TCM Prescriptions with Astringent Effects

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Muli San, Oyster Shell Powder
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Source: Taiping Huimin Hejiju Fang (Benevolent Prescriptions from Taiping Pharmaceutical Bureau).

Ingredients:
No. 1 Huangqi (Radix Astragali seu Hedysari) 30 g;
No. 2 Mahuanggen (Radix Ephedrae) 30 g;
No. 3 Duanmuli (Concha Ostreae) (calcined) 30 g.

Administration:
Grind the above drugs into powder; decoct 9 g with 30 g of Xiaomai (Fructus Tritici Aestivi) each time and twice daily for oral administration after the residue is removed.

Actions:
Replenishing qi and consolidating superficial resistance, preserving yin and arresting sweat.

Clinical Application:
This recipe is indicated for spontaneous perspiration and night sweat, marked by constant perspiration, especially while asleep at night, palpitation, susceptibility to fright, shortness of breath, vexation, lassitude, reddish tongue, thready and feeble pulse. It is applicable to spontaneous perspiration and night sweat due to weakened constitution after illness or operation or delivery, and others, which belong to failure of healthy qi to consolidate superficies. In case of cold limbs after perspiration with aversion to cold and preference for warmth, add Fuzi (Radix Aconiti Praeparatae) to dispel cold.

In case of perspiration with shortness of breath, which gets aggravated with slight exertion, increase the dosage of the first ingredient and add Renshen (Radix Ginseng) and Baizhu (Rhizoma Atractylodis Macrocephalae) to replenish qi and restore body resistance. In case of night sweat with dry mouth, reddened tongue and little fur, add Shanzhuyu (Fructus Corni) and Baishaoyao (Radix Paeoniae Alba) to nourish and preserve yin.
   
Elucidation:
The syndrome is caused by superficial weakness and discharge of yin fluid, leading to impairment of heart-yin and failing to store yang. It should be treated by supplementing qi and consolidating superficies as well as preserving yin and arresting sweat. The last ingredient is used as monarch drug, capable of arresting sweat, preserving yin and suppressing the hyperactive yang. The first ingredient can strengthen body resistance and replenish qi for arresting perspiration, and acts as minister drug. Ingredient No. 2 is specialized in arresting sweating and Xiaomai (Fructus Tritici Aestivi) in invigorating the heart and relieving vexation, both serving as adjuvant drugs.

Yupingfeng San and this recipe both bear the action of consolidating superficies and arresting perspiration in the treatment of polyhidrosis of the weak. But this recipe is very and anhidrotic effect and widely good at its astringent used for spontaneous perspiration or night sweat, which are ascribed to weak body and striae of the skin and muscles being not strong. However, the former is effective in supplementing qi and consolidating the superficies and has dispersing action, thus is fit for spontaneous perspiration due to weakened superficies or for general debility likely to be attacked by pathogenic wind.

Danggui Liuhuang Tang and this recipe are both used in the treatment of night sweat. But the latter has a mild efficacy with astringent and anhidrotic effect and belongs to prescriptions for treating the secondary aspect of a disease. It can be modified to treat spontaneous perspiration or night sweat due to general debility, which are ascribed to weakened superficial resistance or failure of yin-fluid in staying in the interior due to qi deficiency. The former, however, is cold in nature and functions mainly to nourish yin and purge away fire, which belongs to prescriptions for clearing away heat and dealing with the primary cause of a disease. It, thus, is only indicated in hyperactivity of fire due to yin deficiency with manifestations as fever and night sweat. In case of severe night sweat from hyperactivity of fire due to yin deficiency, it is advisable to combine both for application.

Cautions:
Drastic as this recipe is in its astringent and anhidrotic effect, it should be used with great caution for the case of excessive interior heat or that complicated with phlegm-dampness, manifesting dry mouth and  throat, dry yellowish or greasy fur.



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