many doctors such as Zhu Zhen Heng (1281-1358) identified ‘Minister Fire’ with the Fire of the Gate of Life (and therefore the Kidneys), others, such as Zhang Jiebin (1563-1640), identified the ‘Minister Fire’ with such internal organs as the Kidney, Liver, Triple Burner, Gallbladder, and Pericardium. In fact, the Minister Fire is said to go upwards to the Liver, Gallbladder and Pericardium (in so doing it is compared to the ‘Fire Dragon flying to the top of a high mountain’) and downwards to the Kidneys (in so doing it is compared to the ‘Fire Dragon immersing in the deep sea’) (1).
膽居相火,溫煦諸臟,相火源於腎,寄居於膽而布於三焦。少陽相火溫煦,才能延續生命。
『醫貫』云:「飲食入胃,猶水穀在釜中,非火不熟,脾能化食,全借少陽相火之無形者。然少
火生氣,非獨脾胃受益,十一臟皆賴之以榮。」(素問、陰陽應象大論:壯火散氣(病理之
火),少火生氣(生理之火))
The gallbladder houses the ministerial fire, which warms and nourishes all organs. The source of the ministerial fire is the kidney; it resides in the gallbladder and spreads through the triple burner. The warming and nourishing effect of the Shaoyang (Lesser Yang) ministerial fire is essential for sustaining life.
The Yiguan states: "Food and drink enter the stomach, just like water and grains in a pot, which cannot be cooked without fire. The spleen is able to digest food entirely due to the formless ministerial fire of Shaoyang. Thus, the ministerial fire generates qi, not only benefiting the spleen and stomach but also vital for the flourishing of all eleven organs." (Suwen, Yin Yang Ying Xiang Da Lun:
Wang Bing: “Qi generates strong fire. Hence [the text] states: ‘a strong fire feeds on qi.’ A small fire nourishes qi. Hence [the text] states: ‘Qi feeds on small fire.’ Because a strong fire feeds on qi, when qi gets a strong fire, then [the qi] diminishes and disperses. Because a small fire increases qi, when qi gets a small fire, then [the qi] grows. The same applies to the strength or weakness of yang qi [in humanity],” (2).
Traditional Components and Usage
The traditional components include Bupleurum Root (Chai Hu), Dragon Bone (Long Gu), Oyster Shell (Mu Li), Ginseng (Ren Shen), Dried Ginger (Gan Jiang), Skullcap (Huang Qin), Pinellia (Ban Xia), Cinnamon Twig (Gui Zhi), each playing a pivotal role in harmonizing and nourishing the body's Qi, Blood, and Yin/Yang. The Shang Han Lun prescribes this formula for patterns characterized by the disruption of the shaoyang pivot, with internal disturbances affecting the mind and spirit.
Kan’s formulation adds Dai Zhe Shi (Hematite) and Zhi Zi (Gardenia) to further settle and anchor the spirit by clearing heat which may be disturbing the heart.
Addressing Patterns and Shaoyang Conformation
This formula is tailored for the shaoyang conformation disharmony, a unique pathological state in TCM that reflects a liminal phase between the body's exterior and interior. When compromised, symptoms like fluctuating fever and chills, bitter taste in the mouth, and irritability may arise, indicating a disharmony between the Gallbladder and Triple Burner. By addressing shaoyang disorders, this formula ensures the smooth flow of ying and wei qi, descending yang and anchoring yin.
Insights from Bencao Gangmu
Li Shizhen's Bencao Gangmu offers detailed descriptions of Long Gu (Dragon Bone) and Mu Li (Oyster Shell), noting their powerful sedative and stabilizing properties. These substances are revered for their ability to calm the spirit (Shen), anchor and subdue the floating Yang, and mitigate symptoms of unease and restlessness.
Contemporary and Historical Perspectives
Both ancient and modern practitioners recognize the versatility of Calm Dragon Formula (Chai Hu Jia Long Gu Mu Li Tang) in addressing a spectrum of syndromes beyond its classical indications. It's valued for its ability to harmonize the interior with the exterior, cool down excess heat, and subdue Yang, making it suitable for TCM syndromes related to unease and sleep disturbances.
