Sān Rén Tāng

Three-nut Decoction

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Category: Dispel Damp Heat ⌕ 
Source: Wen Bing Tiao Bian  
Actions: Disseminates the qi, facilitates the qi mechanisms, and clears damp-heat [Song]
Diagnosis
Tongue: greasy, white coating      Pulse: wiry, thin, soggy    Other:pale yellow face 
Patterns: Damp Heat 
Indications: Early-stage Damp-Warmth disease affecting Wei/Qi levels (Damp > Heat) [35] • Damp> Heat; No thirst, aversion to cold, headache, body pain and heaviness, afternoon fever, white tongue coating, no thirst; Damp obstructs defensive yang: headache, aversion to cold, body heaviness pain, lassitude; Damp blocks qi movement: chest oppressed; Damp-heat steaming: afternoon fever, yellow complexion; T: white tongue coating ; P: wiry thin [31]• Early stage damp warmth affecting the Qi. Headache, aversion to cold, heaviness and body ache, poor appetite, no thirst, afternoon heat sensation, ptitis media, pneumonia, arthritis, hepatitis, cholecystitis, gastroenteritis, restless legs, lymphadenitis, obesity with dizziness. T: pale. P: wiry, fine, soggy. Pale yellow face[22]
Contraindications: yellow greasy tongue where Heat>Damp
Description
Name Variations:San Ren Tang , 三仁汤, Three-nut Decoction,
Herb List: Xing Ren(K, 12g) • Bai Dou Kou(K, 6g) • Yi Yi Ren(K, 18g) • Hua Shi(M, 18g) • Tong Cao(M, 6g) • Dan Zhu Ye(M, 6g) • Ban Xia(A, 10g) • Hou Po(A, 6g) [22]
Commentary: Dampness is still more than heat. Dampness is obstructing defensive yang, blocks Qi. Afternoon fever is more of dampness and heat symptom. Dampness is wrapped around the heat and won't let it loose. Xing Ren disperse upper jiao, Bai Kou Ren dispel dampness from middle jiao, Yi Yi Ren drains dampness from lower jiao by promoting urination. Hua Shi drains damp heat. Tong Cao drains damp heat and promote urination. Dan Zhu Ye promote urination and drain heat. Use Huang Qi Hua Shi Tang is where damp=heat. San Ren Tang focuses on dampness, and mildly clears heat.[31]
Related Formulas: Attachment: Huo Po Xia Ling Tang [ San Ren Tang (Xing Ren, Bai Kou Ren, Yi Yi Ren, Tong Cao, Ban Xia, Hou Po) + Huo Xiang + Chi Fu Ling + Bai Dou Kou + Zhu Ling + Dan Dou Chi + Ze Xie] - release exterior and resolve dampness
NCCAOM: Damp Heat symptoms include afternoon fever, body hot to touch, aversion to cold, feels heavy, sticky taste, thirst with no desire to drink. NCCAOM has 4 formulas for Damp Heat. They are Sān Rén Tāng, Yīn Chén Hāo Tāng, Bā Zhēn Tāng, and Èr Miào Sǎn. • San Ren Tang - Early-stage Damp-Warmth disease affecting Wei/Qi levels (Damp > Heat). Has afternoon fever, aversion to cold, body aches, heaviness, no thirst. White tongue coat since pathogen is still in the exterior. Wiry, thin pulse. • Yin Chen Hao Tang - Jaundice due to LV/GB Damp-Heat. Heat > Dampness. Hepatitis A. No weating except at the head. This is the basic formula for Yang type jaundice. Yin Chen Si Ni Tang is for Yin Type jaundice. Herbs: Yin Chen Hao, Zhi Zi, Da Huang. Red tongue yellow coat, rapid pulse. • Ba Zheng San - Damp-Heat clumping in the Lower Jiao. Classic formula for UTIs. For acute damp heat Lin syndrome while Zhu Ling Tang is for chronic Lin syndrome like nephritis. Yellow greasy coat, slippery rapid pulse. • Er Miao San - Damp-Heat lodging in Lower Jiao with swollen painful knees and feet, damp heat leucorrhea, damp sores in lower limbs, heavy sensation, no thirst. Yellow greasy coat. Slippery soggy pulse. Herbs: Huang Bai, Cang Zhu. Comparison: San Ren Tang is when the damp heat is still in the exterior. The remaining 3 are interior. Yin Chen Hao is for LV/GB, Ba Zhen San is for UTI, Er Miao San is for lower body damp heat (bones and sinew pain, rheumatoid arthritis, leucorrhea, damp sores, concentrated urine, etc.
