Traditional TCM Proprietary Medicines and Their Use with *Yao-Yinzi* (Drug-Guides)
That a traditional TCM proprietary medicine, used together with a yao-yinzi ("drug-guide"), gives better effect, is common knowledge among clinicians and pharmacists. But the knowledge of guides and their pairing with proprietary medicines lives only in scattered formula-books or in usage notes for particular drugs — there is no monograph.
The famed TCM shops of northern China have long produced their own proprietary medicines, store-in-front, workshop-behind. At these shops, the old apothecaries and pharmacists, hearing a patient's complaint, could match a suitable proprietary medicine and, by the shop's own rules, also a yao-yin to strengthen its action and bring out the best effect. These shops kept dedicated handbooks of how their medicines were to be used; the handbooks were closely-held — for in-shop use only, not circulated. So to this day there is no monograph on the yao-yin. From the other side, clinicians have not held pharmacist's knowledge as required learning. Since liberation, with medicine and pharmacy parted, knowledge of yao-yin has gradually been lost.
Drawing on the proprietary-medicine handbooks of several famed Beijing shops, I have gathered and analyzed; an initial summary follows.
From the Shanghan Lun and Jinkui Yaolüe on, the classical formulas, and later shi-fang (era-formulas) and experience-formulas, when made into proprietary medicines, were given guides at the moment of taking, the better to bring out the drug's nature. E.g., in Jinkui Yaolüe, Shenqi Wan is taken with light salt-water to enhance its action of entering kidney to warm yang.
Proprietary medicines have fixed formulas with set indications. Clinically, illness is complex; patients may have several conditions at once, or with the same main pattern have varying side-signs. One proprietary medicine alone cannot cover everything. In such cases, pair the proprietary medicine with a yao-yin, another proprietary medicine, or a decoction.
Pairing proprietary medicines with yao-yin is an important traditional part of TCM proprietary-medicine use. Yao-yinzi, also called yin-yao — most formulas don't note them; some that do note them only mouth-pass them; with their few herbs and small dose, they are easily overlooked.
Their main role: guide-the-drug-to-the-channel, strengthen the effect — sometimes also harmonizing, protecting, restraining, or correcting flavor. Properly paired with a proprietary medicine, they give complementary results.
Main roles of the yao-yin:
1. Channel-guiding: focus the drug's action on a body-part or storehouse. E.g., Liuwei Dihuang Wan for kidney-yin vacuity is often taken with light salt-water; salt enters the kidney, and so guides the formula to the kidney for fullest effect.
2. Strengthening effect: in pungent-warm surface-releasing for wind-cold colds, shengjiang and congbai are added as guides, strengthening the sweat-releasing action.
3. Detoxifying: some raw herbs are toxic; a guide lowers or removes the toxicity. Shengjiang lowers the toxicity of raw nanxing and raw banxia.
4. Correcting flavor: some herbs are bitter, astringent, hard to swallow, or off-flavored. For pediatric pertussis, jikudan (chicken bile) is taken with red sugar or rock sugar as guide to soften the bitterness.
5. Protecting the gut: some drugs irritate digestion. The heat-clearing summer-relieving Baihu Tang is bitter-cold, easily harming the stomach; often paired with jingmi (polished rice) and red dates to protect the stomach and support the right.
Common yao-yin in clinical use:
1. **Red dates (dazao)**: sweet, warm; tonifies the middle, eases qi, nurtures blood, calms spirit; supplements spleen-stomach, generates fluid, harmonizes ying-wei, resolves drug-toxin. Contains protein, sugars, organic acids, mucilage, vitamins A, B2, C, etc. For spleen-stomach qi-vacuity, post-partum blood-vacuity, ying-wei disharmony, palpitations and similar weak patterns — 5–10 dates decocted, the decoction taken with the proprietary medicine. For spleen-vacuity diarrhea, red-date decoction may carry Renshen Jianpi Wan or Lizhong Wan.
2. **Fresh ginger (shengjiang)**: disperses wind-cold, releases the surface and checks cough, warms the gut, harmonizes the stomach and stops vomiting, warms the middle and disperses cold. For wind-cold cold, wind-cold lung-bound cough, yin-cold stomach pain, vomiting-diarrhea with belly pain — 3–5 slices decocted; the ginger-soup carries the matching proprietary medicine.