Mechanisms of Action
In TCM, Long Gu and Mu Li work synergistically to anchor the Yang, calm the spirit, and prevent the ascent of pathogenic Qi. From a Western perspective, the minerals and compounds found in these substances might exert neuroprotective effects, modulate neurotransmitter activities, and influence hormonal balances, contributing to their calming and stabilizing actions.
Long Gu (Dragon Bone) and Mu Li (Oyster Shell) are two pivotal components in traditional Chinese medicine known for their calming effects on the spirit and their ability to anchor and stabilize what is referred to as "floating Yang". From a scientific and physiological perspective, the greater formula Chai Hu Jia Long Gu Mu Li Tang is believed to work through several mechanisms:
Neurological Impact: Both Long Gu and Mu Li have properties that can affect the central nervous system. They are considered as essential tools for calming unease and settling the spirit, which can be beneficial for TCM syndromes related to conditions like restlessness, insomnia, palpitations with anxiety, and various forms of emotional distress. This calming effect might be related to the modulation of neurotransmitter activity, suggesting a direct influence on the brain's chemical environment.
A study on Chai Hu Jia Long Gu Mu Li Tang, published in the journal Nature (3), which includes Long Gu and Mu Li, suggests a multi-target approach to addressing depression. It highlights the potential mechanisms involving neuroinflammatory response reduction, improvement of neurotransmitter function, and neuroplasticity. The decoction's effects may be linked to the ingredients' interaction with key proteins like AKT1, IL-6, TNF, and modulation of pathways such as AGE-RAGE and IL-17. This points to a complex interplay in its therapeutic impact on the central nervous system.
Hormonal Regulation: The action of these substances might also extend to the regulation of hormonal balances. By anchoring the floating Yang and calming the Liver, they could indirectly influence the endocrine system, which is responsible for hormone production and regulation. This could have implications for conditions characterized by Yin deficiency and rising Yang, manifesting as irritability, restlessness, and symptoms of stress.
Mineral Content: The mineral content in Long Gu and Mu Li, particularly calcium compounds, might play a role in their physiological effects. Calcium is crucial for various bodily functions, including muscle contraction and nerve function. The sedative and stabilizing actions of these substances could be partly due to their influence on calcium channels, which are involved in the transmission of nerve impulses and the regulation of muscle tone.
Bone and Joint Health: Apart from their neurological and hormonal effects, Long Gu and Mu Li are also recognized for their role in promoting bone and joint health. They are used in traditional practices to address TCM syndromes related to osteomyelitis and arthritis, which could be linked to their mineral composition supporting bone density and joint function.
These insights into the actions of Long Gu and Mu Li from a scientific perspective provide a bridge between traditional Chinese medicine practices and modern physiological understanding. While the exact mechanisms are still being explored, the integration of these ancient substances into contemporary therapeutic practices highlights the potential for a more holistic approach to health and wellness, addressing both the mental and physical aspects of conditions.
Modern Clinical Applications
Today's practitioners can apply Calm Dragon Formula (Chai Hu Jia Long Gu Mu Li Tang) in various clinical settings, particularly for patients experiencing stress-related syndromes, unease, or sleep disturbances. Understanding its contraindications, such as in cases of severe depression or in the absence of constraint, is crucial for safe administration.
Dosing and Additional Uses
Low-dose applications and modifications of the formula are common, allowing practitioners to tailor treatments to individual patient needs. This adaptability extends the formula's use to TCM syndromes related to mild anxiety or episodic palpitations, where its grounding and calming effects can be beneficial without overwhelming the patient's system.
Addressing Palpitations
Specifically for palpitations, this formula offers a dual approach. In TCM, it calms the spirit and anchors the floating Yang, addressing the root causes of palpitations such as emotional distress or constraint. From a Western perspective, the calming effect on the nervous system and potential impact on electrolyte balance and heart rhythm can offer a complementary approach to managing symptoms.
In traditional Chinese medicine (TCM), palpitations can be a manifestation of various patterns of disharmony, with the shaoyang syndrome being one of them. Chai Hu Jia Long Gu Mu Li Tang, known for its ability to harmonize and soothe, is particularly suited for addressing palpitations that arise from shaoyang disturbances. Here’s how a shaoyang pattern might cause palpitations and how this formula can be applied.
