This is a modern formulation that may reduce blood pressure. The selection of herbs in this particular formula combines both TCM and Western principles of treatment. Thus, there are herbs that extinguish Interior Wind, clear Heat, nourish the Liver and Kidney Yin and reduce Yang hyperactivity. In addition, the herbal combinations are chosen according to a demonstrated hypotensive action in clinical or animal studies.

Generally, patients with hypertension are already taking antihypertensive medication, which tends to make their symptomatology less apparent. Therefore, differential diagnosis is not always clear cut and one needs to rely mainly on the pulse and tongue. This difficulty is further compounded by the fact that the major presenting syndromes in patients with hypertension exist on a continuum. A patient may start out with Liver Fire ‐ a pure excess syndrome; subsequently, the Fire consumes the Yin, leading to Liver and Kidney Yin deficiency with Yang hyperactivity; this may give way to a more severe Yin deficiency with deficiency Fire; and this may in turn lead to deficiency of both the Yin and Yang, also with deficiency Fire.

Therefore a careful appraisal of patients with hypertension is warranted, so that the following syndromes can be clearly differentiated: Liver Fire vs. Liver Yang hyperactivity due to Liver and Kidney Yin deficiency. These are both characterised by marked features of excess. However, the latter also has some signs of deficiency, i.e. thready pulse and scanty tongue coat.

This formula is fairly ‘middle of the road’ in terms of its actions. Thus it is suitable for cases with both Liver and Kidney Yin deficiency together with some degree of Liver Fire. The distinguishing clinical features are: scanty tongue coat, wiry-rapid but also thready pulse and possibly also soreness and weakness of the lower back and knees, night sweating, dry mouth and throat.

TCM ACTIONS
Nourishes the Liver Yin and the Kidney Yin, clears Liver Fire, calms the Liver and extinguishes Interior Wind.

TCM SYNDROMES

• Interior Wind due to hyperactivity of the Liver Yang and
• Liver Fire

INDICATIONS
Hypertension.

SIGNS & SYMPTOMS (Key clinical features in bold)

• Elevated blood pressure
• Headache
• Dizziness
• Tinnitus
• Dry mouth and throat
• Pain and weakness of the lower back and knees
• Night sweating
• Tongue is red with a scanty coat
• Wiry and thready pulse that may also be rapid