In traditional Chinese medicine, properties of herbs are described in terms of temperature and taste characteristics. There are five temperature properties (warm, cold, hot, cool and neutral) and five basic tastes (sour, sweet, bitter, pungent and salty). These properties do not necessarily refer to the literal meanings of these designations but reflect their functions and therapeutic indications. "Hot diseases must be cooled, cold diseases must be warmed." Thus, an herb able to cure heat or warm symptoms is of cool or cold property, and an herb for cold symptoms has a hot or warm property. The tastes are correlated with their functions. Pungent herbs disperse exopathogens from superficies and facilitates the move of Qi and blood; sweet herbs nourish, replenish, tonify and harmonize; bitter herbs clear heat and fire, send down adverse flow of Qi and dry dampness; sour herbs arrest discharges; salty herbs purge and soften hard mass (Zhu, 1998).
Ge Gen is an herb with pungent and cold properties and hence, according to the principles of traditional Chinese medicine, it belongs to a group of medicinal materials that cure heat and warm symptoms and disperse pathogenic factors from the superficies of the body and relieve exterior syndromes. According to Chinese medical theory, exterior symptoms appear when the exogenous causes of diseases invade the body and lodge in the superficies. The main function of Ge Gen is to dispel pathogenic factors from the superficial muscles to allay fever, headache and stiffness of the nape. It also promotes the rash of measles to surface to hasten recovery from measles with incomplete eruption of the rash. In addition, Ge Gen also promotes production of body fluid to alleviate thirst and diabetes. It is also used to arrest diarrhea in acute dysentery and diarrhea (Zhu, 1998).
Modern scientific research has led to the use of Ge Gen for coronary disease and angina pectoris. This new use is based on the research on the effects of Ge Gen on smooth muscle, cerebrovascular and cardiovascular systems (see Chapter 8 for details). Ge Gen is also recommended for stiff neck and pain from hypertension based on lengthy clinical experience of using Ge Gen for neck stiffness and pain from externally contracted disorders (Bensky and Gamble, 1986).
COMMON GE GEN FORMULATIONS: INDICATIONS AND EFFICACIES
Rare is the case in traditional Chinese medicine that an herb is used alone. Herbs are often combined in order to produce optimal therapeutic effects, to accommodate complex clinical conditions, and/or to minimize toxicity and side effects (Zhu, 1998).
For cold or flu with headache, neck stiffness and pain, Ge Gen is often used with Gui Zhi (Caulis cinnamomi) and other herbs as in Ge Gen Tang (Kudzu decoction) to relieve exterior symptoms. For measles in the early stages where the rash has not yet appeared, Ge Gen is used together with Sheng Ma (Radix cimicifugae) as in Sheng Ma Ge Gen Tang (Cimicifuga and kudzu decoction). For hot diarrhea and dysentery-like disorders caused by damp heat, Ge Gen is used together with Huang Lian (Rhizoma coptidis) and often with Huang Qin (Radix scutellariae) as well, as in Ge Gen Qin Lian Tang (Kudzu, scutellaria and coptis decoction). With Tian Hua Fen (Radix trichosanthis) and Mai Meng Dong (Tuber Ophiopogonis japonici), Ge Gen is used to relieve thirst in what is called "thirsting and wasting syndrome" in traditional Chinese medicine, which often refers to diabetes (Wang, 1985).
There are many Chinese herbal formulas containing Ge Gen as the major ingredient and the most renowned ones are Ge Gen Tang (Kudzu decoction) and Ge Gen Qin Lian Tang (Kudzu, scutellaria and coptis decoction).
Ge Gen Tang (Kudzu decoction) is composed of Ge Gen (20 per cent), Ma Huang (Herba ephedrae, 15 per cent), Gui Zhi (Ramulus cinnamomi, 10 per cent), Shao Yao (Radix paeoniae, 10 per cent), Sheng Jiang (Rhizoma Zingiberis Officinalis Recens, 15 per cent), Da Zhao (Fructus Zizyphi jujubae, 20 per cent) and Gan Cao (Radix glycyrrhizae, 10 per cent). This formula is indicated for fever and chills without sweating, and for stiff and rigid neck and upper back. This is the type of externally-contracted symptoms caused by pathogenic factors and is defined in Chinese medicine as wind-cold, which often refers to upper respiratory infection and other disorders with upper respiratory manifestations such as rhinitis and sinusitis.
In this formula, Ge Gen is the principal ingredient. It acts to relieve the muscle layer (especially of the upper back and neck) by drawing fluids to the affected area, and release the exterior. Gui Zhi helps the principal to relieve the exterior and Ma Huang induces sweating (Bensky and Barolet, 1990).
Pharmacological studies showed that Ge Gen Tang has antimicrobial, antipyretic, diaphoretic and natural killer (NK) cell stimulating activities. This decoction and its ingredient were also found to have anti-allergic activities (Deng, 1990).
The primary indications of Ge Gen Tang are various acute infectious diseases including respiratory infection, enteritis and dysentery, and suppurative skin infections such as carbuncles and sores. In Japan, Ge Gen Tang is one of the most commonly used formulas for cold and flu. According to a Japanese survey comparing effects of various cold formulas, Ge Gen Tang is the most effective. Subjective symptom improvement, clinical efficacy and safety in cold patients reached 93 per cent, 90 per cent and 100 per cent, respectively. It is particularly effective in children (Deng, 1990).
Another indication of the formula is cervical spondylopathy, neck and shoulder problems. In addition, the formula has also been used in the treatment of allergic diseases including urticaria and eczema (Deng, 1990).
Ge Gen Qin Lian Tang (Kudzu, scutellaria and coptis decoction), consisting of Ge Gen (50 per cent), Huang Qin (Radix scutellariae baicalensis, 18.75 per cent), Huang Lian (Rhizoma coptidis, 18.75 per cent) and Gan Cao (Radix glycyrrhizae, 12.5 per cent), is indicated for acute gastroenteritis, acute enteritis, early-stage poliomyelitis and bacillary dysentery. The importance of Ge Gen is reflected in its relatively large dosage. It releases the exterior, clears heat and treats dysenteric diarrhea. Huang Lian, as the deputy, stops diarrhea and Huang Qin assists the deputy in stopping diarrhea. Irrespective of the prior treatment history, the use of this formula has been expanded to include any early-stage dysenteric disorder characterized by fever, foul-smelling stools and a burning sensation in the anus. With the appropriate presentation, it may be used in treating such biomedically-defined diseases as acute gastroenteritis, acute enteritis, measles, early-stage poliomyelitis and bacillary dysentery (Bensky and Barolet, 1990).
Pharmacological activities of the formula relavent to its applications include antimicrobial, antipyretic, anti-inflammatory and spasmolytic actions. Anti-arrythmic actions of the formula have also been reported. Clinically this formula is mainly used in cases of acute intestinal infection such as acute bacillary dysentery, enteritis and diarrhea (Deng, 1990).
This formula has been made into tablet and pill forms and they are included in the Chinese Pharmacopoeia. The tablet (Ge Gen Qin Lian Pian) is indicated for dysenteric diarrhea, and the pill (Ge Gen Qin Lian Wei Wan) is indicated for dysenteric diarrhea, bacillary dysentery and enteritis (Pharmacopoeia Commission of the Ministry of Health of PRC, 1995).
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