(278) Zi Su Ye (Perilla Leaf)

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INTRODUCTION
Zi Su Ye is most often compared to Huo Xiang since they both treat Tai Yang Exterior and Tai Yin Interior.  Both herbs have the ability to treat interior and exterior conditions, and both can treat nausea and vomiting.  Zi Su Ye has a special additional ability to calm the fetus and is more for exterior conditions.  Huo Xiang is more for interior conditions and reducing nausea.

1. Release the Exterior, Calm the Middle, Descend Qi, Stop Cough
a. Zi Su Ye is for both interior and exterior conditions. It is applicable for weak digestive function, especially for the combination of food retention plus Cold.  Zi Su Ye can be used for weakened, Qi deficient, elderly, children, or even pregnant patients because its diaphoretic action is very gentle.  Gentle diaphoresis refers to a subdued ability to open the pores and promote sweating.  This is quite the opposite of Ma Huang, which is known as one of the best herbs to open the pores and promote sweating.  If Ma Huang is the representative herb of strong diaphoretics, then Zi Su Ye can be regarded as the representative of gentle diaphoretics.  Examples of formulas in which Zi Su Ye is utilized for gentle diaphoresis include: Xiang Su San, Jia Wei Xiang Su San and Xiong Zi Xiang Su San.  Huo Xiang Zheng Qi San utilizes the combination of Huo Xiang + Zi Su Ye to release the exterior and reduce nausea and vomiting.

b. Zi Su Ye and Zi Su Zi are different parts of the same plant.  Zi Su Zi is the seed, while Zi Su Ye is the leaf.  Zi Su Zi has a significant ability to stop cough.  Zi Su Ye has a much less significant ability to stop cough, which makes sense considering that leaves tend to have a light, upward and outward energy while seeds tend to have a heavy, descending energy.  Zi Su Ye can release the exterior and gently relieve cough.  Formulas which incorporate Zi Su Ye to release the exterior and relieve cough include: San Su Yin, Xing Su Tang, Xiang Ge Tang, Shin Bi Tang, Zi Su Ban Xia Tang and Jia Biao Er Chen Tang.

2. Regulate Qi in the Middle, Treat Qi Stagnation for Abdominal Distention
a. Zi Su Ye has a good Qi regulating effect, so it is often combined with Qi regulating herbs.  Zi Su Ye may be referred to as a Tai Yin Spleen herb and is especially useful for Qi stagnation in the Middle Jiao.  For example, if a patient has stress leading to Qi stagnation in the Middle Jiao and Stomach problems, Zi Su Ye is applicable.  Common combinations used in clinical practice include: Zi Su Ye + Chen Pi / Zi Su Ye + Hou Po, Da Fu Pi / Zi Su Ye + Jie Geng, Zhi Ke.

The king herb of Fen Xin Qi Yin is Zi Su Ye.  In this formula Zi Su Ye is combined with other herbs that descend the Qi to treat edema due to Qi stagnation, abdominal distension, constipation or urinary difficulty.  Liu Yu Tang is another formula for abdominal distension in which Zi Su Ye is utilized for its ability to regulate Qi in the Middle Jiao.

b.  Xiao Chang Yin Zi also utilizes Zi Su Ye to regulate Qi in the Middle Jiao for severe gas and abdominal distension.  Combined with Qi regulators, herbs that break up Qi stagnation and expel Phlegm, Zi Su Ye can be found in Shi Liu Wei Liu Qi Yin and Jia Wei Si Qi Tang.  These two formulas treat Qi and Phlegm stagnation and open the Ren meridian.  Pain in the Middle Jiao due to Qi stagnation, especially as a result of gynecological disorders, can be treated with Jie Ge Shi Jing Tang.  For this purpose Zi Su Ye is combined with Qi regulators and herbs that open the channels in order to circulate Qi in the Middle Jiao as well as in the superficial skin area.

3. Calm the Fetus, Stop Nausea/Vomiting
a. Zi Su Ye is well known for its ability to calm the fetus and reduce nausea and vomiting.  This makes it an excellent choice in case of morning sickness or Wind-Cold during pregnancy.  The most common formula for this purpose is An Tai Yin, which is comprised of Si Wu Tang + Bai Zhu, Huang Qin, Sha Ren, Chen Pi and Zi Su Ye.  Bai Zhu + Huang Qin is a good combination for calming the fetus, while Sha Ren + Chen Pi + Zi Su Ye regulate the Middle Jiao and reduce nausea and vomiting.  This formula is helpful for pregnant women who experience morning sickness due to weak Stomach function or morning sickness triggered by smells.

CASE: A thin, 28 year old female complained of nausea and vomiting especially whenever she smelled food.  She was 8 weeks pregnant.  Smelling food made her feel sea-sick.  Her digestion was poor before her pregnancy.  Her morning sickness was so severe that she had barely been able to eat for a few days.  It was determined that she was suffering from Middle Jiao deficiency and hormone imbalance.  The treatment strategy was to regulate and warm the Middle Jiao, and calm the fetus.  She was given: Zi Su Ye 12g, Chen Pi 8g, Bai Zhu 6g, Sha Ren 3g, Huang Qin (fried) 2g, and Sheng Jiang 6g.

4. Compared to Zi Su Zi
Zi Su Zi is the seed of Zi Su Ye.  It does not release the exterior, but it can descend Qi to stop cough and expel phlegm.  It is used for cough and asthma.  It is commonly combined as follows: Zi Su Zi + Ban Xia / Zi Su Zi + Er Chen Tang / Zi Su Zi + Lai Fu Zi, Bai Jie Zi / Zi Su Zi + Sang Bai Pi

Formulas with Zi Su Zi include: Su Zi Jiang Qi Tang, Jia Wei Er Chen Tang, San Zi Yang Qin Tang, Su Zi Dao Tan Jiang Qi Tang, Jiang Fei Tang and Ding Chuan Tang.

5. Dosage and Comment
When used as a king herb, the dosage of Zi Su Ye is 4-12g.  The dosage when it is used a deputy or assistant is 3-4g.  Zi Su Ye is most powerful when combined with Huo Xiang or Chen Pi.