Comparing 苓桂甘枣汤 and 苓桂术甘汤
By mchern • Mar 27th, 2008 • Category: Blood, Heart/Mind, Herbs & Substances苓桂甘枣汤 ：
苓桂甘枣汤 appears in line 65, and is indicated for:
“发汗后，其人脐下悸者，欲作奔豚…”
We can infer that the patient had some kind of immune reaction expressed as an exterior pattern. Somehow after treatment, the patient feels a kind of throbbing below his belly button, and the “running piglet” feeling is about to happen. I believe that 桂枝 and 甘草 are used here to supplement heart yang, because weak heart yang is the cause of his symptoms. 茯苓 and 大枣 are used to calm the patient down, somewhat like tonifiers, but their speciality is in helping sooth the heart-mind. Note that half-jin of 茯苓 is used, 2x the amount used in 苓桂术甘汤.
苓桂术甘汤 ：
苓桂术甘汤 appears in line 67, and is indicated for:
“伤寒若吐、若下后，心下逆满，气上冲胸 ，起则头眩，脉沉紧，发汗则动经，身为振振摇者…”
We notice here a whole barrage of signs. And we see once again how the patient’s exterior signs are dealt with using everything but perspirations. Either he’s made to vomit or to precipitate. And he experiences:
- qi shooting upward from below where his heart is
- signs that he’s deficient in something and this deficiency causes him to
- feel giddy when he rises from a sitting position (low blood pressure, perhaps?)
- have a deep but tight pulse (as if his vessels are trying hard to pulsate whatever blood there is through
- involuntary spasms after perspiring (perhaps potassium loss?)
- unstable gait (once again a sign that he’s feeling really weak
Once again we have 桂枝 and 甘草 as the base formula, The two other are 茯苓 (once again) and 白术. Now we see this herb-pair being used often in clinical practice to boost spleen qi. But we think of it this way, then 大枣 (see above) has a similar role, meaning that the two formulae compared here are not that different in their functions.
But no, remember that 白术 is an herb used to treat dizzyness. I will think of it as a supplement that herbs take away all the symptoms that tell us
- there isn’t healthy blood; and
- the body is trying really hard to get whatever blood there is to the places that need it.
That’s what this formula is for, to help treat “清阳之气不升”.