Astringent herbs, being sour and astringent in nature, are applied to stop sweating, check diarrhea, control essence, hold in urine and stop leukorrhea, bleeding, and coughing. They are indicated in cases with weakness from chronic disease or unconsolidated anti-pathogenic factors which lead to spontaneous sweating, night sweats, chronic diarrhea, chronic dysentery, seminal emissions, nocturnal emissions, enuresis, frequent urination, chronic cough and asthma, or uterine bleeding, leukorrhea, and prolapse of the uterus or rectum.
Astringent herbs relieve symptoms so as to maintain the strength of the anti-pathogenic factor. In order to treat the symptoms and the root cause simultaneously, corresponding tonifying herbs should be added to the combination.
Astringent herbs should not be used while pathogenic factors are in the exterior, when there is interior accumulation of dampness or when accumulated heat exists.
Astringent Prescriptions are those mainly composed of astringent herbs with restraining and consolidating functions. They treat syndromes of consumption or extreme loss of Qi, blood, essence, and body fluid. These syndromes may have a variety of causes and can affect many different parts of the body. As the syndromes manifest the respective characteristics, so must the Prescriptions treat them. These Prescriptions can be classified as follows:
(1)Prescriptions for consolidating the exterior and arresting sweating: They stop sweating and are mainly used to treat spontaneous sweating and night sweats
(2)Prescriptions for astringing the intestines and stopping diarrhea: They astringe the intestines and stop diarrhea and dysentery, and are suitable for cases of protracted diarrhea or dysentery due to Yang deficiency of the spleen and kidney, as well as the failure of the large intestine to control defecation.
(3)Prescriptions for astringing essence and stopping spermatorrhea: They astringe sperm production and are often used to treat seminal emissions and enuresis caused by deficiency of the kidneys.
(4)Prescriptions for relieving metrorrhagia and leukorrhagia: They are used for metrorrhagia and leukorrhagia due to deficiency of the Thoroughfare Vessel and the Conception Vessel, and disorders of the Belt Vessel.
In clinical application, it must be noted that astringent prescriptions are not suitable for a person with excess pathogenic factors. Use of Astringent Prescriptions causes the pathogenic factors to remain in the body and cause further ill health.
Astringent Herbs (收敛固涩药)
(i) Schisandra fruit (Wu Wei Zi,)
Pharmaceutical Name: Fructus Schisandrae
Part Used: Fruit
Properties: Sour and warm
Meridians: Lung, kidney, and heart
Functions: | (a) | To astringe the lungs and nourish the kidneys; |
(b) | To promote the production of body fluids and astringe sweat; | |
(c) | To restrain the essence and stop diarrhea; | |
(d) | To calm the heart and soothe the mind. |
Applications:
(a)Chronic cough and asthma due to rebellious lung-Qi caused by deficiency of the lungs and kidneys, manifested as cough with scanty sputum and asthma aggravated by slight exertion. Schisandra fruit (Wu Wei Zi, ) is used with Dogwood fruit (Shan Zhu Yu, ), prepared Rehmannia root (Shu Di Huang, ), and Ophiopogon root (Mai Dong, ).
(b)Deficient Qi and body fluids, manifested as spontaneous sweating, night sweats, thirst, palpitations, shortness of breath, and a deficient forceless pulse. Schisandra fruit (Wu Wei Zi, ) is used with Ginseng (Ren Shen, ) and Ophiopogon root (Mai Dong, ).
(c)Diabetes manifested as thirst, preference for excessive fluid intake, shortness of breath, lassitude, and a deficient forceless pulse. Schisandra fruit (Wu Wei Zi, ) is used with Astragalus root (Huang Qi, ), Fresh Rehmannia root (Sheng Di Huang, ), Ophiopogon root (Mai Dong, ), and Trichosanthes root (Tian Hua Fen, ).
