Author: Wu Tang / Wu Ju Tong, 吴瑭 / 吴鞠通
Year: 1798
Source: Systematic Differentiation of Warm Pathogen Diseases (Wen Bing Tiao Bian, 溫病條辨)
Category: Formulas that Drain Downward
Pattern: Yangming Warm Pathogen disorder with Heat clumping the intestines and Phlegm-Heat clogging the Lungs
Key Symptoms: Afternoon tidal fever, constipation, acute wheezing, a stifling sensation in the chest, overabundance of sputum and oral mucus
Tongue: Thick, greasy, yellow coating
Pulse: Submerged, slippery and rapid
Ingredients
Shi Gao
| 15g | |
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Pinyin: Shi Gao
Chinese: 石膏
Pharmaceutical: Gypsum Fibrosum / Calcium Sulphate
Taxonomy: CaSO4
English: Gypsum / Plaster of Paris
| |
Tastes: Pungent and sweet
Meridians Entered: Lung and Stomach
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Actions & Indications:
- Clears Heat in the Qi Stage, drains Fire, relieves irritability and quenches thirst
Heat in the Qi Stage or Yangming Heat with high fever, no chills, irritability, intense thirst, profuse sweating, restlessness, encephalitis, a flooding, big pulse and a red tongue with a yellow coat
- Clears Excess Heat from the Lungs
Lung Heat with cough, wheezing, fever and a thick viscous sputum
- Clears Blazing Stomach Fire
Stomach Fire with headache, toothache or swollen gums
- Heals eczema, burns and ulcerated sores and wounds
Sores and wounds (topically or internally)
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Standard Dosage: 15-60g in decoction.
Cautions: The high mineral content of this medication may prevent the oral absorption of the fluoroquinolone class of antibiotics.
Mineral products are prohibited from use in the UK under the Medicines Act 1968 ch. 67 which restricts herbalists to the use of plant products only. It can sometimes be replaced with Zhi Mu and Mu Dan Pi bit its action difficult to substitute in many cases. The patient may have to rely on OTC mineral based antacids from the pharmacy such as sodium bicarbonate and calcium carbonate which have a similar effect of binding and neutralising the stomach acid, then using herbal medicines as an adjunctive treatment. |
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Da Huang
| 9g | |
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Pinyin: Da Huang
Chinese: 大黄
Pharmaceutical: Radix et Rhizoma Rhei
Taxonomy: Rheum palmatum
English: Chinese Rhubarb Root
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Tastes: Bitter, cold
Meridians Entered: Large Intestine, Spleen, Stomach, Liver and Heart
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Actions & Indications:
- Drains Heat and purges accumulations
Intestinal Heat Excess, with high fever, profuse sweating, thirst, constipation, abdominal distention and pain, delirium, a yellow tongue coat and a full pulse
Yang-Ming Fu Stage
Qi Level Heat in the Intestines
- Drains Fire
Fire from Excess with intense fever, sore throat, and painful eyes and constipation
Fire toxin sores due to Xue Level Heat, especially with constipation
- Clears Heat, transforms Dampness and promotes urination
Damp-Heat with oedema, jaundice, painful urinary dysfunction and acute, hot dysenteric disorders
- Drains Heat from the Blood
Bloody stool either from hemorrhoids or Heat in the Intestines
Chaotic movement of hot Blood with hemoptysis or epistaxis with constipation
It can be powdered and administered orally for bleeding in the upper digestive tract
- Invigorates the Blood and dispels Blood Stasis
Blood Stasis with amenorrhea, fixed abdominal masses or fixed pain
Blood Stasis due to traumatic injury
Intestinal abscess
- Clears Heat and reduces Fire toxicity
Topically or internally for burns or skin lesions (Chuang Yung) due to Heat
- Clears Heat and eliminates Phlegm
Chronic Accumulation of Phlegm-Heat with cough, dyspnea, mania, disorientation and other symptoms of Phlegm Misting the Heart
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Standard Dosage: 10-15g in decoction. Excessive decoction will reduce the purgative action. Therefore it should be added at end to achieve this purpose and over-decocted to eliminate this action.
Cautions: It should be used with caution in case of spleen and stomach deficiency for its bitter and cold property which is easily to damage stomach qi. It is contraindicated to women during pregnancy, menstruation or lactation for it has actions of activating blood and resolving stasis, and can make the purged substances follow lactating out. |
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Xing Ren
| 6g | |
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Pinyin: Xing Ren
Chinese: 杏仁
Pharmaceutical: Semen armeniacae
Taxonomy: Prunus armeniaca seu mandshurica seu sibirica
English: Bitter Apricot Kernel
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Tastes: Bitter, slightly warm, slightly toxic
Meridians Entered: Lung and Large Intestine
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Actions & Indications:
- Stops coughing and calms wheezing
Coughs due to either Heat or Cold (depending on combination) Wind-Dry coughs (especially useful)
- Moistens the Intestines and unblocks the bowels
Constipation
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Standard Dosage: 3-10g in decoction.
Cautions: It should not be overused for its slight toxicity. It should be used with cautions for infants and patients with diarrhea. |
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Gua Lou Pi
| 5g | | |
Pinyin: Gua Lou Pi
Chinese: 瓜蒌皮
Pharmaceutical: Pericarpium Trichosanthis
English: Snakegourd Fruit Peel
| |
Tastes: Sweet, cold
Meridians Entered: Lung and Stomach
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Actions & Indications:
- Clears the Lungs and transforms Hot Phlegm
Phlegm-Heat in the chest Dry cough with difficult-to-expectorate sputum and dry throat due to Wind-Heat
- Regulates Qi and expands chest
Qi accumulation in the chest Chest BiEarly stages of breast abscess
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Standard Dosage: 9-12g in decoction.
Cautions: It is contraindicated in case of damp phlegm due to spleen deficiency. It is contraindicated for combining with Wu Tou. |
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Subsitutions:
In the UK Shi Gao must be substituted. Zhi Mu may make a suitable substitute in this instance.
Preparation: Decocted in 5 cups of water until 2 remain. The patient drinks 1 cup and the second only if the bowels do not move after the first.
Actions: Drains clumped Heat downwards, disseminates the Lung Qi, transforms Phlegm
Research Links:
Reference Notes: (click to display)
Most formulas are found in Scheid, Bensky, Ellis & Barolet (2009): Chinese Herbal Medicine: Formulas & Strategies and Chen & Chen (2015) Chinese Herbal Formulas and Applications. Others are from translations of primary sources. It is recommended that the original material is cross-referenced for mistakes and additional information.
Substitutions have been taken from Ken Lloyd & Prof. Leung (2004): Mayway UK Substitution List or the above publications and are intended as suggestions to help navigate the tight restrictions in the UK quickly. More applicable substitutions may be appropriate in specific situations.
Individual herb information has initially been sourced from TCM Wiki and American Dragon for basic data and then updated manually with my own notes.
These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.