(290) Yi Gan San (Restrain the Liver Powder)

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HERBAL FORMULA FOR TEENAGER's VIOLENCE

YI GAN SAN (Restrain the Liver Powder)
8g  Bai Zhu  (White Atractylodes rhizhome)
8g  Fu Ling  (Poria fungus)
6g  Dang Gui  (Chinese Angelica root)
6g  Chuan Xiong  (Szechuan Lovage root)
6g  Gou Teng  (Gambir vine)
4g  Chai Hu  (Hares Ear root)
4g  Gan Cao  (Licorice root)


CLASSIC SOURCE:
Yi Gan San (Restrain the Liver Powder) is from Bao Ying Cuo Yao (Synopsis of Caring for Infants) which is a pediatric formula from 1555, Ming dynasty.   


MODERN TEXT:
In Chinese Herbal Medicine: Formulas & Strategies (by Bensky & Barolet), Yi Gan San is categorized under Harmonize LV and SP with related formula, Si Ni San (Four Frigid Powder).

From the Text, Yi Gan San was originally used in treating children for LV Yin deficiency, Heat with spasms, feverishness and bruxism; palpitations with anxiety, fever and chills, or spitting of sputum and saliva; abdominal distention, reduced appetite, and restless sleep due to the LV over-controlling the SP.
Its use has subsequently been expanded to cover a wide variety of chronic deficiency disorders with spasmodic movement including seizure disorders, hysteria, and night terrors. 


INTERPRETATION:
The above information comes directly from the text.  We can further expand its use in modern applications.

Yi Gan San has a Dang Gui Shao Yao San idea inside.  There are two herbs from Si Wu Tang (Dang Gui, Chuan Xiong) and two herbs from Wu Ling San (Bai Zhu, Fu Ling) combined with Chai Hu and Gou Teng.

1. Gou Teng is one of the best herbs to send blood to the blood vessel in the brain.  You can imagine that Gou Teng expands the crooked, (shrunk) brain blood vessels.  To enhance this effect, we use Tian Ma + Gou Teng together.   Therefore Tian Ma + Gou Teng can be added when a Zhi Gan Cao Tang or Bai Wei Di Huang Wan patient has a headache.   If Gou Teng + Huang Qi are combined, narrow cerebral blood vessels expand with greater ease.  This application is seen in Qi Wu Jiang Xia Tang, which can lower blood pressure effectively.
2. Chai Hu calms both the sympathetic nervous system and the heart.
3. Bai Zhu + Fu Ling promote urination to clear stagnated water from the body.
4. Dang Gui + Chuan Xiong circulates blood and fortifies the blood supply.

By facilitating the free flow of blood to the brain, free-flowing Yi Gan San releases emotional or psychological tension, making is supremely useful for psychological concerns.


ABDOMINAL DIAGNOSIS:
Yi Gan San is indicated when there is stress causing tension on the left side of the abdomen.   As you know from abdominal diagnosis, Left refers to Liver, Right refers to Lung, so the left-sided tension is often due to liver-type stress.  In this case, Bai Shao can be added to this formula even though the original formula does not include the herb.


CLINICAL APPLICATION FOR MODERN PRACTICE:
This is a useful formula in modern society particularly for young children, teenagers or adolescents.  They can be very sensitive and dissatisfied with their parents and/or society.  They often do not talk to parents or teachers about the strong emotions they feel inside.  This can lead to some accidental tragedy with violence or gun shooting.  Yi Gan San can help calm the spirit in these patients. 
Yi Gan San can also relieve epileptic seizures, teenage neurosis, psychological disorders, hysteria, tics, bruxism, Terret's syndrome and general seizures.


COMPARISON:
Yi Gan San  &  Yi Gan San + Ban Xia, Chen Pi are two very different formulas although they have the same base formula.  While Yi Gan San is more commonly used for children or young adults, Yi Gan San + Ban Xia, Chen Pi is used more commonly for elderly patients, esp. for women.  It's a very good formula for depression or dementia in elderly women.  Another article about Yi Gan San + Ban Xia, Chen Pi will be written in the next forum.


ACUPUNCTURE:
"Gate Opening" is a good acupuncture treatment to combine with Yi Gan San.  LV3 (human) + LI4 (earth)  or  GB40 (human) + HT7 (heaven) can be combined with Yin Tang and DU20.   For severe symptoms, PC9 and SJ1 can be added for "Great Gate Opening".