Huiyang Jiuji Decoction (Yang-Recovering Emergency Decoction)

Huiyang Jiuji Decoction (Yang-Recovering Emergency Decoction) appears in Shanghan Liushu (Six Books on Cold Damage), a proven formula of the Ming physician Tao Hua.

Its composition is: processed aconite root (Zhi Fuzi) 3 qian (9 g), dried ginger (Ganjiang) 2 qian (6 g), ginseng (Renshen) 2 qian (6 g), honey-fried licorice root (Zhigancao) 2 qian (6 g), Atractylodes macrocephala (Baizhu) 3 qian (9 g), cinnamon bark (Rougui) 1 qian (3 g), tangerine peel (Chenpi) 2 qian (6 g), Schisandra fruit (Wuweizi) 1 qian (3 g), Poria (Fuling) 3 qian (9 g), processed Pinellia (Zhi Banxia) 3 qian (9 g). Decoct with one large bowl of water (500 ml) and three slices of ginger. Just before taking, add 0.1 g of musk and dissolve in the decoction. Artificial musk may be substituted. Take twice daily, stopping once the hands and feet become warm; do not overuse.

This formula recovers yang and secures desertion, and boosts qi to engender the pulse. It addresses cold evil directly attacking the three yin, presenting with cold limbs, fatigue and lassitude, listless somnolence, aversion to cold, vomiting and diarrhea with abdominal pain, no dryness of the mouth, even shivering and rigors, or cyanotic nails and lips, or drooling; a pale tongue with white coating and a deep, faint pulse, or even an imperceptible pulse.

These symptoms resemble acute heart failure, or the state after major hemorrhage (over 1000 ml lost); such conditions are now sometimes treated clinically with Shenfu injection, because this ginseng-and-aconite formula has a notable cardiotonic effect.

This is an emergency formula. According to the eighteen incompatibilities and nineteen mutual antagonisms of Chinese herbal pairing, aconite and Pinellia should not be used together. But those very rules are unscientific and have long been criticized by many physicians; in Zhang Zhongjing’s Han dynasty formulas, Pinellia is used together with aconite and Aconitum without adverse effects. So in an emergency there is little impropriety in using it.

This formula must not be prolonged, because warming and hot herbs—aconite, dried ginger, ginseng, cinnamon—used too long can easily damage the fluids, becoming a new problem. Clinical use must judge the measure carefully.