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DONG QUAI FOUR: Four Ingredient Formula
by Li Guang-zhen, from “The Treatment of 42 Cases of Allergic Rhinitis with Si Wu Tang Jia Wei (Four Materials Decoction with Added Flavors)” Jilin Traditional Chinese Medicine & Medicinals (Ji Lin Zhong Yi Yao), #3, 1993


Since 1985, the author has treated 42 cases of allergic rhinitis with Si Wu Tang Jia Wei. Of these 42 cases 29 were men and 13 were women. They ranged in age from a young of 19 to an old of 62 years of age. The shortest course of disease was 4 months and the longest was 10 years. Runny nose, itchy nose, and sneezing were the main symptoms. Examination revealed that the nasal mucosa were either an ashen white or purplish sooty color, the nasal shell was edematous, and the nasal cavity was producing a flowing secretion. Examination of the nasal secretions were positive for eosinophilia.

The medicinals consisted of: raw Radix Rehmanniae Glutinosae (Sheng Di), 24g, Radix Angelicae Sinensis (Dang Gui) and Radix Rubrus Paeoniae Lactiflorae (Chi Shao), 15g @, Rhizoma Ligustici Wallichii (Chuan Xiong), 6g, Fructus Xanthii (Cang Er Zi) and Flos Magnoliae (Xin Yi), 9g, and Herba Pycnostelmae (Xu Chang Jing), 30g. If there was headache, Radix Angelicae (Bai Zhi) and Flos Chrysanthemi Morifolii (Ju Hua) were added. If there was a cold (gan mao), these medicinals were combined with Yu Ping Feng San (Jade Windscreen Powder). One ji was decocted per day with 15 days equalling 1 course of treatment. Two to 4 courses of treatment were given with a follow-up survey conducted 1 year after treatment.

Twenty-three patients were completely cured. This meant that their symptoms disappeared, their nasal mucosa and secretions returned to normal, and their nasal secretions tested negative for eosinophils. Thirteen cases got fair improvement. This meant that their symptoms were obviously reduced or partially disappeared. The number of attacks or the duration of attacks was also reduced, and their nasal secretions mostly tested negative for eosinophils. 6 patients achieved no result from this treatment. This meant that there was no apparent change in their condition from before the treatment was begun. Therefore, the total amelioration rate was 85.7%.

According to tcm theory, the main disease mechanism of this disease is yin and blood insufficiency. In that case, constructive and defensive are empty and sparse and the exterior defensive fails to secure. This then allows for external invasion of wind cold, and this results in the portal of the lungs (i.e., the nose) losing its disinhibition. Four Ingredient Decoction (Si Wu Tang) enriches yin and nourishes blood, moves the qi and harmonizes the constructive, thus supporting the righteous. As the saying goes, “When the blood is harmonious (or harmonized), wind is automatical­ly extinguished.” Xanthium, Flos Magnoliae, and Pynostelma diffuse the lungs, open the portals, and, therefore, dispel evils. When evils are dispelled, the righteous is at ease. With the righteous returned and evils removed, the disease obtains a cure.

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