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BRIGHTENING THE MIND AND THE SENSES:
Yiqi Congming Tang
Yiqi Congming Tang (Ginseng, Astragalus, and Pueraria Combination) is indicated for treating diminished visual and audio acuity. The formula's name refers to two actions: one is benefiting and increasing the qi (yiqi); the other is brightening the mind and its senses (congming). Cong refers to being sharp, wise, clever, intelligent, and quick at hearing; ming refers to brightness and clarity. The main functions of this decoction (tang) are:
The term "yiqi" appears in the name of another famous formula, Buzhong Yiqi Tang (buzhong is to tonify the center, namely the stomach/spleen). In fact, Yiqi Congming Tang is derived from Buzhong Yiqi Tang by utilizing the main "yiqi" portion of the formula: astragalus, ginseng, licorice, and cimicifuga; the first three herbs are used to increase the qi, and the combination of astragalus and cimicifuga is intended to raise the qi. The Chinese name for cimicifuga is shengma, where sheng means to raise; this refers to the herb's property of raising the yang qi (ma is the term for hemp-like plants with tough stems) to treat disorders of the neck and head. The concept utilized here is that clear qi, derived from the proper digestion of food and assimilation of its nutrients, is raised to the head, where it nourishes and activates the mind, the ears, and the eyes. Presumably, this principle would apply to sense of taste and smell, which, like hearing and vision, may weaken with age and certain diseases. Additionally, cimicifuga helps clear wind-heat from the surface; this external pathogenic influence enters easily due to deficiency of qi and then combines with the internal weak fire to cause the disturbance of mind and senses. The formula includes two other surface relieving herbs for wind heat: pueraria and vitex, which are well-known for their use in treating impaired senses, such as cloudiness of the eyes or ringing in the ears.
There are two herbs in the formula for treating internal fire agitation that disrupts the clarity of the senses; this fire agitation occurs with weakening of the yin essence, particularly as the result of aging, though also from various life style factors and certain diseases. The herbs are phellodendron, aimed at alleviating deficiency fire of the kidney, and peony, for alleviating deficiency fire of the liver (it also astringes liver yin to prevent further loss).
The formula ingredients and dosages for a one week supply, described in the source text, are (1):
The herbs are to be ground to powder, and taken 9 grams each time, twice daily, with the powder briefly decocted in water.
This formula was first described in the text Yuanji Qiwei (Revealing the Mystery of the Origin) by Ni Weide (1370). The main subject of the book is the causes and mechanisms of eye diseases, with special focus on visual disorders secondary to internal organ system weakness and disharmony, as well as problems caused by external pathogenic factors, such as wind heat.
Ni's book was published 120 years after the Pi Wei Lun (Treatise on Spleen and Stomach), the text of medical reformer Li Dongyuan describing Buzhong Yiqi Tang. The theoretical basis for use of this formula is derived from the teaching of Li Dongyuan, who proposed the method of raising clear yang and scattering yin fire. As described in the Pi Wei Lun (2):
Dietary irregularity and immoderate eating of cold and warm foods may damage the spleen and stomach, while joy, anger, worry, and fright may consume and cause detriment to the original qi. If the spleen and stomach qi becomes decrepit and the original qi becomes insufficient, heart fire may become effulgent on its own. This heart fire is a yin fire. It starts from the lower burner and links to the heart. The heart does not reign exclusively; ministerial fire is its deputy. Ministerial fire is the fire of the pericardium developing from the lower burner. It is a foe to the original qi. This yin fire and the original qi are mutually irreconcilable. If one is victorious, the other must be the loser. When spleen and stomach qi becomes deficient and their qi consequently sinks down into the kidneys, yin fire is given a chance to overwhelm the earth phase.
Thus, to rectify the problem, the ministerial fire must be lowered, and the qi of the stomach/spleen must be raised. The proportions of ingredients in the formula can be modified to give more or less emphasis to each of these two complementary objectives.
Yiqi Congming Tang has been widely used in the Orient and subjected to pharmacological research for its ability to improve brain functions (3), but it is rarely taught to Western students. Most overview texts on Chinese herb formulas bypass this one, because it does not fit the individual categories of therapy into which the formulas are classified, such as tonifying qi, clearing heat, or resolving the surface, but combines them in a single formulation. Also, there has been some contradictory information as to whether this formula is suited to treating acute eye and ear disorders, such as conjunctivitis or otitis media, or only chronic disorders such as macular degeneration, senile cataracts, tinnitus, and deafness. For example, in the book Commonly Used Chinese Herb Formulas with Illustrations (4), it is stated that the formula "is not effective in treating acute inflammation of ears and eyes," and this is restated in the Companion Handbook (5) based on that text. By contrast, the formula is sometimes used for such disorders in China, and claimed to be effective, as in the case of otitis media (6). Such contradictory indications may have also inhibited teachings about the formula. Yiqi Congming Tang is designed to rectify internal disorders of yin fire and sinking yang qi, but it can also be used to treat wind-heat syndromes that arise as a consequence of these internal disorders.