GU ADVANCED HERBAL STUDIES: - PowerPoint Presentation

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GU ADVANCED HERBAL STUDIES:

DETOXIFICATION & LIVER DISHARMONYHillary Thing, LAc., Cert. Herbalist (NCCAOM)

Functions of the Liver

Carbohydrate, fat and protein metabolismFiltering and detoxification of the blood from drugs, alcohol, hormones, toxins, emotional and physiological metabolic wasteStorage of iron and vitaminsFormation of substances for blood coagulation Produces many types of enzymesProduces secretions to aid proper absorption and elimination of foods and toxins.Releases bile

Common Liver-related TBD symptomology

Loss of appetite (23%)Nausea (17%) & vomiting (10%)Abdominal pain (8%) & URQ tenderness (8%)Hepatomegaly (5%)Liver inflammation w/ elevated enzymes in both acute and persistent Lyme-BorreliosisHepatitis presentation is common with Ehrlichia (80%)

Known cases of acute liver failure due to Babesia, Bartonella

Excessive burden on the liver makes it a pivotal organ in Lyme / TBD / CCD

Direct attack, infection of liverHigher toxin load due to endotoxinsGenetic weaknesses

Antibiotics & pharmaceuticals

Sluggish circulation

Nutrient depletion

Characteristics of the Liver in Chinese Medicine:

Deals with coping, stress management, and “harmonizing” emotion – our ability to flow with life. The General: commands the flow of qi and blood; pathology reflected in excessive rigidity and over-flexibility; (bamboo)The primary underlying organ dysfunction of all chronic disease syndromes.

When the liver loses harmony, the Spleen (digestion) may be affected; digestive issues are a common side-effect of stress and unresolved emotions.

Hallmark

sx

: PMS and hormonal problems, headaches, eye problems, infertility, allergies, obesity, herpes, digestive problems, constipation, heart and circulatory problems, and cancer signify pre-existing liver disharmony.

Liver constraint produces anger, irritability or in severe cases rage.

Detoxification & the Harmonization School of Chinese Medicine

Founder was Cheng Wu-Ji from the Song D.; strongly influenced by the Shang Han Lun.The body is constantly struggling between exterior and interior forces and levels of disease, so emphasis on the shaoyang (1/2 interior, ½ exterior) level of disease; the axis of this struggle is in the chest.Psych: this strategy works with stuck perspective, loss of flexibility, negative thoughts, isolation and judgement (defense mechanisms).

Chief herb is bupleurum / chai hu.

Treatment Principle for Liver Harmony & Detoxification in Gu Disease

Reduce incoming toxins (examine bodycare, home & work environments, etc.)Strengthen Spleen, reduce damp, treat leaky gut and other GI problems.

Move stagnant Liver qi & blood.

Nourish liver yin & blood.

Transform Liver / Gallbladder damp-heat.

Clear heat (deficiency or excess).

Eliminate Wind.

Nourish the Kidneys.

Eliminate specific microbial infections.

Break up biofilm.

Bupleurum-Based Formulas: Hallmarks of Gu Clinical Presentation

Chest / ribcage fullness, discomfort, stuckness; subjective or on palpation; stress-related sx; constrained breathingAlternating fever and chills; episodic, rhythmic sxShaoyang zone: chest, ribcage, shoulders, hips, nape, lateral head, torso and legs.Tendency for qi stagnation and blood stasis

CNS hyperactivity; insomnia; seizures; Neuro-

lyme

; headaches

All formulas are safe and commonly used in pediatrics.

