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Tong Ren Tang Products And Skin Disorders
(Fangfeng Tongsheng Pills and Skin-detoxing Pills)
By Dr. Greta Young Jie De (Ph.D)
Dermatology and treatment of skin disorders have been a recognized specialty in traditional Chinese medicine. Traditional Chinese medicine treatments for skin disorders have been in use since 1100 to 221 B.C. in China. Acupuncture and Chinese herbal therapy are the most common TCM methods used to treat skin conditions and can provide longer-lasting relief than Western method read more…
In 2008 and 2012, Pearls of Wisdom invited two skin specialists from Dongzhimen Hospital and Beijing Chinese medicine Hospital from Beijing to visit Australia and presented two very interesting and informative seminars on the TCM approach for treatment of some prevalent skin disorders such as urticaria, chloasma, acne, eczema and psoriasis.
Skin problems arise from a number of causes, the most common of which are infections, overexposure to sunlight, parasites, toxic substances, hormonal imbalance, cell dysfunction, and stress. It is standard procedure in traditional Chinese medicine to assess the patient’s symptoms to determine the “pattern” with subsequent diagnosis of heat, cold, excess or deficiency etc. In Chinese medicine, external pathological factors such as Wind, Dampness, Dryness, or Heat or toxin can invade the body and cause skin disorders. Internal imbalances are differentiated into patterns such as Blood Stasis, Disharmony of Liver and Kidney, or Blood Deficiency, and are often reflected on the skin. When skin problems are generated by internal imbalance, the underlying problem must be addressed in order to clear up the surface manifestation.
Over the years, Chinese herbal medicine has built up a sophisticated system for treating skin disorders, using both external and internal administration and there are hundreds of herbal formulas available for skin conditions such as herpes, eczema, and psoriasis. In this article, Pearls would like to feature two of Tong Ren Tang’s herbal products designed to specifically address skin disorders.
Key Treatment Strategies for Management of Many Common Skin Disorders:
Dispelling wind strategy:
- Nourishing blood and dispelling wind: This is indicated for blood deficiency with subsequent engendering of wind, it is indicated for the remission phase of psoriasis characterised by dry scaly skin. Recommended herbs are Yu Zhu, Shou Wu, Dang Gui, Bai Shao, Qin Jiao etc.
- Releasing exterior and dispelling wind: This is indicated for an acute external contraction of wind pathogen manifested skin condition such as acute urticaria or acute dermatitis. Herbs used are Jing Jie, Fang Feng, Dang Gui, Ku Shen, Cang Zhu, Niu Bang Zi, Zhi Mu, Sheng Di, Shi Gao, Chen Tui etc.
Dispersing Cold Strategy:
This is a strategy involving the warming of channel and dissipating cold indicated for external contraction of cold pathogen with ensuing obstruction of collaterals and network vessels such as frostbite. Herbs used are Dang Gui, Bai Shao, Xi Xin, Zhi Gan Cao.
- Clear heat and eliminating dampness strategy indicated for contraction of damp pathogen with subsequent damp transformation to heat such as acute eczema, contact dermatitis etc. Herbs used are Yi Ren, Bi Xie, Fu Ling, Dan Pi, Lian Qiao, Tian Hua Fen, Hua Shi, Yin Hua, Chi Shao, Ze Xie, Gan Cao.
- Tonify the spleen and disinhibit dampness: This strategy is indicated to treat spleen deficiency with impaired transportation movement with ensuing damp stagnation such as chronicerticaria. Herbs used are Dang Shen, Fu Ling, Ze Xie, Bai Zhu, Bian Dou, Yi Ren, Shan Yao, Chen Pi, Jie Geng.
