Author: Tai Yi Ju (Imperial Medical Bureau), 太醫局
Year: 1107
Source: Formulary of the Pharmacy Service for Benefiting the People of the Taiping Era (Tai Ping Hui Min He Ji Ju Fang, 太平惠民和劑局方)
Category: Formulas that Dispel Phlegm
Pattern: Damp-Phlegm from Spleen Deficiency, Fox-like Bulging disorders of the Ren Mai
Key Symptoms: Focal distention, nausea or vomiting
Secondary Symptoms: Cough with copious white sputum that is easy to expectorate, stifling sensation in the chest and diaphragm, palpitations, dizziness, heaviness of the limbs
Tongue: White, greasy coating
Pulse: Slippery
Abdomen: Discomfort in epigastrium, splashing sounds in upper abdomen
Ingredients
|
Zhi Ban Xia
| 10g | |
|
Pinyin: Ban Xia
Chinese: 半夏
Pharmaceutical: Rhizoma Pinelliae
Taxonomy: Pinellia ternata
English: Pinellia Rhizome |
|
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
|
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. |
|
|
Ju Hong
| 10g | |
|
Pinyin: Ju Hong
Chinese: 橘红
Pharmaceutical: Exocarpium Citri Rubrum
English: Outermost Red Tangerine Peel |
|
Tastes: Pungent, bitter, warm
Meridians Entered: Lung and Spleen |
Actions & Indications:
- Regulates Qi, adjusts the Middle and relieves the diaphragm
Spleen/Stomach Qi Stagnation with epigastric or abdominal distention, fullness, bloating, belching, nausea and vomiting
- Dries Dampness and transforms Phlegm
Phlegm-Damp Obstructs the Lung with coughing, a stifling sensation in the chest and/or diaphragm and copious, viscous sputum
Turbid Damp Obstructs the Middle with a stifling sensation in the chest, abdominal distention, anorexia, fatigue, loose stools and a thick, greasy tongue coat
- Helps prevent Stagnation from tonic herbs
Tonic herbs causing Stagnation
- Descends Qi
Qi Rebellion
|
Standard Dosage: 3-9g in decoction.
Cautions: It is contraindicated for yin deficiency with dry cough and qi deficiency. |
|
|
Fu Ling
| 6g | |
|
Pinyin: Fu Ling
Chinese: 茯苓
Pharmaceutical: Poria
Taxonomy: Poria cocos syn. Wolfiporia extensa
English: China-Root / Hoelen / Tuckahoe / Indian Bread |
|
Tastes: Sweet, bland, neutral
Meridians Entered: Heart, Spleen, and Kidney |
Actions & Indications:
- Strengthens the Spleen and harmonizes the Middle Jiao
Spleen Deficiency Dampness with anorexia, diarrhoea and epigastric distention
- Strengthens the Spleen
Phlegm Dampness due to Spleen Deficiency with thin mucus in which Phlegm moves upward manifesting as palpitations, headache, dizziness and a thick, greasy tongue coat
- Promotes urination and leaches out Dampness
Urinary difficulty, diarrhoea or oedema due to Stagnation of Fluids or Dampness
- Quiets the Heart, calms the Spirit and soothes the nerves
Palpitations, insomnia or forgetfulness due to either Spleen and Heart Insufficiency or Internal Obstruction of Turbid Phlegm
- Aids fasting
Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, quiet the Hun, nourish the Shen, make one free from hunger and prolong life. 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).
|
Standard Dosage: 9-15g in decoction.
Cautions: It is contraindicated for spermatorrhea due to deficiency-cold. |
|
|
Zhi Gan Cao
| 3g | | |
Pinyin: Gan Cao
Chinese: 甘草
Pharmaceutical: Radix Glycyrrhizae
Taxonomy: Glycyrrhiza uralensis seu glabra seu inflata
English: Liquorice Root |
|
Tastes: Sweet, slightly cold
Meridians Entered: Heart, Lung and Spleen (and all 12 meridians) |
Actions & Indications:
- Tonifies the Spleen and augments Qi
Spleen Qi Deficiency with shortness of breath, lassitude and loose stools
Qi and Blood Deficiency with an irregular pulse and/or palpitations
Heart Qi Deficiency or Heart Yang Deficiency
- Moistens the Lungs, resolves Phlegm and stops coughing
Lung Heat or Cold
Productive or non-productive coughing
- Moderates spasms and alleviates pain
Painful muscle spasms of the abdomen and legs
- Clears Heat and relieves Fire Toxicity
Raw for Toxic Heat with sore throat or carbuncles and sores (Chuang Yung)
- Antidote for many toxic substances (internal and topical)
Poisoning
Bites (after washing the wound, chew Gan Cao and apply a thick layer on the bite wound, changing whenever it dries out; Bao Xiang-Ao, 1846, New Compilation of Proven Formulas)
- Moderates and harmonizes the harsh properties of other herbs and guides the herbs to all twelve channels
Often added in small doses to harmonise formulas
- Tonifies the Qi while suppressing Parasites
Gu Sydnrome (Fruehauf, 1998)
Chronic inflammatory disease (Fruehauf, 2015)
- Aids fasting
Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, make the body light and prolong life. 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).
|
Standard Dosage: Typically 1.5-9g in decoction. Large doses can be up 30g.