(d)Seminal emissions and nocturnal emissions caused by kidney deficiency. Schisandra fruit (Wu Wei Zi, ) is used with Dragon bone (Long Gu, ) and Mantis egg case (Sang Piao Xiao ,
(e)Chronic diarrhea caused by deficiency of the spleen and kidneys. Schisandra fruit (Wu Wei Zi, ) is used with Nutmeg (Rou Dou Kou, ) and Evodia fruit (Wu Zhu Yu, ).
(f)Deficient Yin and blood of the heart and kidneys, manifested as palpitations, irritability, insomnia, dreamful sleep, and forgetfulness. Schisandra fruit (Wu Wei Zi, ) is used with Fresh Rehmannia root (Sheng Di Huang, ), Ophiopogon root (Mai Dong, ), and Wild jujube seed (Suan Zao Ren, ).
(g)Dosage: 2–6 g.
Cautions and Contraindications: This herb is contraindicated in the early stage of cough or rubella and in excessive internal heat with unrelieved exterior syndrome.
(iii) Black plum (Wu Mei, )
Pharmaceutical Name: Fructus Mume
Part Used: Fruit
Properties: Sour and neutral
Meridians: Spleen, lung, and large intestine
Functions: | (a) | To astringe the lungs and stop cough; |
(b) | To restrain the intestines and stop diarrhea; | |
(c) | To promote the production of body fluids; | |
(d) | To expel roundworms. |
Applications:
(a)Chronic cough due to deficiency of the lung-Qi. Black plum (Wu Mei, ) is ued with Poppy capsule (Yingsuqiao, ) Donkey hide gelatin (E Jiao, ), and Apricot seed (Xing Ren, ).
(b)Chronic diarrhea or dysentery. Black plum (Wu Mei, ) is used with Nutmeg (Rou Dou Kou, ), Chebula fruit (Hezi, ) and Poppy capsule (Yingsuqiao, ).
(c)Acute dysentery. Black plum (Wu Mei, ) is used with Coptis root (Huang Lian, ).
(d)Diabetes. Black plum (Wu Mei, ) is used with Trichosanthes root (Tian Hua Fen, ), phiopogon root (Mai Dong, ), Ginseng (Ren Shen, Pueraria root (Ge Gen, ).
(e)Roundworms in the biliary tract, manifested as abdominal pain, nausea, and vomiting. Black plum (Wu Mei, ) is used with Asarum herb (Xi Xin, ) and Coptis root (Huang Lian, ).
(f)Dosage: 3–10 g.
Cautions and Contraindications: This herb is contraindicated in cases with exterior syndrome or accumulation of excessive heat in the interior.
(iii) Light wheat (Fu Xiao Mai, )
Pharmaceutical Name: Fructus Tritici levis
Part Used: The light grain is first soaked in water and then dried.
Properties: Sweet and cool
Meridian: Heart
Functions: | (a) | To tonify Qi and clear heat; |
(b) | To stop sweating. |
Application:
(a)Weakness of the body, manifested as spontaneous sweating or night sweats. Light wheat (Fu Xiao Mai, ) is used with Oyster shell (Mu Li, ), Astragalus root (Huang Qi, ), and Ephedra root (Ma Huang Gen, ) in the formula Mu Li San .
(b)Dosage: 15–30 g.
(iv) Lotus seed (Lian Zi, )
Pharmaceutical Name: Semen Nelumbinis
Part Used: Seeds
Properties: Sweet, astringent, and neutral
Meridians: Spleen, kidney and heart
Functions: | (a) | To tonify the spleen and stop diarrhea; |
(b) | To reinforce the kidneys and control the essence; | |
(c) | To nourish the blood and tranquilize the mind. |
Applications:
(a)Palpitations, insomnia, and irritability. Lotus seed (Lian Zi, ) is used with Wild jujube seed (Suan Zao Ren, ), Arborvitae seed (Bai Zi Ren, ), and Poria with host wood (Fu shen, ).
(b)Kidney deficiency manifested as seminal emissions or leukorrhagia. Lotus seed (Lian Zi, ) is used with Dodder seed (Tu Si Zi, ), Dioscorea (Shan Yao, ), and Euryale seed (Qian Shi, ).
