Nuan Gan Jian [Warm the Liver Decoction] 煖肝煎 /[Clinical application and cases]

 

Nuan Gan Jian [Warm the Liver Decoction] 煖肝煎 

Jing Yue Quan Shu

Xiao Hui Xiang 6 g

Rou Gui 6 g

Wu Yao 6 g

Chen Xiang (or Mu Xiang) 3 g

Fu Ling 9 g

Dang Gui 9 g

Gou Qi Zi 12 g

Sheng Jiang 9 g

 

1)     Cold stagnation in Liver and Kidney. Symptoms include lower abdominal pain, hernia.

2)     For severe cold, add wu zhu yu, gan jiang, fu zi

3)     If pricking pain is severe, add quan chong(全蟲)

[Clinical application]

# Mounting (hernia) is considered to exist when the ears are attached lower, the size of the nostrils differs, or if one eye is larger than the other.

 

# Pan Cong San (蟠蔥散) is generally used for people who are thin, skinny, and look picky, while Nuan Gan Jian (煖肝煎) is used for people who are fat and have deficiently cold liver and kidney.

 

# When Qi type person has cold mounting (寒疝症), use Pancake Onion Powder. cold and heat are critical to the body. Abdominal coldness indicates cold uterus. So it becomes the cause of no child

 

# When experiencing lower abdominal pain or discomfort after abdominal surgery (such as appendectomy), Nuan Gan Jian is used to alleviate the symptoms.

 

 

# Nuan Gan Jian (煖肝煎) is a medication primarily used for men to warm the lower reproductive organs.

 

# The heart and liver are the regulary organs of the human body. If there is damp heat, dark macula appear in the armpits with itching, moisture develops in the armpits, and

# Moisture develops, leading to dampness and humidity in the yin region, and in this instance, use nuan gan jian to eliminate heat dampness. It is a medication that warms the liver to eliminate damp heat. (jjisan)

 

# There are two ways to dispel damp heat: by pushing it outward or by increasing fire force with fomulas such as Ba Wei Wan (八味丸). In the presence of damp heat, exposure to sunlight immediately disperses it. in the condition of damp heat, worms tend to develop. When worm encounters sunlight, it perishes. Opening windows and using fans to prevent the accumualation of dampness. Turning on a fan can be likened to nuan gan jian which make damp heat not to occur. This principle also applies to utilizing "Lóng Dan Xiè Gān Tāng" when experiencing itchiness in the yin region due to damp heat. (jisan)

 

# Even if deviated eyes and mouth is caused by a bad reproductive organ, use nuan gan jian 煖肝煎.

 

# The difference between 八味丸 (Bā Wèi Wán) and 煖肝煎 (Nuǎn Gān Jiān) :

During the summer rainy season, when there is dmap heat and worms form, exposure to sunlight kills the worms. Showing sunlight is likened to give ba wei wan. Heating a room up is similar to the action of ba wei wan. Opening the window and turning on the fan to prevent the accumulation damp heat is likened to give nuan gan jian. The idea is to change the environment so that damp heat does not form. This is also the case when using Long Dan Xie Gan Tang when damp heat in the liver and gall bladder causes itching in the yin region.

[Clinical cases]

1) A 31-year-old man has inverted triangle face (天垂象) -those who have inverted triangle face tend to be weak in the lower buner- and thin. He has a darkened complexion and red lips. His generalized body pain bring him here. He has mounting sign, and his right wrist pulse is exuberant. He experiences back pain, tightness in the lower abdomen, and has phlegm in his throat. His soles of the feet feel hot, and he coughs in the morning and evening. He has no appetite.

 

[jisan's commentary] 

With the above symptoms, you can also use Ziyin Jianghuo Tang 滋陰降火湯. However, it is necessary to first treat the hernia (mounting sign), because it is the root of the disease. Food accumulation is also considered a hernia 疝症. The food accumulation itself resembles the symptoms of JZiyin Jianghuo Tang 滋陰降火湯, as the face is dark and the soles of the feet are hot, so you might think of using Liu Wei Di Huang Tang, but in fact, people with dark faces are strong in external qi and weak in internal injury. People with dark faces should be considered to have a bad large intestine. The large intestine has a suction effect 吸引作用. When diarrhea occur, if medicine for the liver is used, that is, Nuanganjian is used, the feces harden. If the feces must harden, the genital organs rise. The feces must harden to emit Yang energy. Nuanganjian can also soften hard feces.

 

2) A 65-year-old man presents with a drooping nose and uneven nostrils. He has been on medication for low blood pressure for the past two years, experiencing dizziness and lightheadedness when his blood pressure drops. he has insomnia and unbalanced scrotum.

 

[jisan's commentary] 

Taking a medicine due to low blood pressure should be seen as a cooling mechanism. Just as fish swimming in cold water have warm bodies, and fish swimming in warm water have cool bodies, when a fish living in warm water becomes too hot, it's considered to be suffering from wind disease (blood pressure disease). Observing the 小續命湯 xiao xu ming tang, for cold constitution, fuzi is added, and for heat constitution, shi gao is added. This is crucial for regulating wind strike. This patient requires sunlight because their body is cold, as his reproductive organ is not good. Poor functioning of the reproductive organ manifests diseased eight extraordinary vessels, in other words, this is controlling vessel disease. Scrotum governs the regulation of cold and heat, yet this balance is disrupted. Consequently, scrotum appears unevenly, and the nose becomes crooked due to imbalances of water and fire.

The reason for insomnia is due to inability to keep yin blood. In other words, one cannot sleep because yin cannot return to the house of blood at night, and blood remains in the head. this is due to blood amassment. This is indicative of liver dysfunction. Therefore, Nuan Gan Jian is is recommended.

 

3) A 38-year-old man physically withrooping ears and widened sides of his face. He suffers from pain radiating from his lower abdomen to his side and lower back. His right testicle is enlarged, and he feels lacking in yang qi (impotence). He experiences tingling sensations in his lower abdomen and frequently sees his uncle, with little improvement.

 

[jisan's commentary]  

Your stomach may feel nauseous due to food accumulation with phlegm. When the kidneys [ears] are attached lower, you may experience pain in your back and buttocks, and you may be prone to contract foxy mounting. Imbalance in the ears can also cause pain. "Foxy mounting" is originally treated with Er Chen Tang Jia Wei Fang 二陳湯加味方. Here, damp heat is in the liver, Nuan Gan Jian is appropriate.