Herbs Cat/Dosage Actions Attributes
Xing RenApricot Seeds • 杏仁  Phlegm Cough + Wheezing Stops cough • Calm wheezing • Moisten intestines • Unblock bowel Used to treat cancer hypotensive, antitussive, antiasthmatic, antineoplastic, bowel lubricant [18]
Bai Dou KouRound Cardamon Fruit • 白⾖蔻  Aromatic Transform Damp Move Qi, transform dampness and strengthen Stomach, warm Middle Jiao, descends Qi and stops vomiting[3] • Awakens Spleen, clear turbidity[42]
Yi Yi RenCoix Seeds • 薏苡仁  Drain Dampness Strengthen Spleen • Clear Damp Heat at any level • Promote urination • Clear abscess in Lung and Large Intestine • clear Wind Damp Bi for bones and sinews
Hua ShiTalcum • 滑石 Drain Dampness Clear heat • Drain dampness • Clear summer heat diuretic • antipyretic
Tong CaoRice Paper Herb • 通草 Drain Dampness Dry dampness • Promote urination • Increase lactation Diuretic
Dan Zhu YeLophatherum Stem Leaves • 淡竹叶 Clear Heat Drain Fire Clear damp heat • Drain fire• Promote urination • Reduce irritability • Clear heart or stomach heat • Reduce mouth ulcers
Ban XiaPinellia Root • 半夏 Phlegm Cold Transforms damp-phlegm • Direct stomach Qi downward• Stop cough/ wheezing • Relieve nausea & vomiting • Dissolve nodules and swellings reprotoxic, warming, drying, antitussive, antiemetic
Hou Po • Magnolia Bark • 厚朴 Aromatic Transform Damp Transform spleen dampness • Transform stomach dampness • Clear food stagnation • Transform Phlegm • Clear Qi stagnation moving downwardPairs with Cang Zhu GABA-ergic • Sedative • Cannabimimetic • Antioxidant • Anticoagulant • Antidepressant • Anti-inflammatory • Antibiotic • Antispasmodic • Antitumor • Antimicrobial
King/Chief    ♥ Minister/Deputy      Assistant     ♦ Envoy
Directions: 
Modifications For
+ Huo Xiang + Xiang Ru Severe exterior syndrome 31
+ Qing Hao + Cao Guo With alternating fevers and chills 31

Caution

ALERT: Contraindications of each herb - use with caution under these conditions:
Xing Ren: Pregnancy • Infants • Diarrhea • Yin deficiency cough
Bai Dou Kou: Yin or blood deficiency
Yi Yi Ren: None noted
Hua Shi: Spleen deficiency, polyuria, weak body fluid, spermatorrhea [18]
Tong Cao: Pregnancy
Dan Zhu Ye: Cold and deficiency of Spleen and Stomach
Ban Xia: Yin deficiency cough • Bleeding • Dehydration • Heat • Pregnancy • Incompatible with Wu Tou and Fu Zi • Antidepressant drugs • Blood pressure medication • Terfenadine (antihistamine) • Foods: lamb, goat
Hou Po: Anticoagulant drugs • Antidepressant drugs

Notes

 

Bibliography: [3], [8], [9], [14]

Information in this post came from many sources, including class notes, practitioners, websites, webinars, books, magazines, and editor's personal experience.  While the original source often came from historical Chinese texts,  variations may result from the numerous English translations.   Always consult a doctor prior to using these drugs.  The information here is strictly for educational purposes. 

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