1. Prescription Source & History

1. Ancient Literature Records

Ganlu Yin was first recorded in the Taiping Huimin Heji Jufang (Formulary of the People's Welfare Pharmacy for Peace) in the Song Dynasty. This is the first monograph on proprietary medicine formulas compiled and promulgated by the government in the history of our country. At that time, it was regarded as an effective prescription for treating various diseases. The book details the drug composition, processing methods, and dosage of Ganlu Yin, providing important basis for later generations of physicians to apply and study this prescription.

2. Historical Inheritance & Development

Over time, Ganlu Yin has been continuously applied and developed in the clinical practice of later generations of physicians. Many medical books have included and elaborated on it, and according to different historical backgrounds and clinical needs, the medication and efficacy of the prescription have been further expanded and refined. For example, physicians in the Jin and Yuan dynasties innovated the application of Ganlu Yin on the basis of inheritance, achieving better curative effects in treating some special diseases. In the Ming and Qing dynasties, physicians conducted more in-depth research on the prescription. They not only summarized more clinical experiences but also explored the mechanism of action of the prescription theoretically, further enriching the connotation of Ganlu Yin.

2. Composition Introduction (King, Minister, Assistant, Guide)

1. King Drug - Rehmannia Root

Raw Rehmannia Root is the monarch drug in Ganlu Yin. It tastes sweet and bitter, is cold in nature, and belongs to the heart, liver, and kidney meridians. It has the effects of clearing heat and cooling blood, nourishing yin and promoting fluid production. In the prescription, Raw Rehmannia Root can nourish yin and blood, clear heat and reduce fire, laying the foundation of nourishing yin and clearing heat for the whole prescription. It can nourish the yin of the liver and kidney, making the yin fluid in the body sufficient, thus restricting pathogenic factors of yang heat, achieving the effect of balancing yin and yang. For various symptoms caused by yin deficiency and internal heat, Raw Rehmannia Root can play a very good therapeutic role.

2. Minister Drugs - Prepared Rehmannia, Asparagus, Ophiopogon

Prepared Rehmannia Root is also an important drug for nourishing yin and blood. It tastes sweet and is slightly warm in nature, belonging to the liver and kidney meridians. Its combination with Raw Rehmannia Root further enhances the efficacy of nourishing yin and blood, making the power of nourishing yin more powerful. Asparagus Root and Ophiopogon Root also have the effects of nourishing yin and moistening dryness, clearing heat and reducing fire. Asparagus Root is sweet, bitter, and extremely cold, belonging to the lung and kidney meridians, and can clear the lung and reduce fire, nourish yin and moisten dryness; Ophiopogon Root is sweet and cold, belonging to the lung, stomach, and heart meridians, and can moisten the lung and nourish yin, benefit the stomach and promote fluid production. These two drugs act synergistically with Rehmannia Root, strengthening the efficacy of nourishing yin, clearing heat, moistening dryness, and promoting fluid production in the prescription, and assisting the monarch drug to play the main therapeutic role.

3. Assistant Drugs - Artemisia, Scutellaria, Aurantii Fructus, Eriobotryae Folium

Artemisia Capillaris has the effect of clearing heat, promoting diuresis, and reducing jaundice. It can clear and remove dampness-heat in the spleen, stomach, liver, and gallbladder, making the pathogenic factors of dampness-heat excrete through urine. Scutellaria Baicalensis is bitter and cold, belonging to the lung, gallbladder, spleen, large intestine, and small intestine meridians, and has the effects of clearing heat and drying dampness, purging fire and detoxifying, and can clear heat in the upper and middle jiao. Fructus Aurantii Immaturus regulates qi, widens the middle jiao, promotes qi movement, and relieves distension. It can regulate qi activity, making qi flow smoothly, and helps the transportation and transformation of pathogenic dampness. Folium Eriobotryae reduces the adverse rising of lung qi and harmonizes the stomach to lower adverse qi. It can clear heat in the lung and stomach and stop vomiting and nausea. These drugs play the roles of assistant and adjuvant in the prescription, assisting the monarch drug and ministerial drug to better play the therapeutic effect, and at the same time preventing the drugs from being too greasy and obstructing qi activity.

4. Guide Drug - Licorice Root

Licorice Root tastes sweet, is neutral in nature, and belongs to the heart, lung, spleen, and stomach meridians. It has the effects of invigorating the spleen and replenishing qi, moistening the lung and relieving cough, and harmonizing all drugs. In Ganlu Yin, Licorice Root can not only harmonize the properties of other drugs, making them synergistic without conflicting with each other, but also tonify the spleen and stomach, enhance the transportation and transformation function of the spleen and stomach, making the whole prescription play a better role and guiding the medicinal power directly to the affected area.

