炙甘草汤

3. Tongue and pulse

• Tongue: Pale-red or red and dry tongue, thin and small tongue body, scanty or absent coating.
• Pulse: Knotted or intermittent pulse, or deficient and rapid, or thin and weak.

4. Granule conversion and dose

Calculation of the total raw herb weight of the original formula (excluding rice wine):

Zhi Gan Cao (prepared licorice root) 12 g + Sheng Di Huang (fresh rehmannia root) 48 g + Ren Shen (ginseng) 6 g + Da Zao (jujube) 45 g + E Jiao (donkey-hide gelatin) 6 g + Mai Dong (ophiopogon root) 15 g + Huo Ma Ren (hemp seed) 15 g + Gui Zhi (cinnamon twig) 9 g + Sheng Jiang (fresh ginger) 9 g = 165 g.

Converted to a 5:1 granule concentrate:

165 g raw herb ÷ 5 = 33.0 g granules.

Granule dose: Dissolve in warm water and take in 2-3 divided doses, morning and evening.

• Twice daily, about 16.5 g per dose.
• Three times daily, about 11.0 g per dose.

(The original formula was decocted with rice wine to aid the action of the herbs. When taking the granules dissolved in water, if the condition requires, a small amount of yellow rice wine may be used as a guiding vehicle under a practitioner's instruction; consult a pharmacist regarding feasibility.)

5. Cautions and clinical notes

[Contraindications]:

1. Use with caution or avoid in Spleen-Stomach deficiency-cold with turbid dampness obstructing the middle, manifesting as abdominal distension and loose stools. This formula contains many yin-nourishing herbs that are rich and cloying in nature, which may easily hinder Spleen-Stomach transportation and transformation.
2. In cases of yin deficiency with internal heat and pronounced flaring of deficiency fire, use Gui Zhi, Sheng Jiang, and rice wine with caution, or modify the formula as needed.

[Safety warnings]:

1. E Jiao in this formula is an animal-derived gelatin; ProCare Herbs granules may package it separately or process it using special methods—please follow the product instructions.
2. This formula has a relatively strong tonifying action and should be used under the guidance of a TCM practitioner's pattern diagnosis, particularly for patients with severe conditions such as coronary heart disease or arrhythmia.

Modern applications: Mainly used for arrhythmias of various causes (such as premature beats, atrial fibrillation, sinus tachycardia, etc.), coronary heart disease, angina pectoris, myocarditis, cardiomyopathy, sick sinus syndrome, and hyperthyroid heart disease, where the pattern is one of combined deficiency of qi, blood, yin, and yang. It may also be used for qi and yin damage following tumor radiotherapy or chemotherapy.

Duration of use: This formula is a regulating preparation, mainly used for chronic deficiency-type disorders, and requires a certain period of consistent use before an effect becomes apparent. It may be taken long-term according to a practitioner's guidance, with modifications made according to the pattern.