(c)Chronic diarrhea due to deficiency of the spleen-Qi. Lotus seed (Lian Zi, ) is used with White Atractylodes (Bai Zhu, ), Dioscorea (Shan Yao, ), and Poria (Fu Ling, ).
(d)Dosage: 6–15 g.
Cautions and Contraindications: This herb is contraindicated in cases with constipation.
(v) Euryale seed (Qian Shi, )
Pharmaceutical Name: Semen Euryales
Part Used: Seeds
Properties: Sweet, astringent, and neutral
Meridians: Spleen and kidney
Functions: | (a) | To tonify the spleen and stop diarrhea; |
(b) | To strengthen the kidneys and control essence; | |
(c) | To dispel dampness and relieve leukorrhea. |
Applications:
(a)Chronic diarrhea due to deficiency of the spleen. Euryale seed (Qian Shi, ) is used with White Atractylodes (Bai Zhu, ) and Dioscorea (Shan Yao, ).
(b)Seminal emissions or leukorrhea. Euryale seed (Qian Shi, ) is used with Flattened milkvetch seed (Shayuanzi, ) and Cherokee rose hip (Jinyingzi, ).
(c)Dosage: 10–15 g.
(vi) Dogwood fruit (Shan Zhu Yu, )
Pharmaceutical Name: Fructus Corni
Part Used: Fruit
Properties: Sour and slightly warm
Meridians: Liver and kidney
Functions: | (a) | To tonify the liver and kidneys; |
(b) | To astringe essence; | |
(c) | To stop sweating. |
Applications:
(a)Deficiency of the liver and kidneys, manifested as dizziness, blurred vision, soreness in the lower back, weakness of the legs, seminal emissions, and impotence. Dogwood fruit (Shan Zhu Yu, ) is used with prepared Rehmannia root (Shu Di Huang, ), Dodder seed (Tu Si Zi, ), Wolfberry fruit (Gou Qi Zi, ), and Eucommia bark (Du Zhong, ).
(b)Spontaneous sweating due to weakness of the body. Dogwood fruit (Shan Zhu Yu, ) is used with Ginseng (Ren Shen, ), Prepared aconite root (Fu Zi, ) and Oyster shell (Mu Li, ).
(c)Dosage: 5–10 g.
Cautions and Contraindications: This herb is contraindicated in cases with damp-heat or dysuria.
Astringent Prescriptions
Prescriptions for Consolidating the Exterior and Arresting Sweating (固表止汗剂)
(i) Mu Li San )
(Oyster Shell Powder)
Composition: | Oyster shell (Mu Li, ) | 30 g |
Ephedra root (Ma Huang Gen, ) | 30 g | |
Astragalus root (Huang Qi, ) | 30 g |
Administration: Grind the above herbs into granules; decoct 9 g each time in water with 30 g Light wheat (Fu Xiao Mai, ). After removing the residue, the decoction is ready to drink, twice daily.
Functions: | (a) | To replenish Qi and strengthen superficial resistance; |
(b) | To preserve Yin and stop sweating. |
Indications: Spontaneous sweating or night sweats, palpitations, susceptibility to fright, shortness of breath, irritability, fatigue, a pink tongue, and a thready weak pulse.
Formula Analysis: This is the commonly used formula for superficial weakness and discharge of Yin fluid, while there is insufficient heart-Yin and hyperactive heart-Yang. The disorders should be treated by means of supplementing Qi and strengthening the superficies, replenishing the heart-Yin, as well as suppressing heart-Yang and arresting sweating. Mu Li with salty and cold properties acts as the chief herb, arresting sweating, nourishing Yin, and suppressing hyperactive Yang. Huang Qi with sweet and warm properties is used as the assistant herb, strengthening body resistance and replenishing Qi to arrest sweating. Serving as the adjuvant herbs, Fu Xiao Mai invigorates the heart-Yin, purges heart-Fire, and relieves irritability. Ma Huang Gen serves as guide to arrest sweating, cooperating with other herbs.
