(245) Huang Qin (Scutellariae Radix)

[HB KIM]

INTRODUCTION
Imagine the feeling of being inside a sauna: hot, damp, wet, stuffy.  That is the internal condition which Huang Qin can treat.  Huang Qin can clear out the wet, damp sauna-type environment and leave the body feeling clean and fresh. 

If the differential diagnosis is Damp-Heat, Huang Qin should be the first herb that comes to mind.  The etiology is usually created in the Stomach, especially when people who have constitutional Heat recurrently take in greasy, spicy, fast food or processed foods.  Damp-Heat will easily be created in the Middle Jiao with that kind of diet.  Some people may have constitutional Damp-Heat; they will have a robust body, thick skin, sweat a lot, and tend to be obese.  Damp-Heat may start in the Middle Jiao, but it will inevitably move into other organs such as the Large Intestine or Liver.  Whatever the case, Huang Qin should come to mind, along with Cang Zhu or Bai Zhu.   


1. DAMP-HEAT moves into the LARGE INTESTINE
Damp-heat in the Large Intestine may present as diarrhea immediately after eating, irritable bowel syndrome, chronic diarrhea, or ulcerative colitis.  The treatment principle is to remove Damp-Heat first, and afterwards tonify the Large Intestine.  In this case the combination of Huang Qin + Bai Shao is a must.

CASE: A man in his 30's had a lot of stress and didn't eat regularly.  When his stomach was empty, he felt pain in the epigastric area.  He frequently ate late at night.  Sometimes he had indigestion and acid regurgitation.  After an endoscopy, his MD diagnosed chronic gastritis and prescribed a pharmaceutical drug.  The drug provided temporary relief, but didn't improve the condition, so he decided to see if herbs could help him.  Luckily he went to a clever herbalist who gave him this:
Hai Piao Xiao 8g
Bai Shao 8g
Mu Li 8g
Bai Zhu (fried) 6g
Fu Ling 6g
Huang Qin (fried) 3g


2. DAMP-HEAT moves into the LUNG
Damp-Heat may transform into Phlegm and move into the Lung, which can lead to chronic bronchitis.  The treatment principle is to clear Lung Heat and expel Phlegm.  In this case, Huang Qin is best combined with Sang Bai Pi, since it can stop cough and dissolve Phlegm.


3. DAMP-HEAT moves into the LIVER
Actually, Damp-Heat can move into either the Liver or Gall Bladder or both.  Damp-Heat in the LV/GB can form easily with the kind of lifestyle that includes a lot of alcohol and greasy foods, especially when they're consumed together.  A patient may present with indigestion, fatigue, hepatitis, fatty liver or Liver enzyme increase.  A basic combination for Damp-Heat in the LV/GB is Huang Qin, Chai Hu, Yin Chen Hao, and Ze Xie.

CASE: A man in his early 30's gained about 15 lbs after overworking at the office for two years.  He has a high stress level and drinks a lot.  He is always fatigued, his eyes easily feel strained, and he experiences indigestion with abdominal distention and gas after meals.  His MD told him he has a fatty liver and his GOT/PGT is in the range of 60-80 (under 40 is normal). 

Even though this patient is fatigued and there is evidence of Spleen deficiency, the Damp-Heat must be expelled first.  It might be tempting to prescribe a formula like Bu Zhong Yi Qi Tang, but in this case the result would not be the desired effect.  The priority is to first remove the pathogen, after which the Spleen can be tonified.  This combination will do: 
Ze Xie 10g
Yin Chen 8g
Bai Zhu 6g
Fu Ling 6g
Chai Hu 4g
Huang Qin 4g    


4. DAMP-HEAT moves into the UTERUS
Women who are overweight, eat a lot of instant, processed, and fast food, and get little exercise are the most susceptible to Damp-Heat in the uterus.  Leukorrhea, hysteritis, or pelvic inflammatory disease may result.  This is a situation of Damp-Heat in the Lower Jiao, so Huang Qin is best combined with Long Dan Cao and Ku Shen.

CASE: A woman in her 40's suffered from leukorrhea and vaginal itching for six months.  A protozoan test was negative.  Her MD prescribed a course of antibiotics which didn't help at all.  She was a bit overweight and had an irregular diet.  This formula helped:
Yi Yi Ren 12g
Fu Ling 6g
Cang Zhu 6g
Lai Fu Zi 4g
Huang Qin 4g
Ku Shen 5g
Long Dan Cao 4g 


5. DAMP-HEAT moves into the MUSCLE
Damp-Phlegm can move into the muscle layer and cause stiffness, especially in the shoulders and upper back.  People who do physical labor, especially those with constitutional Heat, thick skin, and a greasy diet, are the most susceptible to Damp-Heat moving into the muscle.  Huang Qin + Ge Gen are a good combination, especially when the neck, shoulder and upper back are affected.

CASE: A construction worker in his late 40's is suffering from muscle pain and spasms everywhere in his body.  He has a robust physique and consumes primarily meat.  He feels relief of the muscle pain and spasms after sweating, but he can't tolerate the heat required for that self-treatment. 

The spasms might lead some practitioners to consider a formula such as Er Chen Tang, but the priority in this case must be to expel the Damp-Heat first.  This is an ideal combination for this case:
Ge Gen 12g
Yi Yi Ren 12g
Cang Zhu 6g
Fu Ling 6g
Huang Qin 6g
Bai Shao 4g
Mu Gua 4g


CASE: A 40 year old with a good appetite and obese abdomen was experiencing indigestion and muscle spasms in various parts of the body which were relieved after sweating.  The diet consisted of a lot of meat.  Bowel movements were loose, 2-3 per day.  This formula is appropriate:
Yi Yi Ren 40g
Ge Gen 12g
Fu Ling 8g
Ma Huang 6g
Huang Qin 3g


SUMMARY
Damp-Heat originates from the Middle Jiao, but it can move into any part of the body. 
In the Upper Jiao in moves into the Lung,
in the Middle Jiao it moves into the Liver or Gall Bladder,
in the Lower Jiao it moves into the Large Intestine or the uterus,
and it may even move into the limbs and muscles. 
If Damp-Heat is identified anywhere, call on Huang Qin for help and combine with other herbs based on the location and symptoms.

DOSAGE
The usual dosage for Huang Qin is 6-9 grams; if the Damp-Heat symptoms abate, reduce the dosage to 3-6 grams.  Decrease the dosage as the symptoms diminish.

DIANGOSIS
Tongue: The Huang Qin tongue will have a greasy, yellow coat.
Pulse: In general the pulse of a Huang Qin patient will be stronger and slippery.  It will definitely be an excess pulse.
Other visual cues: An abdomen with heat signs and thick skin may tip you off about the presence of Damp-Heat.