3. Red dates with fresh ginger: often paired as guide; tonifies spleen-stomach, sharpens appetite, aids drug absorption, raising the proprietary medicine's effect.
4. **Brown sugar (hongtang)**: sweet, warm; tonifies blood, disperses cold, breaks stasis. For gynecological blood-vacuity and blood-cold, post-partum unfinished lochia, scant milk, dry mouth, nausea, vacuity-blood dysentery. Usually 10–30 g brown sugar in boiled water, with the proprietary medicine. For post-partum scant milk, brown-sugar water carries Xialu Yongquan San.
5. Lotus-root juice or lotus-node: clears heat, cools blood, stops bleeding. With proprietary medicines for blood-heat bleeding. Lotus root, juiced; or 5–10 lotus nodes decocted.
6. **Reed root (lugen)**: clears heat, generates fluid, slakes thirst, stops vomiting. For wind-heat externally contracted, dry mouth and throat, early-stage pediatric measles. 10–30 g, decocted to carry the proprietary medicine. E.g., reed-root decoction with Lingqiao Jiedu Wan for early-stage cold.
7. Yellow wine, white liquor: pungent-hot; warms and opens channels, disperses wind-cold, drives the drug. The alcohol dissolves some active components, speeding action. Small low-alcohol amounts aid stomach absorption; moderate amounts dilate vessels, redden and warm the skin — so wine unblocks sinews and channels, breaks stasis, drives blood circulation. Aromatic and warm, it drives the drug, opens the channels, benefits the gut, moistens the skin, disperses cold-damp. With cold-natured drugs, mitigates cold; with hot-natured, enhances movement, strengthening qi-and-blood regulation, sinew-channel opening. Yellow wine is best. Usually 15–50 ml yellow wine, less of white liquor; adjust by sex, age, constitution, alcohol tolerance — beware of intoxication. Warm yellow wine; e.g., to dispel wind-damp and open sinew-channel, take Xiaohuoluo Dan with yellow or white wine; for blood-quickening, stasis-resolving, swelling-and-pain reduction, take Qili San with yellow or white wine.
8. **Rice broth (mitang)**: supplements spleen-stomach, protects stomach-qi, prevents bitter-cold drugs from injuring the stomach. The "rice-oil" — the rich layer on top of the broth — is the best part. For spleen-stomach weakness or intestinal disorders, especially when bitter-cold drugs are used. The broth of xiaomi (foxtail millet) is best; dami (rice) is good too. Take the rich liquid from cooked porridge; no fixed dose. E.g., Longdan Xiegan Wan — clear-drain liver-gallbladder fire — taken with rice broth to spare stomach-qi.
9. **Bamboo leaf, dengxincao**: both clear heart-fire, free the urine, drain lower-jiao damp-heat. For heat-strangury and small-intestinal damp-heat with painful, dribbling urination. 3–5 g, decocted, taken with the proprietary medicine.
10. **Scallion white (congbai)**: induces sweat to release the surface, disperses cold and opens yang, resolves toxin, disperses bound. For wind-cold contracted externally and yin-cold-internal cold-block patterns. 2–3 scallion whites, chopped, decocted.
11. Salt: salty enters the kidney; kidney delights in salty. Channels the drug into the kidney channel. For kidney-yin vacuity: lassitude, impotence, seminal emission, low-back pain, thin hair. 1–2 g salt in water as guide. E.g., for kidney-vacuity with fire blazing, bone-steaming labor-heat — take Da Bu Yin Wan with light salt-water.
12. Honey: sweet, neutral; rich in nutrients. Tonifies vacuity, eases urgency, moistens the lung, stops cough, moistens the bowel, eases stool. For lung-dryness cough, yin-vacuity chronic cough, intestinal-dryness constipation, habitual constipation, gastric-and-duodenal ulcer. Because it is thick, first dilute with boiling water — 1–2 tablespoons in a cup makes the honey guide.