III. Pathogenesis, Efficacy and Treatment

1. Pathogenesis Analysis

The pathogenesis targeted by Ganlu Yin is mainly yin deficiency and internal heat, accompanied by dampness-heat. When the body's yin fluid is deficient and internal heat is generated, symptoms such as dry mouth and throat, restlessness and fever may occur. At the same time, the transportation and transformation function of the spleen and stomach is abnormal, dampness pathogen is generated internally, and combines with heat pathogen to form the manifestation of dampness-heat. The accumulation of dampness-heat in the spleen, stomach, liver, and gallbladder can lead to symptoms such as sticky sensation in the mouth, bitter taste, and jaundice. In addition, yin deficiency and internal heat can also affect the functions of the lung and stomach, presenting manifestations such as cough and vomiting and nausea.

2. Efficacy

Based on the above pathogenesis, Ganlu Yin has the effects of nourishing yin, clearing heat, promoting diuresis, and resolving turbidity. By nourishing yin fluid, clearing internal heat in the body, and at the same time resolving dampness-heat pathogen, it achieves the purpose of balancing yin and yang in the human body and restoring the functions of zang-fu organs.

3. Treatable Diseases

Ganlu Yin is mainly used to treat the syndrome of damp-heat steaming upward in the stomach, insufficiency of lung yin, resulting in dry mouth and throat, hunger without desire to eat, dry lips and teeth, retching, poor appetite, or gum swelling and pain, mouth ulcers, red tongue with less coating, thready and rapid pulse, etc. Clinically, it is often used to treat various diseases caused by yin deficiency and damp-heat, such as stomatitis, pharyngitis, gastritis, hepatitis, etc. For some chronic diseases, such as diabetes, Sjogren's syndrome, etc., if there are symptoms of yin deficiency and damp-heat, Ganlu Yin can also be appropriately selected and modified for treatment based on syndrome differentiation and treatment.

IV. Analysis of Formula Principles

1. The Wonderful Method of Nourishing Yin and Clearing Heat

In the formula, raw rehmannia root and prepared rehmannia root are used as the monarch drugs, nourishing yin and blood, clearing heat and cooling blood, nourishing the yin of the liver and kidney, and suppressing the flaring up of deficient fire. Asparagus root and ophiopogon root assist the monarch drugs to nourish yin and moisten dryness, clear heat and reduce fire, and strengthen the power of nourishing yin and clearing heat. The combination of the monarch and ministerial drugs enables the deficiency of yin to be replenished and the deficiency heat to be cleared, fundamentally resolving the pathogenesis of internal heat due to yin deficiency.

2. Method of Promoting Diuresis and Removing Turbidity

Artemisia capillaris and scutellaria clear heat and promote diuresis, and fructus aurantii regulates qi and promotes qi movement, helping to promote the transportation and transformation of damp pathogens. Loquat leaf descends the qi of the lung and stomach, harmonizes the stomach and suppresses nausea, allowing the damp-heat pathogens to have an outlet. These drugs cooperate with each other to effectively clear the damp-heat pathogens in the body and improve various symptoms caused by the accumulation of damp-heat.

3. Function of Harmonizing Herbs

Licorice root serves as the adjuvant drug, harmonizing all the drugs, making the properties of the whole formula more mild, and synergistically playing the roles of nourishing yin and clearing heat, promoting diuresis and resolving turbidity. At the same time, licorice root can also tonify the spleen and stomach, enhance the transportation and transformation function of the spleen and stomach, and provide a good basis for the absorption and action of drugs.

V. Comparison with Other Similar Formulas

1. Comparison with Shashen Maidong Decoction

Sha Shen Mai Dong Tang mainly nourishes the yin of the lung and stomach, focusing on treating the syndrome of yin deficiency in the lung and stomach, manifested as dry cough with little sputum, dry throat and thirst, etc. Its drug composition is mainly composed of drugs that nourish yin and moisten dryness such as glehnia root, ophiopogon root, and polygonatum odoratum, and the compatibility is relatively simple. While Ganlu Yin on the basis of nourishing yin, also takes into account the role of clearing heat and promoting diuresis, and is applicable to diseases with yin deficiency complicated by damp-heat. The symptoms are more complex and diverse. There are not only manifestations of yin deficiency, but also symptoms of damp-heat accumulation, such as sticky mouth, bitter taste in the mouth, etc.