Chai hu, Bupleurum root,

thorowax root“Kindling of the barbarians”Enters Gallbladder, Liver, Pericardium, San JiaoCool, acrid, bitterReleases shaoyang (1/2 interior, ½ exterior) conditionsAlternating constipation / diarrhea, alternating fever / chills; nausea, bitter taste, irritability

Releases constrained Liver Qi

Pent up, stagnant feeling, bloating, indigestion, vague type pain / pressure, moody, menstrual disorders

Raises yang qi and vents the surface (combine with sheng ma / black cohosh)

Prolapse, diarrhea, rashes

Classical Formulas for Liver Detoxification

Xiao Chai Hu TangXiao Yao WanJia Wei Xiao Yao WanChai Hu Shu Gan San (Wan – Golder Flower)Xue Fu Zhu Yu WanTao Hong Si Wu TangYi Guan JianChai Hu Long Gu Mu Li Tang

Minor Bupleurum Decoction / Xiao Chai Hu Tang

From Shang Han Lun (Zhang Zhong-Jing), 220 ADaIngredients:Bupleurum / chai hu. 10 gScutellaria / huang

qin

. 6 g

Zhi

ban

xia

/ processed

pinellia

rhizome. 6g

Ginseng /

ren

shen

5g ->

huang

qi

fresh ginger / sheng jiang. 10 g

Licorice /

gan

cao

. 10g

Jujube / da

zao

. 12g

Tx hepatitis, cholecystitis, URTI, UTI, GI

inf

, encephalitis, etc.

Fever, bitter taste, indigestion, irritability & expressive depression,

Wiry pulse, yellow tongue coating

Bupleurum, Cinnamon Twig & Dried Ginger Decoction / Chai hu

Gui zhi Gan jiang TangFrom Shang Han Lun (Zhang Zhong-Jing), 220 ADaIngredients:Bupleurum / chai hu. 24 g

Trichosanthes

root / tian

hua

fen. 12 g or

gua

lou

/ (fruit)

Oyster shell / mu li. 6 g

Cinnamon twig /

gui

zhi

. 9g

Scutellaria

/

huang

qin

. 9 g

Dried ginger /

gan

jiang. 6 g

Honey fried licorice /

zhi

gan

cao

6 g ->

gan

cao

Releases phlegm and qi stagnation in the chest;

Helps person find their sense of direction; emotionally drained.

Calming + restores energy; nervous system fragility; unstable energy levels due to stress.

Chai Hu Jia Long Gu Mu Li Tang / Bupleurum, Dragon Bone & Oyster Shell Decoction

Shang Han Lun, Discussion of Injury by Cold, 220ADIngredients:Bupleurum / chai hu. 12 g Cinnamon twig / gui zhi. 4.5 gRhubarb / da

huang

. 6 g

Pinellia

/ ban

xia

. 6-9 g

Scutellaria

/

huang

qin

. 4.5 g

Fresh ginger / sheng jiang. 4.5 g

Poria

/

fu

ling. 4.5 g

Ginseng /

ren

shen

4.5 g

Dragon bone / long

gu

. 4.5 g

Oyster shell / mu li. 4.5 g

Jujube / da

zao

. 6 pc

**For neuro-psych presentations. Panic, anxiety, HT palp; neuro-muscular pathologies

Tx acute stress, SAD, illness worsened by stress, environmental or hormonal changes

EPF + interior deficiency; good for chronic conditions

Free Wanderer Powder / Xiao Yao San

Tai Ping Hui Min He Ji Ju Fang, 1078AD (Imperial Medicine)Ingredients:Chai hu / Bupleurum root Bai zhu / Atractylodes -> huang qi / astragalus

Bai shao / White Peony root

Fu ling /

Poria

Dang

gui

/ Angelica

Sinensis

Sheng jiang / fresh ginger root

Bo he / Field mint

Gentler formula for stress-related and hormone-related symptom aggravation.

Jia Wei Xiao Yao San: classic modification adds

zhi

zi

/ gardenia + mu

dan

pi /

moutan

peony root bark to also clear heat

Da Chai Hu Tang / Major Bupleurum Decoction

Shang Han Lun, 220 ADIngredients:Chai hu / bupleurum. 10gHuang qin / scutellaria. 6gBai shao / white peony root. 6g

Ban

xia

/

pinellia

. 6g.

Sheng jiang / fresh ginger. 1 slice, add last

Zhi

shi

/ citrus

aurantium

. 6g

Da

zao

/ jujube. 10g

Da

huang

/ rhubarb. 5g.

Constipation, heat signs (fever, irritability, redness, etc.)