Applications in Bio-medicine: Spontaneous sweating, night sweats, and prolonged profuse perspiration due to weakness of the body after illness, surgery or operation or delivery, and other conditions which pertain to the failure of healthy Qi to consolidate the superficies.
Modifications:
(a)For Yang deficiency manifested as severe spontaneous and sweating, add White Atractylodes (Bai Zhu, ) and prepared aconite root (Fu Zi, ).
(b)For Yin deficiency manifested as severe night sweats, add White peony root (Bai Shao, ), Dried Rehmannia root (Gan Di Huang, ), and Wild jujube seed (Suan Zao Ren, ).
(c)For severe blood deficiency, add prepared Rehmannia root (Shu Di Huang, ) and Donkey hide gelatin (E Jiao, )
(d)For severe Qi deficiency, add Pilose Asiabell root (Dang Shen, ) and White Atractylodes (Bai Zhu, ).
Cautions: For a patient with night sweats caused by Yin deficiency and excessive fire in the interior, or for a patient with profuse sweating, cold limbs, and a weak pulse due to collapse of Yang, the above-mentioned herbal additions should be made to the basic formula. As Mu Li San corrects symptoms rather than syndromes, it is essential to add the appropriate herbs so as to relieve the syndrome.
Prescriptions for Astringing the Intestines and Stopping Diarrhea (涩肠固脱剂)
(i) Sishen Wan
(Pills of Four Miraculous Herbs)
Composition: Nutmeg (Rou Dou Kou, ) 60 g
Schisandra fruit (Wu Wei Zi, ) 60 g
Psoralea fruit (Bu Gu Zhi, ) 120 g
Evodia fruit (Wu Zhu Yu, ) 30 g
Administration: The above herbs are ground into granules along with 240 g of Fresh ginger (Sheng Jiang, ) and 100 pieces of Jujube (Da Zao, ), and then made into pills. Take 6–9 g twice daily.
Functions: | (a) | To warm and reinforce the spleen and kidneys; |
(b) | To astringe the intestines and stop diarrhea. |
Indications: The syndrome of diarrhea before dawn due to Yang deficiency of the spleen and kidneys, manifesting as abdominal pain and diarrhea, anorexia, or protracted diarrhea, abdominal pain with preference for warmth and pressure, soreness about the waist and cold limbs, mental fatigue and lassitude, a pale large tongue with a thin whitish coating, and a deep slow forceless pulse.
Formula Analysis: This is the commonly used formula for the deficiency of kidney-Yang, while there is insufficient fire to warm spleen earth. The disorders should be treated by means of warming and invigorating the spleen and kidneys to relieve diarrhea. As the chief herb, Bu Gu Zhi activates kidney-Yang and warms the spleen to relieve diarrhea. Rou Dou Kou acts as the assistant herb to warm the kidneys and spleen. Wu Wei Zi has astringent and anti-diarrheal functions, while Wu Zhu Yu warms the interior and dispels cold. Sheng Jiang and Da Zao both invigorate the spleen and regulate the stomach. These four herbs serve as guides to strengthen the effects of the chief and assistant herbs.
Applications in Bio-medicine: Chronic or allergic enteritis and intestinal tuberculosis with morning diarrhea, all of which belong relate to Yang deficiency of the spleen and kidneys.
Modifications:
(a)In cases of rectal prolapse, add Astragalus root (Huang Qi, ), Cimicifuga (Sheng Ma, ), and Pilose Asiabell root (Dang Shen, ).
(b)For severe soreness of the lower back and cold limbs, add Prepared aconite root (Fu Zi, ) and Cinnamon bark (Rou Gui, ).
Prescriptions for Astringing Essence and Stopping Spermatorrhea (金锁固精丸)
(i) Jinsuo Gujing Wan
(Pills to Fix Sperm)
Composition: | Flattened milkvetch seed (Sha Yuan Jili, ) | 60 g |
Euryale seed (Qian Shi, ) | 60 g | |
Dragon bone (Long Gu, ) | 30 g | |
Lotus seed (Lian Zi, ) | 60 g | |
Lotus stamen (Lian Zixu, ) | 60 g | |
Oyster shell (Mu Li, ) | 30 g |
Administration: The herbs and substances are made into pills. Take 9 g twice daily with lightly salted water.