2. Comparison with Sanren Decoction

Sanjiren Decoction Its main effects are to promote qi movement, clear away dampness and heat. It is mainly used to treat the initial stage of damp-warm syndrome and the syndrome of dampness being more severe than heat in summer-warm syndrome complicated by dampness. Its drug composition mainly includes almonds, cardamom seeds, coix seeds, etc., which are drugs for dispersing and regulating qi in the middle-jiao, promoting diuresis and clearing heat, focusing on dispersing qi movement in the upper-jiao and promoting the elimination of damp-turbidity in the middle-jiao. Ganlu Decoction pays more attention to nourishing yin and clearing heat, promoting diuresis and resolving turbidity, and is applicable to diseases with yin deficiency as the root and damp-heat as the superficial manifestation. It has a stronger effect of nourishing yin, and takes into account the pathogenesis of yin deficiency while clearing heat and promoting diuresis.

VI. Clinical Applications and Indications

1. Oral Diseases

Ganlu Decoction It is often used to treat diseases such as stomatitis and oral ulcers. Because of its functions of nourishing yin and clearing heat, detoxifying and detumescence, it has good curative effects on symptoms such as oral ulcers and gum swelling and pain caused by hyperactivity of fire due to yin deficiency and the accumulation of heat-toxicity in the oral cavity. Patients often have manifestations of yin deficiency such as dry mouth and throat, and red tongue with little coating. After taking Ganlu Decoction, the symptoms can be relieved and the repair of oral mucosa can be promoted.

2. Digestive System Diseases

In digestive system diseases such as gastritis and gastric ulcer, if symptoms of damp-heat in the stomach and internal heat due to yin deficiency appear, such as dull pain in the epigastrium, dry mouth and bitter taste, and lack of appetite despite hunger, Ganlu Decoction can be used as an auxiliary treatment prescription. It can regulate the functions of the spleen and stomach, clear away damp-heat pathogens, nourish the stomach yin, and improve the uncomfortable symptoms in the stomach. For hepatitis patients, if manifestations of damp-heat accumulating in the liver and gallbladder with concurrent yin deficiency appear, such as distending pain in the hypochondrium, bitter taste in the mouth and dry throat, and yellow and greasy tongue coating, Ganlu Decoction can also be used with modifications based on syndrome differentiation and treatment, which helps to clear the liver and gallbladder, nourish yin and clear heat.

3. Respiratory System Diseases

For respiratory system diseases such as chronic pharyngitis and cough, if patients show symptoms of deficiency of lung yin with concurrent damp-heat, such as dryness and itching in the throat, less sputum in cough, and red tongue with little coating, Ganlu Decoction can play the role of nourishing yin and moistening the lung, clearing heat and resolving phlegm. By regulating the functions of the lung, it can improve respiratory symptoms and enhance the quality of life of patients.

VII. Modifications

1. Modifications for Oral Diseases

If the symptoms of stomatitis are severe and there is obvious local swelling and pain, honeysuckle, forsythia, dandelion and other heat-clearing and detoxifying drugs can be added to enhance the effects of clearing heat and detoxifying, detumescence and pain relief. If oral ulcers recur frequently and there is more severe hyperactivity of fire due to yin deficiency accompanied by restlessness and insomnia, coptis chinensis, gardenia and other heat-clearing and fire-purging drugs can be added, and sour jujube seed, semen platycladi and other drugs for nourishing the heart and tranquilizing the mind can also be added.

2. Modifications for Digestive Diseases

For gastritis patients, if there is obvious epigastric distending pain, costus root, magnolia officinalis and other qi-regulating and pain-relieving drugs can be added; if there is excessive gastric acid, cuttlefish bone, calcined spinulose tree fern and other acid-regulating and pain-relieving drugs can be added. For hepatitis patients, if jaundice is relatively deep, gardenia, rhubarb and other heat-clearing and dampness-promoting drugs for jaundice elimination can be added; if the pain in the hypochondrium is severe, Corydalis yanhusuo, toosendan fruit and other liver-soothing and qi-regulating drugs for pain relief can be added.

3. Modifications for Respiratory Diseases

For patients with chronic pharyngitis who have obvious foreign body sensation in the pharynx, Pinellia ternata and Magnolia officinalis can be added to resolve phlegm and soothe the throat; for those with severe cough, Fritillaria cirrhosa and Armeniaca vulgaris can be added to moisten the lungs and relieve cough. If accompanied by external symptoms such as fever and aversion to cold, exterior-resolving drugs can be appropriately added according to the specific situation, such as Schizonepeta tenuifolia and Saposhnikovia divaricata, but attention should be paid to avoiding excessive dispersion to prevent yin injury.

