Jingyue's "Eryin Jian": Nourishes Yin, Descends Fire, and Calms the Spirit

There are several TCM formulas named Eryin Jian (Two-Yin Decoction). This article introduces the "Eryin Jian" recorded in the Ming-dynasty physician Zhang Jingyue's Jingyue Quanshu (Complete Works of Jingyue). It is composed of Shengdi (Rehmanniae Radix Recens), Maidong (Ophiopogonis Radix), and Fuling (Poria), each 3 qian; Suanzaoren (Ziziphi Spinosae Semen) and Huanglian (Coptidis Rhizoma), each 2 qian; Gancao (Glycyrrhizae Radix) 1 qian; and Xuanshen (Scrophulariae Radix) and Mutong (Akebiae Caulis), each 1.5 qian. In modern dosages this is approximately: Shengdi 9 g, Maidong 9 g, Fuling 9 g, Suanzaoren 6 g, Huanglian 6 g, Gancao 3 g, Xuanshen 5 g, Mutong 5 g.

What are the indications of Eryin Jian? According to Zhang Jingyue, Eryin Jian clears the heart and drains fire, and nourishes yin and calms the spirit. It is indicated for heat in the Heart channel, when water fails to control fire, with fright mania and loss of will, much talking and much laughter, and capricious joy and anger; or for sores, boils, rashes, and toxins, with vexing heat and bleeding. So this formula can treat "emotional diseases" (i.e., what are now called mental illnesses), and also sores and rash-toxins (mostly dermatological diseases) and diseases involving vexing heat and bleeding, such as excessive menstruation in women and gingival bleeding.

The Shengdi, Maidong, and Xuanshen in Eryin Jian are the components of Zengye Tang (Fluid-Increasing Decoction); together these three nourish yin and increase fluids. Mutong promotes urination and clears heart heat; Xuanshen, Huanglian, and Gancao clear heat and detoxify. Suanzaoren and Fuling calm the spirit and aid sleep. Used together, they jointly achieve the effects of clearing heat and detoxifying, promoting diuresis and relieving strangury, and calming the spirit and aiding sleep.

This formula actually treats the neurological sequelae appearing in the late stages of certain infectious diseases in modern medicine, and can also be used for depression, bipolar disorder, and schizophrenia whose symptoms resemble this formula's indications. Nowadays this formula is mostly used to treat oral ulcers, acne, pediatric pneumonia, and insomnia; it is especially suitable for use in spring and summer.

Patients suited to Eryin Jian often have short, dark urine; dry or loose stool with a burning sensation at the anus during defecation; an irritable, quick temper; gingival bleeding; epistaxis; excessive menstruation; and insomnia. Some patients also frequently have acne on the face or elsewhere on the body. Western medicine has no suitable drug for this whole series of symptoms, but Eryin Jian can resolve them together.

For patients with severe constipation, Mangxiao (Natrii Sulfas) 10–30 g and Dahuang (Rhei Radix et Rhizoma) 3–15 g can also be added on the basis of this formula to unblock the bowels and drain heat. Usually, after taking Eryin Jian, the urine changes from short and dark to clear and copious, and the burning sensation at the anus disappears during defecation. Generally, once the two bowel movements show these signs, it means the patient's condition is improving, and the manic mental symptoms will also markedly ease. But external signs such as acne may not fully resolve; at this point, remove Mangxiao, Dahuang, Huanglian, and Mutong and continue taking it for a while until the acne is much subdued, then stop. The patient should avoid spicy and greasy food and rest quietly for a period to recover on their own.