If constipation does not resolve, add rhubarb in last 5 minutes of decoction.

Tx GB, pancreas, liver, GI inflammation; if Minor Bupleurum is not strong enough

Gu Detox Formula Checklist

Is this strategy included in the formula? Does the patient need this, and if so, in what proportion?Move liver qiMove liver blood

Nourish liver blood

Nourish liver yin

Nourish kidney yin and yang

Strengthen the Spleen (GI), eliminate damp, heal leaky gut

Eliminate wind (neuro)

Clear heat – excess or deficiency

Drain liver / gallbladder damp-heat

Address specific microbial infections

Break up biofilm

Modern Gu Detox Formulas

Liver Detox Formula (UL)Kidney Detox Formula (UL)Heavy Metal Detox Formula (UL)

Liver Gu-Detox Formula (UL)

Actions: Support detoxification pathways and the movement of blood through the liver; anti-oxidant and liver protective; anti-inflammatory; treats gallbladder congestion too.Ingredients:Chai hu / bupleurumDang gui / angelica sinensisMilk thistle

Xiang

fu

/

cyperus

Bai shao / white peony

Huang

qin

/

scutellaria

Zhi

zi

/ gardenia

Pu gong

ying

/ dandelion

Yu

jin

/ curcuma

Yin

chen

hao

/ artemisia

yinchenhao

Jin

qian

cao

/

lysimachia

Available in raw herb, granule or tincture

Kidney Gu-Detox Formula (UL)

Actions: Aids the movement of water through the kidneys; supports kidney’s filtering function; anti-inflammatory.Ingredients:Ze xie / alismaFu ling / poriaZhu ling /

polyporus

Gui

zhi

/ cinnamon twig

Mu

zei

/ horsetail

Yu mi

xu

/

cornsilk

Huang bai /

phellodendron

Che

qian

zi

/ plantain seeds

Available in tea, granule and tincture forms (UL)

Heavy Metal Detox Formula (UL)

Actions: Neutralizes poisons, facilitates binding, replaces minerals, and stimulates excretion of the heavy metals.Ingredients:Dang gui / angelica sinensisTu fu ling / smilax

Fang

feng

/

ledeboriella

Jin

qian

cao

/

lysimachia

herb

Ji

xue

teng

/

milletia

Mu

zei

/ horsetail

Ban

lan

gen /

isatis

Chi

shi

zhi

/ Halloysite (kaolin)

Shan

yao

/

dioscorea

Gan

cao

/ licorice

Available in tea, granule and tincture forms.

REFERENCES

Stephen Buhner, Natural Treatments for Lyme Coinfections, Anaplasma, Babesia, and Ehrlichia, 2014, Healing Arts Press.James Schaller MD MAR, Kimberly Mountjoy, MS, What You May Not Know About Bartonella, Babesia, Lyme Disease, and Other Tick & Flea-Borne Infections, 2012, International University Infectious Disease Press

http://www.labome.org/research/Granulomatous-hepatitis-associated-with-chronic-Borrelia-burgdorferi-infection-a-case-report.html

Babesiosis presenting as acute liver failure.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803690/

Research Open Access 2014;1:875. Read the full article: 

http://dx.doi.org/10.13070/rs.en.1.875

.

Granulomatous hepatitis due to Bartonella

henselae

infection in an immunocompetent patient. https://

www.ncbi.nlm.nih.gov

/

pmc

/articles/PMC3287964/

Syed Ali Zaidi, Carol Singer; Gastrointestinal and Hepatic Manifestations of Tickborne Diseases in the United States, 

Clinical Infectious Diseases

, Volume 34, Issue 9, 1 May 2002, Pages 1206–1212, 

https://doi.org/10.1086/339871

Treatment of Lead Poisoning and Other Environmental Diseases by Chinese Herbal Medicine.

Subhuti

Dharmananda

, PhD, ITM, June 1993

Huang,

huang

.

10 Key Formula Families.

Eastland Press, 2009.

Yuen, Jeffrey. Personal notes from lectures 2000-2005.