Suan Zao Ren Tang Jia Wei

This formula is a modification by Bob Flaws of Zhang Zhong-jing’s Suan Zao Ren Tang (Zizyphus Decoction) found in his late Han dynasty Jin Gui Yao Lue (Essentials from the Golden Cabinet). Our version is a 10:1 extract in a glycerin base.

Rx:
Suan Zao Ren (Semen Zizyphi Spinosae)       50 mg
Fu Ling (Poria)                                             40 mg
Bai Shao (Radix Paeoniae Albae)                  40 mg
Zhi Mu (Rhizoma Anemarrhenae)                   30 mg
Chuan Xiong (Rhizoma Chuanxiong)               30 mg
Gan Cao (Radix Glycyrrhizae)                       10 mg
 

INDICATIONS
This formula is for the treatment of pediatric crying, drooling, fidgeting, fussiness, and insomnia due to teething associated with the hyperactivity of life-gate/ministerial fire and heat harassing the heart spirit.

THE SIGNS AND SYMPTOMS OF HYPERACTIVITY OF LIFE-GATE/MINISTERIAL FIRE INCLUDE:

• Teething

• Warm body

• Red face

• Possible fever

THE SIGNS AND SYMPTOMS OF HEAT HARASSING THE HEART SPIRIT INCLUDE IN ADDITION:

• Insomnia

• Crying

• Restlessness

• Fidgeting

FORMULA EXPLANATION
In Chinese medicine, children do not grow and develop in a steadily progressive, linear fashion. As with everything else in Chinese medicine, children’s growth and development is cyclic in nature. In other words, it is governed by changes and transformations which wax and wane. Like all transformation in the body, these changes are warm transformations (wen hua). In other words, they are empowered by the yang qi which is rooted in the life-gate/ministerial fire, the moving qi between the kidneys or the source yang, and this yang qi waxes and wanes. When yang qi waxes, this is called “change and steaming” (bian zheng) as in heat steaming upward. Therefore, growth spurts, including teething, are a time when the life-gate/ministerial fire is relatively more active and, thus, also warmer. Remember, the teeth are the surplus of the bones and the bones are governed by the kidneys. Hence teething is a time when there can easily be inflammation or even fever as well as normal physiological activity and growth. This is all the more likely in infants whose bodies are constitutionally pure yang. This means that their yang qi and yin fluids are not mutually interpenetrating and restricting. So yang qi can transform into depressive heat all the more easily. Because it is yang qi which moves water fluids in the body, hyperactivity of yang qi can also lead to drooling, i.e., the emission of water fluids from the mouth. Further, because all heat in the body travels upward and the heart is located in the upper burner, heat may harass the heart spirit leading to insomnia, restlessness, and fidgeting.

Based on the foregoing explanations, within this formula, Zhi Mu clears heat floating upward due to hyperactivity of life-gate/ministerial fire. Suan Zao Ren and Fu Ling quiet the heart spirit. Fu Ling also fortifies the spleen which, according to Li Dong-yuan’s yin fire theory helps to control upwardly stirring ministerial fire. Chuan Xiong moves the qi and blood which helps to disperse inflammation locally, understanding that inflammation is a depressive accumulation of yang qi. Chuan Xiong also leads the other medicinals in the formula to the region of the head and acts as a spirit-quieting medicinal in infants and young children. Gan Cao clears heat and also harmonizes all the other medicinals in the formula. The addition of a relatively large amount of Bai Shao is meant to help clear heat from the liver since Bai Shao is bitter, sour, and mildly cold. The liver commonly has a surplus in children and also has an especially close relationship to the life-gate/ministerial fire. If the liver becomes depressed, it easily transforms heat which then leads to the mutual engenderment of stirring ministerial fire. Thus gently clearing or restraining liver heat clears and restrains ministerial fire. In addition, the combination of Bai Shao and Gan Cao helps stop pain, while the combination of Bai Shao and Suan Zao Ren strengthens this formula’s ability to quiet the spirit and promote sleep.

COMBINATIONS
If teething is also associated with food stagnation as it often is due to the recent introduction of solid foods, this formula can be combined with Blue Poppy Herbs’ Quiet Nites in order to also abduct food, disperse stagnation, and clear heat.