Cautions: It is contraindicated for combining with Hai Zao, Da Ji, Gan Sui and Yuan Hua because of "eighteen antagonisms". It is also contraindicated in cases of dampness obstruction in middle energizer and edema because it can help dampness obstruct qi, and it is prohibited from long-term usage in large dosage (more than 20g/day) and should be avoided or used with extreme caution in patients with high blood pressure because it may raise aldosterone levels in the blood causing retention of sodium.
The NHS recommends avoiding during pregnancy. |
|
Subsitutions:
Original source included Sheng Jiang and Wu Mei. These are often omitted today and Ju Hong may be replaced with Chen Pi.
Preparation: Decoction.
Actions: Dries Dampness, transforms Phlegm, regulates the Qi, harmonises the Middle Burner
Contraindications: Cough associated with Yin deficiency. Improper use can result in excessive thirst and dry throat.
Notes:
Extraordinary Vessel attributions come from Li Shi-Zhen's (1577-8) Exposition on the Eight Extraordinary Vessels (Qi Jing Ba Mai Kao), trans. Chace & Shima (2009). This formula is given by Shen Jin-Ao in the commentary.
---------------------------------------
Similar to other fundamental formulas, this is the basis for a number of other Phlegm-related formulas including:
Liu Jun Zi Tang: Add Ren Shen and Bai Zhu to combine with Si Jun Zi Tang for Spleen Qi Deficiency accompanied by Phlegm.
Fu Ling Wan: Remove Ju Hong and add Gan Jiang, Ren Shen and Bai Zhu, to combine with Li Zhong Wan to treat Cold thin mucus due to Spleen Yang Deficiency.
Wen Dan Tang: Add Zhu Ru and Zhi Shi for Phlegm-Heat obstructing the Qi dynamic and disturbing the Shen. Huang Lian can also be added for Phlegm-Fire.
Jia Wei Er Chen Tang: Add Huang Lian, Huang Qin and Bo He for Phlegm-Fire causing incessant tinnitus and deafness.
Zhu Li Da Tan Wan: Add Ren Shen, Bai Zhu, Huang Qin, Da Huang, Chen Xiang and Meng Shi for Dian Kuang due to chronic and stubborn Phlegm-Heat in a person with a weak constitution.
Ban Xia Bai Zhu Tian Ma Tang: Add Tian Ma and Bai Zhu for Wind-Phlegm causing severe dizziness or headaches.
Dao Tan Tang: Add Tian Nan Xing and Zhi Shi for Phlegm Inversion causing fainting.
Di Tan Tang: Add Tian Nan Xing, Shi Chang Pu, Zhu Ru, Ren Shen and Zhi Shi for Phlegm obstructing the orifices of the Heart and Collaterals of the tongue due to Wind-Stroke.
Fu Ling Wan: Change Ju Hong for Zhi Ke, add Mang Xiao, and remove Zhi Gan Cao to treat Phlegm in the Middle Jiao overflowing into the Channels and Collaterals causing pain and immobility the arms.
Er Zhu Tang: Add Cang Zhu, Bai Zhu, Huang Qin, Tian Nan Xing, Xiang Fu, Wei Ling Xian and Qiang Huo for pain in the upper arm due to Phlegm-Dampness in the Upper Jiao that enters the Channels and Collaterals.
Qing Shi Hua Tan Wan: Add Cang Zhu, Tian Nan Xing, Huang Qin, Qiang Huo, Bai Jie Zi, Bai Zhi and Gan Jiang for joint dysfunction due to Phlegm-Dampness in the Channels.
Jiang Qi Hua Tan Tang: Add Zi Su Zi, Qian Hu, Sang Bai Pi, Xing Ren and Jie Geng for cough and wheezing due to phlegm obstructing the Lungs.
Jiang Shen Su Yin: Change Chen Pi for Zhi Ke and add Zi Su Ye, Ren Shen, Ge Gen, Qian Hu, Mu Xiang and Jie Geng for Wind-Cold with thin mucus and a weak constitution.
Qing Qi Hua Tan Wan: Add Dan Nan Xing, Gua Lou Ren, Huang Qin, Xing Ren and Zhi Shi for stubborn productive cough due to Internal Clumping of Phlegm-Heat.
---------------------------------------
Ploberger (2017), in Westliche und traditionell chinesische Heilkräuter, offers the following alternative using western herbs:
| Pericarpium Citri ret. | (Orange peel) | 9g | (Emperor) |
| Radix Angelicae archangelicae | (Angelica) | 4g | (Minister) |
| Herba Thymi | (Thyme) | 3g | (Minister) |
| Radix Glycyrrhizae | (Licorice root) | 2g | (Assistant) |
| Rhizoma Zingiberis recens | (Fresh Ginger) | 2g | (Envoy) |
| Herba Menthae | (Peppermint) | 3g | (Minister) |
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.