The Multiple Actions of Jiaotai Pill
Jiaotai Pill comes from the Han Shi Yi Tong by the Ming physician Han Mao. It consists of raw Chuanhuanglian (Coptis) 1 liang (30 g) and Rouguixin (Cinnamon heart) 1 qian (3 g). Preparation: grind the two into a fine powder and make pills with white honey. Take 5-8 fen (1.5-2.4 g) each time. According to TCM theory, this formula governs insomnia and severe palpitation due to non-intercourse of heart and kidney and hyperactivity of heart fire.
TCM holds that Huanglian clears heart fire and that Rougui guides fire back to its origin. If the patient has hyperactive heart fire and the thunder-dragon fire cannot descend to the kidney, the pattern of heart-kidney non-intercourse appears. Such patients show irritability, insomnia and severe palpitation. To treat them, the upwardly hyperactive heart fire must be guided back to the kidney and mingmen to transform into original yang, so that heart and kidney can interact. This formula follows the "excess harms, control restrains" idea of the Huangdi Neijing.
Jiaotai Pill can be used for senile insomnia, cardiac neurosis and menopausal syndrome, and reports also show it can treat impotence.
Animal experiments show that Jiaotai Pill, composed of Huanglian and Rougui in a 2:1 ratio, has a good sedative-hypnotic effect, inhibits spontaneous activity in mice, and synergizes the hypnotic action of sodium pentobarbital, stronger than the 1:1 Huanglian-Rougui combination. But another report shows that the 10:1 ratio of the original formula has a better sedative and sleep-promoting effect.
Why can Jiaotai Pill treat insomnia? This may be related to its action on gastrointestinal disease. TCM says when the stomach is not harmonized, sleep is restless; people with poor digestion sleep poorly. Berberine hydrochloride tablets (berberine) used today for gastrointestinal disease have their active ingredient extracted from Coptis. Coptis is overly bitter-cold; adding appropriate Cinnamon reduces its bitter-cold nature, so Jiaotai Pill uses Cinnamon to assist Coptis. Jiaotai Pill combined with Gan Mai Dazao Decoction treats insomnia better. If the patient has marked yin deficiency, it may also be combined with Erzhi Pill.
But the actions of Huanglian and Rougui go far beyond treating gastrointestinal disease. Huanglian clears heat and dries dampness, drains fire and resolves toxin; it treats welling-abscesses and sores, throat swelling pain, and mouth and tongue ulcers due to fire toxin attacking upward, as well as high fever, irritability, clouded spirit and delirium in warm diseases. Since Huanglian drains fire and eliminates vexation, it is no surprise that it relieves menopausal syndrome.
There are reports that treating menopausal syndrome with Jiaotai Pill (Coptis:Cinnamon = 2:1) as a base gives good results. If the patient is agitated and uneasy, add Zhizi, Huangqin and Gancao; for dry mouth add Tianhuafen, Maidong, Wuweizi and Zhimu; for severe insomnia add Yejiaoteng, Baihe, Hehuanhua and Danshen; for liver constraint and qi stagnation add Yujin and Xiangfu; for hot flashes and sweating add Fuxiaomai and Mudanpi. Treating by this approach relieves most clinical symptoms of menopausal syndrome.
Jiaotai Pill can also treat cardiac neurosis, which causes palpitations, shortness of breath, fatigue and chest pain. Combine Huanglian and Rougui in a 2:1 ratio, grind to powder, mix with water into a paste, and apply to the navel. Change the dressing every 24 hours; one week is a course. Treat for one week, rest three days, then continue the next course. In 30 cases of cardiac neurosis, 25 were cured and 4 improved, for a total effective rate of 96.7%.