Shaoyang Pattern and Palpitations
The shaoyang conformation, in TCM theory, represents an intermediary phase between the body's external and internal environments, associated with the Gallbladder and Triple Burner complexes. A disharmony within the shaoyang can manifest as an imbalance between yin-yang, leading to the disruption of proper qi-vectors. This disruption often results in symptoms such as alternating chills and fever, a bitter taste in the mouth, dizziness, and palpitations.
Palpitations in the context of shaoyang disharmony may arise from an underlying struggle between pathogenic factors attempting to penetrate deeper into the body and the body's qi trying to expel them. This tug-of-war creates a state of tension that can affect the heart and pericardium, manifesting as palpitations. Additionally, the shaoyang's association with the Gallbladder and Triple Burner channels links it to the emotional aspect of the individual, where stress, unease, and frustration can further exacerbate palpitations.
Targeted Approaches
Chai Hu Jia Long Gu Mu Li Tang addresses palpitations within the shaoyang pattern by targeting the root causes of the disharmony. The formula works through several mechanisms:
Harmonizing the Shaoyang: The key ingredient, Chai Hu (Bupleurum root), plays a pivotal role in resolving the half-exterior, half-interior nature of shaoyang disorders. It helps in spreading the Liver Qi, reducing tension, and alleviating the feeling of being 'stuck' which can contribute to palpitations.
Calming the Spirit: Long Gu (Dragon Bone) and Mu Li (Oyster Shell) are heavy, sedating substances that anchor the spirit (Shen) and calm the mind. This action is crucial for reducing palpitations, especially when they are accompanied by unease, restlessness, or insomnia.
Supporting Yin-Yang: The formula balances the Yin-Yang within the body, ensuring that neither is in excess or deficiency. This equilibrium is essential for stabilizing the heart's rhythm and thus, reducing palpitations.
Addressing Underlying Imbalances: By incorporating ingredients that tonify the Qi and nourish the Blood, the formula supports the overall energy and vitality of the body, which is essential for heart health and preventing palpitations.
Clearing Heat and Dampness: Palpitations can also be aggravated by internal heat or dampness. Certain components of the formula work to clear heat and dry dampness, further alleviating symptoms.
Clinical Practice
In clinical practice, the use of Chai Hu Jia Long Gu Mu Li Tang for palpitations would be considered when the patient exhibits signs of shaoyang disorder alongside symptoms such as restlessness, fluctuating fever and chills, a bitter taste in the mouth, and a fullness in the chest. The practitioner would also take into account the patient's tongue and pulse diagnosis to confirm the presence of a shaoyang pattern and the suitability of this formula.
Adjustments to the formula or the addition of other herbs might be necessary based on the individual's specific manifestations of disharmony, underlying conditions, and overall constitution. As always, a comprehensive TCM diagnosis and consultation with a qualified practitioner are essential before starting any treatment.
Addressing palpitations, especially when rooted in complex patterns like the shaoyang syndrome, highlights the nuanced approach of TCM in understanding and addressing the interconnectedness of the body's physical, emotional, and psycho-spiritual realms.
Calm Dragon Formula (Chai Hu Jia Long Gu Mu Li Tang) exemplifies the depth of TCM's integrative approach to healthcare, offering solutions that address both the physical and emotional well-being of patients. Its balanced composition makes it a versatile tool for modern practitioners seeking to bridge the gap between TCM and Western medical practices, especially in complex conditions like TCM-based palpitation syndromes, where a holistic approach can significantly enhance patient care.
(1) Maciocia, G. (2021). The Practice of Chinese Medicine: The Treatment of Diseases with Acupuncture and Chinese Herbs (3rd ed.). Elsevier.
(2) Unschuld, P. U., & Tessenow, H. (2011). Huang Di nei jing su wen: An Annotated Translation of Huang Di’s Inner Classic — Basic Questions (Vol. 1). University of California Press.
(3) Kwon, C.-Y., Lee, B., Chung, S.-Y., Kim, J. W., Shin, A., Choi, Y.-y., Yun, Y., & Leem, J. (2019). Efficacy and safety of Sihogayonggolmoryeo-tang (Saikokaryukotsuboreito, Chai-Hu-Jia-Long-Gu-Mu-Li-Tang) for post-stroke depression: A systematic review and meta-analysis. Scientific Reports, 9(1), 14536. https://doi.org/10.1038/s41598-019-51055-6