Functions: To reinforce the kidney and astringe the essence.
Indications: Nocturnal and spontaneous emissions caused by kidney deficiency which cannot control essence (sperm), marked by spermatorrhea, frequent diarrhea, soreness about the waist, tinnitus, mental fatigue, lassitude, a pale tongue with a whitish coating, and a thready weak pulse.
Formula Analysis: This is the commonly used formula for the failure of the kidney to store essence due to kidney deficiency, and the spontaneous discharge of sperm. The disorders should be treated by means of reinforcing the kidney and stopping emissions. Sha Yuan Jili acts as the chief herb, and not only reinforces the kidney but also restrains emissions. Lian Zi and Qian Shi are used as assistant herbs to enhance the effects of the chief herb. The remaining three herbs are all major astringent herbs for restraining sperm, and they function as the adjuvant herbs. In combination with the chief and assistant herbs, the adjuvant herbs allow the formula to achieve an even better result.
Applications in Bio-medicine: Spermatorrhea, prospermia, enuresis, chyluria, and other conditions which relate to deficient and instable kidney-Qi.
Modifications:
(a)For Yin deficiency with excessive fire and the flaring-up of Mingmen (Gate of Life) Fire, add Anemarrhena rhizome (Zhi Mu, ) and Phellodendron bark (Huang Bai, ).
(b)For kidney-Yin deficiency with internal heat, add Tortoise plastron (Gui Ban, ) and Glossy privet fruit (Nu Zhen Zi, ).
(c)In cases of kidney-Yang deficiency, add Asiatic cornelian cherry fruit (Shanyurou) and Psoralea fruit (Bu Gu Zhi, ).
(d)For constipation, add Cistanche (Rou Cong Rong, ) and Chinese Angelica root (Dang Gui, ).
(e)For loose stools, add Schisandra fruit (Wu Wei Zi, ) and Psoralea fruit (Bu Gu Zhi, ).
(f)For severe pain and soreness about the waist, add Eucommia bark (Du Zhong, ), Himalayan teasel root (Xu Duan, ) and Mulberry mistletoe (Sang Ji Sheng, ).
(g)For impotence and prospermia, add Epimedium (Yin Yang Huo, ), Cynomorium stem (Suo Yang, ), and Dodder seed (Tu Si Zi, ).
Prescriptions for Relieving Metrorrhagia and Leukorrhagia (固崩止带剂)
(i) Guchong Tang
(Decoction to Consolidate the Chong Meridian)
Composition: | White Atractylodes (Bai Zhu, ) | 30 g |
White peony root (Bai Shao, ) | 12 g | |
Dragon bone (Long Gu, ) | 24 g | |
Dogwood fruit (Shan Zhu Yu, ) | 24 g | |
Cuttlefish bone (Hai Piao Xiao, ) | 12 g | |
Carbonized petiole of windmill palm (Zong Lu Tan, ) | 9 g | |
Gallnut (Wu Bei Zi, ) | 1.5 g | |
Astragalus root (Huang Qi, ) | 18 g | |
Oyster shell (Mu Li, ) | 24 g | |
Rubia root (Qian Cao, ) | 9 g |
Administration: The herbs and substances are cooked with water. The decoction without residue is ready to drink, twice daily.
Functions: | (a) | To tonify Qi and strengthen the spleen; |
(b) | To strengthen the Chong Meridian and control the blood. |
Indications: Weakness and insecurity of the Chong meridian due to spleen-Qi deficiency, marked by metrorrhagia or profuse but thin pale menstrual flow, palpitations, shortness of breath, soreness and weakness about the waist and knees, a pale tongue, and a thready and weak or feeble and large pulse.