Clear Heat and Relieve Toxicity:
This is indicated for heat and toxin congestion with qi and blood congelation characterised by sensation of subjective skin heat, flushed face with suppuration accompanied by fever, aversion to cold, thirst, dark urination, constipation etc. Herbs used are Huang LIan, Huang Qin, Huang Bai, Zhi Zi, Yin Hua, Pu Gong Ying, Di Ding, Ju Hua, Zao Xiu etc
Elimination of Stasis:
- Cooling blood and Dispelling stasis:
This is a pattern of blood heat congestion with stagnation of blood stasis characterised by macules, nodules such as telangiectasia, erythema, tissue hypertrophy of the skin etc. Herbs used are Sheng Di, Dang Gui, Chi Shao, Huang Qin, Fu Ling, Hong Hua, Chuan Xiong, Gan Cao.
- Invigorating blood and Dispelling Stasis:
This is indicated for impeded qi and blood movement with manifestation of stasis stagnation such as Erythema nodosum and panniculitis etc. Herbs used are Huang Qi, Chi Shao, Tao Ren, Hong Hua, Dang Gui, Chuan Xiong.
Fangfeng Tongsheng Pills (AUST L 156180)
Fang Feng Tong Sheng San is a classic formula first created by the Jin Yuan specialist Liu Wan Su (1110~1200 AD) indicated for exuberant pathogenic wind- heat with interior constrained heat characterized by dizziness, chest oppression, generalised skin itch, bitter taste in the mouth, scant and dark urination and constipation. This formula can also be used to treat acne and eczema with severe skin itch.
Ingredients: Dang Gui, Bai Zhu, Shi Gao, LIan Qiao, Zhi Zi, Gan Cao, Chuan Xiong, Bo He, Bai Shao Zi Su Ye, Jie Geng, Da Huang, Jing Jie Sui, Huang Qin, Fang Feng, Mang Xiao.
Professor Huang Huang of Nanjing University frequently uses a modified version of Fang Feng Tong Sheng San to treat many skin disorders.
Fang Feng Tong Sheng San modified: (Professor Huang Huang)
Fang Feng Tong Sheng San omit Dang Gui, Chuan Xiong, Bai Shao, Mang Xiao, Zhi Zi, Huang Qin, Bai Zhu add Xing Ren. Ma Huang disperses wind and releases exterior; Jing Jie and Fang Feng dispel wind and stop skin itch; Da Huang purges heat and moves the bowel; Shi Gao and Lian Qiao clear heat, drain fire and relieve toxicity; Bo He disperses wind–heat while Xing Ren and Jie Geng expel pus and relieve toxicity. The modified Fang Feng Tong Sheng San releases exterior; frees the interior constraint; dissipates wind and stops the itch coupled with heat clearing and relieving toxicity.
Case Study of Huang Huang:
Zhang xx, 53 year-old female
First consultation: 26th March 2012
The patient complained of facial itch for four years with red facial lesion, the facial skin was parched and scaling characterized by skin itch. Her condition was relieved when topical herbal ointment was applied. The patient was robust and strong, her urination was dark and her menstruation was normal.
Prescription: Sheng Ma Huang 10g ) ; Sheng Shi Gao 30g; Sheng Gan Cao 5g; Jing Jie 15g; Zhi Da Huang 10g; Jie Geng 10g; Lian Qiao 30gh; Bo He 10g. One pack per day.
Second Consultation: 31st March 2012
After three packs of medication, the facial pain was reduced , her urination was still dark but there was no scorching sensation when urinating, her lips were parched and she still suffered from skin itch. Increase the dosage of Jing Jie and Fang Feng to 20g.
Third consultation: 10th April 2012
Her facial swelling and redness were substantially reduced. Continued with the prescription for another 15 packs with five days of medication and two days of rest.
Fourth consultation: 15th May 2012
Most of her symptoms were gone. Stick with the original prescription for another two weeks to consolidate.
Ma Huang is a banned herb in Australia and can be substituted with Jing Jie.
(Ref: Shanghai Zhong Yi Yao Za Zhi 2013 March edition)
Direction for Fangfeng Tongsheng Pills:
Take 1 sachet (6g) each time, 2 times daily.
Cautions and Contraindications:
- Drink plenty of water
- Prolonged use may cause serious bowel problems.
- This product may have a laxative effect.