VIII. Dosage (Traditional and Modern Concentrated Granules)

1. Traditional Method

The traditional usage is to decoct the drugs in the prescription with water. Generally, an appropriate amount of water is used for each dose. Soak the drugs for about 30 minutes first, then bring to a boil with strong fire, and then change to gentle fire and decoct for 20 - 30 minutes to obtain the decoction. Repeat this decoction 2 - 3 times, mix the decoctions obtained each time evenly, and take it warm in 2 - 3 doses. The specific dosage of the drugs varies according to the condition and individual differences of the patient. Generally, Rehmannia glutinosa and Rehmannia glutinosa preparata are each 12g, Asparagus cochinchinensis and Ophiopogon japonicus are each 9g, Artemisia capillaris, Scutellaria baicalensis, Aurantii Fructus Immaturus, and Eriobotrya japonica are each 9g, and Glycyrrhiza uralensis is 6g.

2. Modern Concentrated Granules

Modern concentrated granules are granule preparations made from traditional Chinese medicines through processes such as extraction and concentration, which are convenient to take. Their dosage is generally adjusted according to the content of the drug and the instructions. For example, for a certain brand of concentrated granules of Ganlu Yin, each bag is equivalent to about 10g of the crude drug. Generally, take 1 - 2 bags each time, 2 - 3 times a day. When using modern concentrated granules, just take them with boiling water, without the need for decoction, saving time and energy and being convenient to carry.

IX. Precautions and Taboos

1. Dietary Taboos

During the period of taking Ganlu Yin, spicy, greasy, and stimulating foods such as chili peppers, fried foods, and coffee should be avoided. These foods are likely to generate heat and promote dampness, aggravating the pathogenic damp-heat in the body and affecting the therapeutic effect of the prescription. At the same time, alcohol should be avoided, as alcohol is hot in nature and will aggravate the symptoms of yin deficiency and internal heat.

2. Constitution Differences

Those with a constitution of deficiency-cold should use Ganlu Yin with caution. Since most of the drugs in the prescription are cold in nature, those with a constitution of deficiency-cold may experience symptoms such as discomfort in the epigastrium, abdominal pain, and diarrhea after taking it, damaging the yang qi of the spleen and stomach. Pregnant women should consult a doctor before using it, because some drugs in the prescription may have a certain impact on the fetus.

3. Drug Interactions

If taking other drugs, it should be informed to the doctor, because the drugs in Ganlu Yin may interact with certain drugs. For example, it is not suitable to take it simultaneously with drugs containing Veratrum nigrum to avoid adverse reactions.

X. Modern Research Progress

1. Pharmacological Research

Ganlu Yin originated from 'Taiping Huimin Heji Ju Fang - Yixue Zaicui', and it is a commonly used prescription for treating oral erosion, gingival erosion and bleeding, oral and tongue ulcers, gingival swelling and erosion, sometimes discharging purulent blood, bad breath, and sore throat, and is mainly used for treating symptoms such as ptosis of the eyelids, often wanting to close, being fond of eating but being emaciated. In the prescription, Rehmannia glutinosa, Rehmannia glutinosa preparata, Dendrobium officinale, Eriobotrya japonica, Aurantii Fructus Immaturus, Scutellaria baicalensis, and Glycyrrhiza uralensis, etc., clear heat and nourish yin, and are taken warm after decoction with water, having a good therapeutic effect on the syndrome of damp-heat in the upper jiao or yin deficiency with internal heat, and are often used with modifications clinically.

Modern pharmacological studies have shown that some drugs in Ganlu Yin have various pharmacological effects. Nourishing yin drugs such as Rehmannia glutinosa and Rehmannia glutinosa preparata can regulate the immune function of the body, enhance the resistance of the body, and at the same time have antioxidant and anti-aging effects. Drugs for clearing heat and promoting diuresis such as Artemisia capillaris and Scutellaria baicalensis have antibacterial, antiviral, and anti-inflammatory effects, can inhibit the growth and reproduction of various pathogens, and reduce the inflammatory response. Drugs for regulating qi and harmonizing the stomach such as Aurantii Fructus Immaturus and Eriobotrya japonica can promote gastrointestinal peristalsis, enhance digestive function, and improve gastrointestinal motility disorders.

2. Clinical Research

In recent years, clinical studies have also confirmed the effectiveness of Ganlu Yin in the treatment of various diseases. Some studies have shown that Ganlu Yin has certain curative effects in the treatment of autoimmune diseases such as oral lichen planus and Sjogren's syndrome, can improve the clinical symptoms of patients, and regulate immune indexes. In the treatment of digestive system diseases, Ganlu Yin can relieve the symptoms of diseases such as chronic gastritis and peptic ulcer, and promote the repair of gastric mucosa. These studies provide more scientific basis for the clinical application of Ganlu Yin and also lay a foundation for the further development and utilization of this prescription.