Author: Zhang Zhong-Jing, 張仲景
Year: c. 220
Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)
Category: Formulas that Dispel Phlegm
Pattern: Clumping of Phlegm and Heat in the chest
Key Symptoms: Focal distention (with or without nodules) in the chest, flanks and epigastrium that is painful when pressed
Secondary Symptoms: Expectoration of yellow and viscous sputum, chest pain on coughing, nausea, vomiting, bitter taste, constipation
Tongue: White, gray or yellow greasy coating
Pulse: Slippery and rapid, or slippery and floating
Abdomen: Fullness and distention in epigastric area with tenderness on pressure
Ingredients
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Gua Lou
| 15-30g | |
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Pinyin: Gua Lou
Chinese: 瓜蒌
Pharmaceutical: Fructus Trichosanthis
English: Snakegourd Fruit |
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Tastes: Sweet, lightly bitter, cold
Meridians Entered: Lung, Stomach and Large Intestine |
Actions & Indications:
- Clears Lung Heat and transforms Hot Phlegm
Phlegm-Heat cough with thick, difficult-to-expectorate Phlegm
It can be used as a stand alone herb, especially for children
- Regulates Qi (unbinds the chest)
Qi accumulation in the chest with a stifling or distended sensation in the chest, constriction and pain or pressure in the diaphragm
- Reduces abscesses, dissipates nodules and eliminates pus
Lung, intestinal or breast abscesses
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Standard Dosage: 10-20g in decoction.
Cautions: It is prohibited for loose stool due to spleen deficiency because of its sweet, cold and slick property. Contraindicated to Wu Tou. |
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Huang Lian
| 6-9g | |
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Pinyin: Huang Lian
Chinese: 黄连
Pharmaceutical: Rhizoma Coptidis
Taxonomy: Coptidis chinensis
English: Coptis Rhizome / Goldthread Rhizome |
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Tastes: Bitter, cold
Meridians Entered: Heart, Stomach, Large Intestine and Liver |
Actions & Indications:
- Clears Heat and drains Dampness
Damp-Heat in the Stomach or Intestines with diarrhoea or dysenteric disorder
Stomach Heat with vomiting and/or acid regurgitation
- Drains Fire and resolves Fire toxicity
Heat with Blazing Fire (Toxic Heat) with high fever. irritability, disorientation, delirium, a red tongue and a rapid, full pulse
Heat from Excess with toxicity: painful, red eyes and a sore throat
Boils, carbuncles and abscesses (Chuang Yung)
- Clears Heat and stops bleeding
Blood Heat with epistaxis, hematuria, hemafecia and hemoptysis
- Clears Heat topically
Infected wounds, red and painful eyes, ulcerations of the tongue and mouth (topical)
- Clears Heart Fire (sedative)
Heart Fire
Lack of communication between the Heart and Kidneys
- Drains Stomach Fire
Stomach Fire
- Aids fasting
Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, improve memory. This may suggest it was part of supplementing the diet when engaging in an "avoiding grain" (Bigu 辟穀) fasting regime to cultivate life (Yangsheng 養生).
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Standard Dosage: 2-10g in decoction.
Cautions: It is contraindicated for deficiency-cold syndrome. Because its taste is extremly bitter and dryness, overdosage and long-time taking will impair spleen and stomach, yin and fluids. |
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Zhi Ban Xia
| 12-15g | | |
Pinyin: Ban Xia
Chinese: 半夏
Pharmaceutical: Rhizoma Pinelliae
Taxonomy: Pinellia ternata
English: Pinellia Rhizome |
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Tastes: Pungent, warm, toxic
Meridians Entered: Lung, Spleen and Stomach |
Actions & Indications:
- Dries Dampness and transforms Phlegm
Cold-Phlegm in the Lungs (cough with copious sputum)
Especially effective for Damp-Phlegm of the Spleen (Cold-Damp Stagnation)
- Descends Rebellious Qi and stops vomiting (harmonizes the Stomach)
Vomiting due to Phlegm-Damp in the Stomach (Tan Yin), Cold thin mucus, Stomach Deficiency, Stomach Heat or pregnancy
- Dissipates nodules and reduces Stagnation (clumps)
Phlegm in the chest (nodules, pressure, distention, pain)
Phlegm nodules in the neck (goiter, scrofula)
Focal distension in the chest and epigastrium
Obstruction caused by Phlegm anywhere in the body
- Treats sores, skin ulcerations and carbuncles and reduces swelling (external)
Topically as a powder for sores, skin ulcerations and carbuncles
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Standard Dosage: 3-10g in decoction.
Cautions: Contraindicated to Wu Tou. Use with cautions during gestation.
Must be processed before use as raw Ban Xia is toxic. Ingesting the raw form can cause severe irritation of the mouth, pharynx, and gastrointestinal tracts, and has toxic effects on the nervous system. Symptoms of toxicity include a dry mouth, numbness of the tongue, gastric discomfort, burning sensations and swelling of the mouth, tongue, throat and salivation. In serious cases ingesting Ban Xia can result in hoarseness, spasms, dyspnoea and asphyxia.
Processing can be done with ginger and alum (Jiang Ban Xia) to make a warming herb best suited for Cold-Damp and thin Phlegm conditions, or with liquorice (Fa Ban Xia) to make a more neutral herb that is less drying and can be used for Damp-Heat conditions too. |
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Preparation: Decoction.
Actions: Clears Heat, transforms Phlegm, expands the chest, dissipates clumping
Contraindications: Pronounced Spleen deficiency
Notes:
One liang is taken as 3g in modern sources but in Eastern Han times it was equivalent to 13.875g. This means that the dosages in classical formulae could have been more than 4x what is given today making them far higher than recommended safe dosages today but prompts consideration of what an effective dose may be (He, 2013).
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.