The remedy Clear Yang is a variation of the formula Ban Xia Bai Zhu Tian Ma Tang (Pinellia-Atractylodes-Gastrodia Decoction). The original formula is for Wind-Phlegm, i.e. a combination of internal Wind and Phlegm. The variation Clear Yang is aimed primarily at subduing Liver-Yang and resolving Phlegm and secondarily, at nourishing Blood and tonifying the Kidneys.
The combination of these patterns, Liver-Yang rising, Phlegm, Blood deficiency and Kidney deficiency is very common in middle-aged or elderly people. One of the characteristics of Phlegm (which, incidentally, sets it apart from Dampness) is that it is always moving and follows Qi in its movements. Therefore, when there is Liver-Yang rising towards the head, Phlegm follows it to the head.
Another characteristic of Phlegm (which also distinguishes it from Dampness) is that it obstructs the orifices. Obstructing the eyes, it causes blurred vision (which is not always due to Liver-Blood deficiency); obstructing the nose, it causes a blocked nose; obstructing the mouth, it causes a sticky taste; obstructing the ears, it may cause tinnitus; obstructing the Brain, it causes dizziness, heaviness and muzziness (fuzziness).
Therefore, the two main symptoms addressed by this remedy are headaches and dizziness (deriving from Liver-Yang rising and Phlegm). In my experience, the combination of these patterns is the most common cause of chronic headaches and migraine in middle-aged and elderly people. Typically, this person would suffer from two types of headaches: there would be a persistent dull headache (from Phlegm) punctuated by episodes of severe, throbbing headaches (from Liver-Yang rising).
Please note that there must not necessarily be headaches in order to prescribe this remedy: I frequently use it purely for dizziness in the elderly.
Other symptoms of Phlegm that may appear are also nausea and expectoration of phlegm. The tongue is Swollen and with a sticky coating; the pulse is Slippery on the whole and it may be Weak on the Kidney positions.
There are two main differences between Clear Yang and the formula from which it is derived (Ban Xia Bai Zhu Tian Ma Tang). Clear Yang:
1) Nourishes Blood and tonifies the Kidneys (which the classical formula does not do)
2) Has a stronger action in eliminating Phlegm from the Brain and opening the Mind’s orifices (with Shi Chang Pu Rhizoma Acori tatarinowii and Yuan Zhi Radix Polygalae).
Liver-Yang rising towards the head of course causes primarily headaches and dizziness and these are the two main symptoms addressed by Clear Yang.
The following are three tongues that may be appropriate to this remedy. They are all swollen indicating Phlegm. The first is pale while the other two are red on the sides (indicating Liver-Yang rising).
Author: Giovanni Maciocia