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It is the medicinal conducting the main therapeutic effect on the main disease or the main syndrome. The chief medicinal in a formula usually is characterized by the following features. Firstly, the number of the chief medicinals usually is small, there is only one or two in a formula. In some large formulas, the number of the chief medicinals can be greater, but it is still in direct proportion to the deputy, assistant, envoy medicinals.
Secondly, the chief medicinal is usually used in a large dosages, that is to say, the dosage of a chief medicinal is large relative to the dosage in its usual application.
Thirdly, the effect of the chief medicinal is relatively forceful, that refers to selecting the stronger medicinal as the chief in the medicinals of the same category.
For example, má huáng (Herba Ephedrae)in Má Huáng Tāng (Ephedra Decoction)and Dà Qīng Lóng Tāng (Major Green-Blue Dragon Decoction, 大青龙汤), recorded in the Discussion on Cold Damage , possesses the significant characteristics of being the chief medicinal in regard to the amount, the dosage and the medicinal effect. Certainly, because medicinals have different characteristics, and diseases have different syndromes of deficiency or excess, cold or heat, or the combination of them, when analyzing the chief medicinal in a formula, it is necessary to analyze the individual formula, but not always adhere to the above principles.
This is the ingredient which aids the chief medicinal in treating the main disease or main syndrome. Aside from having an amount which is relatively larger than that of the chief medicinal, the deputy medicinal also has a relatively smaller dosage and weaker action than that of the chief medicinal. What should be noted is that when the deputy medicinal aids the chief medicinal, it is mostly in the form of mutual promotion in combination with congeneric medicinals, but according to the specific disease, medicinals with different functions from that of the chief medicinal may also be selected. In the former, it may aim to compensate for the chief medicinal’s insufficiency in its curative action, such as with guì zhī (Ramulus Cinnamomi)in Má Huáng Tāng (Ephedra Decoction);in the latter, it may aim to give attention to the complexity of the disease, such as with huáng qín (黄芩, Radix Scutellariae) in Xiăo Chái Hú Tāng (Minor Bupleurum Decoction, 小柴胡汤). Therefore, in analyzing the deputy medicinal, it is necessary to focus on the characteristic of actions and the requirements of combination, and not be restricted by the amount, dosage, action or other aspects of the medicinal.
This is the ingredient used for strengthening the curative actions of the chief and deputy medicinals, and for restricting their toxicity and overly harsh properties or for preventing repulsion between yin and yang in cases of great severity in disease and pathogens. Medicinals that are combined with the chief and deputy medicinals to strengthen their curative actions or to directly treat the secondary symptoms, are called “assistant aids”. An example of this type of assistant medicinal is xìng rén (杏仁, Semen Armeniacae Amarum) in Má Huáng Tāng (Ephedra Decoction), “ with its function of dispersing wind and cold, as well as with the effect of descending qi to remove asthma ”(既有发散风寒之能，复有下气除喘之功)( Seeking Accuracy in the Materia Medica , Bĕn Căo Qiú Zhēn , 本草求真). Medicinals used for eliminating or weakening the toxicity of the chief and the deputy medicinal, and for restricting their drastic properties are called“assistants for restricting toxicity. ” An example is dà zăo (Fructus Jujubae) in Shí Zăo Tāng (Ten Jujubes Decoction), which can benefit qi and protect the stomach, and is used in the formula for drastically purging and eliminating fluids and exerts the effects of an assistant medicinal that restricts. According to the demands of the disease, combining the chief and the deputy medicinals with medicinals of contrary actions but which can complement each other in the treatment, is called using a “contrary assistant”. An example is with Bái Tōng Jiā Zhū Dăn Zhī Tāng’s (Scallion Yang-Freeing Decoction Plus Pig’s Bile, 白通加猪胆汁汤) zhū dăn zhī (猪胆汁, Pulvis Fellis Suis) with its bitter flavor and cold property, and rén niào (人尿, Hominis Urina) with its salty flavor and cold property, which were added to medicinals in large dosage for restoring yang to rescue collapse, “ leading the warmth of gān jiāng ( Rhizoma Zingiberis ) and fù zĭ ( Radix Aconiti Lateralis Praeparata ) into the cold caused by repulsion between yin and yang in order to regulate the counter-flow syndrome ”(引姜、附之温入格拒之寒而调其逆), this embodies the ingenious action of opposing each other but also complementing each other. The meaning and purpose of the assistant medicinal are relatively complex, and have important significance in the combination of formulas, so analysis of the assistant medicinals should be made according to their compatible characteristics for differentiation.
This is the ingredient with the function of leading medicinals into channels and collaterals and moderating. This medicinal guide can lead other medicinals directly to the affected parts and hence bring forth greater curative actions. For example, Fù Yuán Huó Xuè Tāng (Origin-Restorative Blood-Quickening Decoction, 复元活血汤), recorded in the Inventions in Medical Studies ( Yī Xué Fā Míng , 医学发明), is mainly used for treating blood stasis in the chest and hypochondrium, and as one branch of the liver channel runs through the chest and the hypochondrium, thus as a formula for invigorating blood and transforming stasis, it is combined with “ chái hú (柴胡, Radix Bupleuri), which especially enters the liver and the gallbladder, to diffuse the channels of qi, and promote the flow of stasis” ( Convenient Reader of Established Formulas , Chéng Fāng Biàn Dú , 成方便读), and therefore has distinct direction and selectivity. Moderating means to moderate the actions of many medicinals in a formula, such as with gān căo (Radix et Rhizoma Glycyrrhizae), on which Li Gao made the following commentary: “ its property can relieve acute symptoms and harmonize the actions of other herbs, and make them not too drastic. So when it is combined with a medicinal with a hot property, it moderates its hot property; when it is combined with a medicinal with a cold property, it moderates its cold property, and when it is combined with medicinals with both cold and hot properties, it helps to reach an even property. ”(其性能缓急，而又协和诸药，使之不争，故热药得之缓其热，寒药得之缓其寒，寒热相杂者用之得其平) cited from Grand Materia Medica . So in most formulas combined with gān căo (Radix et Rhizoma Glycyrrhizae) to harmonize the actions of other medicinals, this is the aim. Some experimental research has shown that the envoy medicinal has distinct selective actions on the organs and tissues in the human body, and can strengthen the curative actions of the whole formula. It explains that the envoy medicinal has some pharmacological basis in formulating a prescription.
Of the above, the chief medicinal is the main body in a formula, and the deputy, assistant and envoy medicinals usually surround the chief medicinal to synergize and strengthen its action, hence achieving the overall curative effect. Of these medicinals, the deputy medicinal and the chief medicinal mainly embody the compatible method of “supplementing each other”; the assistant medicinal and the chief medicinal mainly reflect the compatible method of coordination or “opposing yet complementing each other”; the action of the envoy medicinal on the chief and deputy medicinals is to strengthen the selectivity of the formula, or to regulate the properties and flavors of other medicinals. What should be noted is that some medicinals often combine many kinds of actions at the same time. For example, if the chief medicinal combines the action of leading other medicinals into channels and collaterals, the envoy medicinal may be omitted; if the chief medicinal has strong actions and conspicuous effects with comprehensive functions, the deputy medicinal may also be omitted; if the chief and deputy medicinals are non-toxic, or with bland properties, or are used for a relatively mild disease, then the assistant medicinal may be omitted, and so on. So in a formula, aside from the chief medicinal, all of the other medicinals, including the deputy, assistant or envoy medicinals possibly may not be used. As for the scale of a formula, we should aim to use relatively few but effective medicinals, or many medicinals but in an organized fashion.