龙胆泻肝汤

2. Pattern and presentation

• Pattern of excess Liver-Gallbladder fire flaring upward: headache, red eyes, rib-side pain, bitter taste in the mouth, deafness, and swelling of the ear.
• Pattern of damp-heat pouring downward through the Liver channel: swelling and itching of the genitals, muscular flaccidity with genital sweating, painful and turbid urinary dribbling, and foul-smelling yellow vaginal discharge in women.

3. Tongue and pulse

• Tongue: red tongue body with yellow, greasy coating.
• Pulse: wiry, rapid, and forceful.

4. Granule conversion and dose

• Estimated total raw herb weight of the original formula: 96 g.
• Conversion to 5:1 granules:
  • 96 g raw herbs ÷ 5 = 19.2 g granules.
• Recommended dose and method of administration:
  • One dose daily, dissolved in warm water and taken in two portions.
  • As this formula is intensely bitter and cold, it is recommended to take it after meals.
  • Each dose is 9.5 g.

5. Cautions and clinical notes

1. [Contraindications]: Most herbs in this formula are intensely bitter and cold and may easily damage the Spleen and Stomach; it is therefore contraindicated in those with Spleen-Stomach vacuity cold and in those with yin deficiency with yang hyperactivity. It should not be taken for a prolonged period.
2. [Safety warning]: The Mu Tong used in this formula must be Chuan Mu Tong (Clematis armandii stem); Guan Mu Tong (Aristolochia manshuriensis stem, which contains aristolochic acid and is nephrotoxic) is strictly prohibited. When preparing ProCare Herbs granules, only the safe species must be used.
3. Formulation characteristics: This proportioned version places particular emphasis on balancing the disinhibition of dampness (Ze Xie) with the nourishment of yin (Sheng Di Huang), and is suitable for patterns in which damp-heat is pronounced and yin has already been mildly damaged.
4. Modern applications: This formula is widely used for otitis media, hypertension (Liver-yang hyperactivity pattern), acute icteric hepatitis, acute cholecystitis, urinary tract infection, acute pelvic inflammatory disease, and herpes zoster, where these belong to patterns of excess Liver-Gallbladder fire or damp-heat.
5. Duration of use: This formula is a strongly draining, heat-clearing preparation; it should be stopped once the disease resolves and should not be taken for a prolonged period. The formula should be adjusted as soon as symptoms improve. </detail_en> <usage_en>Take in 2 doses daily, dissolved in warm water, about 9.5 g per dose. As this formula is intensely bitter and cold, it is recommended to take it after meals to reduce gastrointestinal irritation.</usage_en>