Formula Analysis: This is the commonly used formula for the failure of the spleen to adequately control the blood, while there is debility of the Chong meridian. The disorders should be treated by means of replenishing Qi and invigorating the spleen, as well as reinforcing the Chong meridian to stop bleeding. Used as the chief herbs, Bai Zhu and Huang Qi (in larger dosages) are meant to supplement Qi and reinforce the spleen to control blood. Shan Zhu Yu and Bai Shao function as the assistant herbs, with the effects of invigorating the liver and kidney, nourishing blood, and preserving Yin. Long Gu , Mu Li , Zong Lu Tan , Hai Piao Xiao, , and Wu Bei Zi astringe and stop bleeding, while Qian Cao resolves blood stasis to stop bleeding. These six herbs are the adjuvant herbs and together they stop bleeding without retaining stagnated blood.
Applications in Bio-medicine: Menorrhagia, dysfunctional uterine bleeding, and postpartum hemorrhage, all of which relate to debility of the Chong Meridian due to spleen deficiency.
Modifications: In cases where listlessness, a pale complexion, cold limbs, and a weak pulse are present, add Ginseng (Ren Shen, ) and Prepared aconite root (Fu Zi, ).
Cautions: This formula is contraindicated for patients with metrorrhagia due to heat in the blood.
(ii) Wandai Tang
(Discharge-Ceasing Decoction)
Composition: | White Atractylodes (Bai Zhu,) | 30 g |
Dioscorea (Shan Yao, ) | 30 g | |
Ginseng (Ren Shen, ) | 6 g | |
White peony root (Bai Shao,) | 15 g | |
Plantain seed (Chen Qian Zi,) | 9 g | |
Schizonepeta (Jing Jie, ) | 1.5 g | |
Atractylodes rhizome (Cang Zhu, ) | 9 g | |
Licorice (Gan Cao, ) | 3 g | |
Citrus peel (Ju Pi, ) | 1.5 g | |
Bupleurum root (Chai Hu, ) | 1.8 g |
Administration: Decoct the above herbs in water for drinking twice daily.
Functions: | (a) | To reinforce the middle Jiao and strengthen the spleen; |
(b) | To resolve dampness and relieve leukorrhagia. |
Indications: Leukorrhagia due to dampness caused by deficiency of the spleen and stagnation of the liver, manifested as a thin, whitish or yellowish thin discharge, leukorrhea without a foul odor, a pale complexion, fatigue, loose stools, a pale tongue with a whitish coating, and a slow or soft, superficial and weak pulse.
Formula Analysis: This is the commonly used for treating the syndrome of leukorrhgia due to dampness caused by deficiency of the spleen and stagnation of the liver. The disorders are treated by reinforcing the spleen, dispersing the stagnated liver-Qi, and eliminating dampness. Bai Zhu and Shan Yao act as the chief herbs (in larger dosages), invigorating the Qi of the middle Jiao and strengthening the spleen by removing dampness. Ren Shen and Cang Zhu restore Qi and dry dampness respectively, and enhance the effects of the chief herbs; Bai Shao and Chai Hu possess the respective functions of softening the liver and regulating stagnated liver-Qi. thus relieving the accompanying symptoms of stagnated liver-Qi. These four together serve as the assistant herbs. Che Qian Zi promotes diuresis, Ju Pi promotes Qi flow to eliminate dampness, and Jing Jie disperses stagnated liver-Qi and lifts Yang; they are all adjuvant herbs. Gan Cao is used as the guiding herb to supplement Qi and mediate the properties of the other herbs.
Applications in Bio-medicine: Leukorrhagia, vulvitis, vaginitis, and cervical inflammation, which are marked by lingering thin whitish leukorrhagia due to spleen-Qi deficiency.
Modifications:
(a)In cases of soreness and pain in the lower back, add Eucommia bark (Du Zhong, ), Dodder seed (Tu Si Zi, ), and Himalayan teasel root (Xu Duan, ).
(b)For abdominal pain, add Mugwort leaf (Ai Ye, ), Cyperus tuber (Xiang Fu, ), and Lindera root (Wu Yao, ).
(c)For prolonged deficiency and coldness, add Degelatinized deer antler (Lu Jiao Shuang, ), Cinnamon bark (Rou Gui, ), and Morinda root (Ba Ji Tian, ).