- If symptoms persist, consult your healthcare practitioner.
Skin-Detoxing Pills (AUST L 124896)
Skin-Detoxing Pills are designed to treat many prevalent skin disorders such as eczema, rash, pruritis, hives attributed to interior heat toxin and blood heat.
Ingredients: Qian Cao, Tao Ren, Jing Jie, Hong Hua, Chi Shao, Dang Gui, Bai Mao Gen, Di Fu Zi, Cang Er Zi, Di Huang, Lian Qiao, Jin Yin Hua, Ku Di Ding, Tu Fu Ling, Huang Bai, Zao Jia Ci, Jie Geng, Yi Mu Cao, Ku Xing Ren, Fang Feng, Chi Fu Ling, Bai Shao, Fu Ping, Niu Bang Zi, Mu Dan Pi, Bai Xian Pi, Ji Xue Teng, Da Huang, Ren Dong Teng, Zi Cao, Zhe Bei Mu, Chuan Xiong, Gan Cao, Bai Zhi.
Clear blood heat, relieve toxicity, reduce swelling and stop itch. This formula is particularly effective in addressing disharmony of the collaterals coupled with damp-heat and blood dryness which manifests as urticaria, eczema characterized by severe pain and itch.
There is an ancient saying that “Disorder of the skin with the root cause being blood toxin”. From the Chinese medicine perspective blood toxin is referring to the pathogen in the blood which is the key pathogenesis of many skin diseases. The aetiology and pathogenesis of skin diseases can be complex but can be classified as external and internal factors. The external factor is due to the contraction of wind-pathogen entering the body via the respiratory system while the internal factor is due to emotional stress, improper diet or damage to the liver and kidney. In accordance with the traditional Chinese medicine theory, the root cause can be ascribed to people endowed with constitutionally more yang heat and constrained lung heat coupled with contraction of wind pathogen manifests as facial rash; or excessive intake of spicy and rich food inducing damp with transformation to heat; or insufficiency of spleen qi with impaired transportation movement and subsequent engendering of damp turbidity and possible transformation to heat.
After years of research, Tong Ren Tang has produced a special formula called Skin-Detoxing Pills which incorporates the major treatment strategies for addressing the root cause of many common skin diseases. It is particularly effective in clearing blood heat, relieving toxin, reducing swelling and arresting severe skin itch. Dang Gui , Chi Shao; Qian Cao, Zi Cao, Bai Mao Gen and Hong Hua invigorate and cool blood to effectively reducing blood stasis. This may be combined with Lian Qiao, Jin Yin Hua, Ku Di Ding to clear heat and relieve toxicity. Wind herbs such as Jing Jie, Fang Feng and Niu Bang Zi are incorporated to expel pathogenic wind and eliminate dampness.
The objective of Skin-Detoxing Pills is based on the root cause of eczema ie, to clear heat, eliminate dampness and itch supplemented by toxin relieving and venting the pathogen to facilitate the reabsorption of dampness and elimination of heat toxin.
Direction for Skin-Detoxing Pills:
20 pills each time, 2 times daily.
- Not suitable for pregnant woman or patients with flu.
- If symptoms persist, consult your healthcare practitioners.
Fangfeng Tongsheng Pills is designed to disperse wind and release exterior. Jing Jie and Bo He dissipate wind and release exterior while Da Huang and Mang Xiao purge heat and move the bowel in the hope that the interior heat can be expelled via the bowel movement. This is supplemented with Hua Shi and Zhi Zi to clear heat and disinhibit urination so as to induce the heat to exit via urination.
Skin Detoxing Pills as the name implied is focused on heat clearing, blood cooling and relieving toxicity and is an effective formula to relieve severe skin itch. If the skin disorder presented with exterior wind and interior heat with blood heat and toxin, then the two formulas can be combined to enhance the therapeutic outcome.
The above information has not been assessed or approved by the TGA, and it is designed for TCM practitioners’ education and training purpose only. Public consumers are recommended to seek TCM diagnosis and consultation before using the products.
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