13. Vinegar: sour; disperses stasis and stops pain, resolves toxin, kills worms, corrects flavor. For gynecological red-and-white discharge, blood-flooding, blood-stool. About 2 tablespoons vinegar in half a cup boiling water as guide. With Shixiao San, strengthens the stasis-resolving, pain-stopping action.
14. Others: bohe, jingjie, suye, watermelon, pear, malt sugar, rock sugar, and more — too many to list.
15. In clinical selection of yao-yin: by the proprietary medicine's function, the chief symptom and its location, disease-duration, season, region, and so on — choose one or several.
Appendix: Pairing yao-yin with cold-treatment proprietary medicines
A surface-pattern externally contracted is the six excesses invading the body-surface — chill, fever, headache, body-ache, floating pulse. Two kinds: wind-cold and wind-heat. Wind-cold: pungent-warm surface-release — Mahuang Tang, Guizhi Tang, Gegen Tang, Xiao Qinglong Tang. Wind-heat: cool-pungent surface-release — Yinqiao San, Sangju Yin, Maxing Shigan Tang.
1. Wind-heat surface-pattern — fever, slight aversion to wind-cold, headache, thirst, sore throat or cough, thin white or slightly yellow coating, floating-rapid pulse — cool-pungent surface-release herbs; e.g., Tianjin Ganmao Pian, Maxing Zhike Ding.
Usual carrier: warm boiled water, or lugen decoction.
Yao-yin pairing:
a. Wind-heat with fever, headache, sore throat dominant: daqingye 15 g decoction with Tianjin Ganmao Pian; for severe headache, take with light tea.
b. To strengthen heat-clearing, anti-inflammatory, pain-stopping: take with light tea, or dengxincao 5 g decoction.
c. To strengthen calming and phlegm-transforming (vexation, throat phlegm): gouteng 10 g, bohe 3 g decoction.
d. Food-stagnation and inner heat with wind-heat — strengthen heat-clearing and food-moving: bohe 5 g or Jiao Sanxian decoction.
e. Wind-heat with sweat-out fever: baitang (white sugar) 15–30 g in water.
f. Wind-heat with strong cough: one pear, chopped and decocted.
g. Wind-heat with high fever, threat of convulsion, or pediatric night-crying: bohe 3 g, gouteng 10 g, jiangcan 6 g decoction.
2. Wind-cold surface-pattern — chill, fever, stiff neck, body ache, no thirst, no sweat or some sweat, thin-white coating, floating-tight or floating-slow pulse — pungent-warm surface-release herbs; e.g., Gegen Tang, Xiao Qinglong Tang.
Usual carrier: warm boiled water, ginger soup, or brown-sugar water.
Yao-yin pairing:
a. Wind-cold with severe cough: scallion whites 2–3, shengjiang 3–5 slices, yellow wine 15–50 g, warmed.
b. Wind-cold with yangming headache: baizhi 5 g, chuanxiong 3 g decoction.
c. Wind-cold with phlegm-and-pant cough, belching, sour regurgitation: maidong 10 g, shengjiang 3–5 slices decoction; or shengjiang alone.
d. Wind-cold with headache, thirst, no sweat: scallion whites 2–3, chopped, decocted. With headache, thirst, sweating: guizhi 10 g decoction.
e. Wind-cold with chills, strong fever, no sweat, headache: zisu 10 g decoction.
f. Wind-cold with nausea-and-vomiting: muxiang 3 g, shengjiang 3–5 slices decoction.
g. Wind-cold-strike cough: jiegeng 6 g, gancao 3 g decoction; or scallion-whites 2–3 and shengjiang 3–5 slices.
h. Wind-cold with food-stagnation and sour-vomiting: Jiao Sanxian decoction; or shanzha and maiya decoction.
i. Wind-cold with vomiting-diarrhea: suye 10 g decoction; or suye 10 g with mugua 10 g.
j. Wind-cold injury with fright-and-fever: scallion-white and shengjiang decoction.
For any wind-cold or wind-heat with no spirit, low energy, no appetite: shengjiang 3–5 slices, red dates 5–10, decocted.
With food-injury: sanxian decoction.
With vomiting: shengjiang decoction.
With vomiting-diarrhea: suye decoction.