Book Review: Dui Yao: The Art of Combining Chinese Medicinals

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Dui Yao: The Art of Combining Chinese Medicinals by Philippe

Sionneau, translated by Bernard Cote. (The translation is from French

into English.)

 

As the editor's preface points out, this book is " an intermediary

step " between the single healing substances listed in a TCM Materia

Medica and a book of Formulas and Strategies. (p. v.) It's a list

(partial) of pairs of herbs that work particularly well together.

When a formula needs to be modified, a pair of herbs frequently is

added to the formula. " This allows such modifications to be more

powerful and more precise. " (Bob Flaws, editor's preface, p. v.)

Studying these pairs also can better enable healers to come up

with " new formulas from scratch " . (p. v.) Which is what TCM

herbalists have been doing for centuries. Sionneau mentions some of

the classical formulas that some of the pairs are found in.

 

Sionneau has managed to write a book which contains both a lot of

facts and an understanding of why things work as they do in TCM

herbalism. There are a lot of insights to be gained from the book.

For example, two of the pairs that treat Blood Deficiency: Dang Gui

(Radix Angelicae Sinensis) & Huang Qi (Radix Astragali), and Dang Gui

& Shu Di (Cooked Radix Rehmanniae).

 

Each pair in the book starts out with a table which compares and

contrasts their " individual properties " . For example, Dang

Gui " nourishes the blood " , and Huang Qi " fortifies the spleen &

middle burner " . Dang Gui " quickens the blood " (it has some properties

for treating Blood Stasis), and Huang Qi " supplements the qi to

engender and transform the blood and to control the blood " . Etc. (p.

63.)

 

The table of Individual Properties is followed by a " Properties when

combined " section. In this case, " One is for the blood; the other is

for the qi. When these two medicinals are combined together, they

supplement the qi to strongly engender and transform the blood.

Therefore, they effectively supplement the qi and blood. " (p. 63.)

 

Why would an herbalist choose both a Blood tonic herb and a Qi tonic

herb? The simpliest answer is when there is both Blood Deficiency and

Qi Deficiency, this pair of herbs works especially well together.

However, Sionneau's presentation of the material gives insights into

why. Throughout the section he mentions the relationship between the

Blood and the Qi. The fact that the Spleen plays a critical role in

the production of both Qi and Blood, and Huang Qi " Fortifies the

spleen & middle burner " is only part of it.

 

Sionneau demonstrates both insight and careful attention to

detail: " Even if this pair treats blood vacuity " (aka Deficiency,

aka Emptiness), " one should use a relatively light dosage of Dang

Gui. Why? Because here blood vacuity is due to qi vacuity and

weakness of he middle burner. Medicinals that nourish the blood,

such as Dang Gui, tend to be rich, slimy, and difficult to assimilate

in cases of spleen weakness. Therefore, a small dosage of Dang Gui

is used to avoid damaging the spleen and causing further weakness, qi

stagnation, and dampness engenderment which would lead to even worse

production of blood. Furthermore, since the origin of blood vacuity

is qi vacuity, the therapeutic strategy has to be first of all to

supplement the qi and then the blood. " (p. 63.)

 

Each herbal pair also has a " Major indications of the combination "

section. In this example the first 3 (out of 5) are 1. " delayed

menstruation " , 2. " low grade fever caused by " blood vacuity " , and

3. " sores and welling abscesses which do not heal due to qi and blood

vacuity " . Following this section is a Notes section which lists the

classical formulas in which the pair is found. When the problem is

delayed menstruation, " this combination is used in Shi Quan Da Bu

Tang (Ten [ingredients] Wholly & Greatly Supplementing Decoction) " .

(p. 63.) When " low-grade fever caused by blood vacuity " is the

problem, " this combination is used in Dang Gui Bu Xue Tang (Dang Gui

Supplement the Blood Decoction) " . The pair is in " Tou Nong San (Out-

thrust Pus Powder) " for " sores and welling abscesses which do not

heal due to qi and blood deficiency. " (p. 63.)

 

Now let's look at another pair which contains Dang Gui and Shu Di

(Cooked Radix Rehmanniae). In the Individual properties table for Shu

Di, " Nourishes the blood, yin, and essence; Enriches the kidneys and

nourishes the liver; Fixed by nature; Promotes the qi intake function

of the kidneys and calms asthma. " (p. 64)

 

" When these two medicinals are combined together, they nourish the

blood and enrich yin, supplement the liver and kidneys. Together,

they downbear the lung qi and promote the qi intake by the kidneys,

stop cough and calm asthma. " (p. 64.) The simpliest explanation is

that this is a pair for when joint Blood Deficiency and Yin

Deficiency is a primary problem. Sionneau's text gives more insight

into why.

 

In TCM physiology, the Lungs send Qi downward to the Kidneys. When

the Kidneys fail to hold onto this Qi, this is called " Kidneys

Refusing to Receive Qi " . It's a subset of Kidney Yang Deficiency.

Cooked rehmannia has the property of " Promotes the qi intake function

of the kidneys and calms asthma. " (p. 64.) However, the Kidneys

failing to grasp the Qi isn't the only thing that can go wrong in

this relationship between the Lungs and the Kidneys. Lung Qi

can " rebel " (flow upward instead of downward like it's supposed to

flow). There are several formulas which address this problem.

Sionneau mentions " Su Zi Jiang Qi Tang (Perilla Seed Downbear the Qi

Decoction) " . (p. 64.)

 

Dui Yao goes into more detail on how how herbs affect the direction

of Qi flow than any other book I'm familiar with. This is an

important part of TCM healing and one that frequently gets short-

shift in the West.

 

Sionneau also goes into some detail on the part of the plant which is

used. Different parts of the plant can have different properties.

When Shu Di is used in the formula Perilla Seed Downbear the Qi

Decoction, it's the whole root which is used. What is called Quan

Dang Gui. (In the comments section Sionneau goes into detail about

the different parts of the rehmannia root and their properties.) (pp.

64-65.) The book also goes into detail about the preparation of herbs

and how this can change their properties.

 

One thing I've never seen in any other book is that Sionneau lists

foods which are incompatible with some herbs. I've seen and have

lists of herbs that are incompatible with other herbs, but not lists

of foods that are incompatible. For example, " Shu Di is incompatible

with animal blood whatever the animal, onions, chives, turnips,

radishes, and garlic. " (p. 65.)