黄连阿胶汤

• Effects: Nourishes yin and drains fire, relieves vexation and calms the spirit.
• Core pathomechanism: A Shaoyin disease pattern of yin deficiency with effulgent fire and disharmony between the Heart and Kidney. Kidney water is deficient below and cannot rise to assist Heart fire; Heart fire is hyperactive above and cannot descend to communicate with the Kidney. As a result, Heart fire becomes solitarily hyperactive and disturbs the spirit.

2. When it is used

This formula is simple in composition and focused in action, combining clearing and tonifying methods. Together the herbs nourish yin, drain fire, and restore communication between the Heart and Kidney.

3. Pattern and presentation

• Main symptoms:
  1. Vexation in the chest with inability to lie down and sleep: unusual restlessness and inability to fall asleep, a typical manifestation of yin deficiency with effulgent fire disturbing the spirit.
• General and accompanying symptoms:

o Dry mouth and throat, heat in the palms and soles.

o Red tongue with little coating, or crimson tongue with no coating.

o Thin, rapid pulse.

4. Tongue and pulse

• Tongue: Crimson-red tongue body, scant fluid, little or no coating.
• Pulse: Thin and rapid, or deep, thin and rapid.

5. Common modifications