Class 4~7: Herbs and Formulas That Treat Phlegm

Xianhui Li

Herbs that Transform Phlegm

• • Herbs that cool and transform phlegm-heat – Bulbus fritillariae cirrhosae (Chuan bei mu) – Bulbus fritillariae thunbergii (Zhe bei mu) – Semen Trichosanthis (Gua lou ren) – Concretio bambusae (Tian zhu huang) – Caulis bambusae in taenis (Zhu ru) – Concha Meretricis (Hai ge ke) – Sargassum (Hai zao) Radix Peucedani (Qian hu) Fructus Trichosanthis (Gua lou) Radix Trichosanthis (Tian hua fen) Succus Bambusae in Taeniam (Zhu li) Pumice (Fu hai shi) Thallus Laminariae (Kun bu) Semen Sterculiae (Pang da hai) • Warm herbs that transform cold phlegm – *Rhizoma Pinelliae (Ban xia) Rhizoma Arisaematis (Tian nan xing) – Rhizoma Typhonii gigantei (Bai fu zi) Flos Inulae (Xuan fu hua) – Radix et Rhizoma Cynanchi (Bai qian) Semen Sinapsis seu Brassicae (Bai jie zi) – Rhizoma Arisaemae cum Felle Bovis (Dan nan xing) Herbs that relieve coughing and wheezing – *Radix Platycodi (Jie geng) Semen Armeniacae (Xing ren) – Radix Asteris (Zi wan) – Fructus Perillae (Su zi) Flos Farfarae Tussilago (Kuan dong hua) Folium Eriobotryae (Pi pa ye) – Radix Stemonae (Bai bu) Cortex Mori (Sang bai pi)

• • • • • • • • •

Bulbus fritillariae thunbergii (Zhe bei mu), Bulbus fritillariae cirrhosae (Chuan bei mu)

Taste and Property

: – Chuan Bei: Bitter, sweet and slightly cold, – Zhe Bei Mu: Bitter and cold

Meridian Tropism

:

Lung and heart Actions:

Dissolve phlegm to relieve cough, clear away heat and dissipate nodules

Applications

: Chronic cough due to lung deficiency with little phlegm and dry throat, cough due to invasion of exogenous pathogenic wind heat or cough with thick and yellow phlegm due to accumulation of both phlegm and fire Scrofula, carbuncles or acute mastitis: Both of them can clear heat and dissipate nodules but the Effect of Zhe Bei is stronger.

– Scrofula—often used with Xuan Shen and Mu Li, i.e. Xiao Luo Wan – Carbuncles or acute mastitis—Used with Pu Gong Ying, Tian Hua Fen and Lian Qiao – Lung abscess—Yu Xing Cao, Lu Gen, Yi Yi Ren.

Zhe Bei is also used to treat adenoma of the thyroid gland, often used with Xia Ku Cao, Hai Zao and Kun Bu.

Dosage:

3-10g

Attention

: Not incompatible with Wu Tou

Radix Peucedani (Qian hu)

• • • • •

Taste and Property

: Bitter, pungent, slightly cold

Meridian Tropism

: Lung meridian

Actions

: Lower rising of qi, dissolve phlegm, disperse wind heat

Applications

: – Cough, dyspnea with thick phlegm due to failure of lung qi to descend: Often used with Sang bai Pi, Bei Mu and Xing Ren, i.e. Qian hu San – Affection of exogenous wind heat: Especially cough caused by wind heat stagnating in the lung, often used with Bo he, Niu Bang Zi and Jie Geng

Dosage

: 6-10g

• • • • • •

Fructus Trichosanthis (Gua lou)

Taste and Property

: Sweet and cold

Meridian Tropism

: Lung, stomach and large intestine

Actions:

–

Gua Lou Pi:

Clear away heat from the lung and dissolve phlegm, benefit flow of qi and soothe flow of qi in the chest –

Gua Lou Ren

: Moisten the lung to dissolve phlegm, moisten the intestine to promote bowel movement –

Quan Gua Lou

: All the above functions

Applications:

– Cough with thick phlegm difficult to expectorate due to lung heat: Often used with Zhi Mu, Zhe Bei. For accumulation of phlegm heat in the lung marked by yellow and thick phlegm, chest stuffiness and constipation, Gua Lou Ren is often used with Huang Qin, Dan nan Xing and Zhi Shi, i.e. Qing Qi Hua Tan Wan – Chest Bi Syndrome, congealed chest and obstruction and pain in the chest and diaphragm —Gua Lou Xie Bai Ban Xia Tang, Xiao Xian Xiong Tang. This herb is specially used to treat coronary heart disease.

– Constipation due to intestinal dryness: Gua Lou Ren is used with Huo Ma Ren, Yu Li Ren and Zhi Ke – Acute mastitis: Used with Pu Gong Ying, Gua Lou, Ru Xiang and Mo Yao

Dosage

: Quan Gua Lou 10-20g, Gua Lou Pi 6-12g and Gua Lou Ren 10 15g

Attention

: incompatible with Wu Tou

Radix Trichosanthis (Tian hua fen)

• • • • • •

Taste and Property

: Pungent, bitter and slightly cold

Meridian Tropism

: Lung and stomach

Actions:

Clears away heat and promotes production of body fluid, subdues swelling and drains pus

Applications

– Impairment of body fluid in febrile diseases marked by dry mouth and tongue and severe thirst, often used together with Lu Gen, bai Mao Gen and Mai Dong. Polyphagia and severe thirst in diabetes, often used together with ge Gen, Wu Wei Zi and Zhi Mu, i.e. Yu Ye Tang.

– Lung heat marked by cough or dry cough with thick phlegm and hemoptysis, often used together with Bei Mu, Sang Bai Pi and Jie Geng, i.e. She Gan Dou Ling Tang.

– Carbuncles or sores due to exuberance of toxic heat marked by bright redness, swelling and pain, often used together with Jin Yin Hua, Bei Mu and Zao Jiao.

– Stop pregnancy at the middle stage

Dosage:

10-15g, decocted for oral use or made into powder and bills.

Attentions:

Spleen stomach deficiency marked by incontinence of stool

Concretio bambusae (Tian zhu huang)

• • • • •

Taste and Property

: Sweet, cold

Meridian Tropism

: GB, HT, LV

Actions:

Clears and transforms phlegm-heat, clears the heart and settles tremors and convulsions

Applications

– For phlegm-heat in the lungs with difficult-to expectorate sputum, used with ban xia – For such disorders as spasms and convulsions due to phlegm heat, wind-stroke with phlegm obstruction and gurgling sounds in the throat, and childhood convulsions, used with dan nan xing, bai jiang can, zhi zi, yu jing

Dosage:

3-9g in decoction, 0.6-1g taken straight.

• • • • • •

Succus Bambusae in Taeniam (Zhu li)

Taste and Property

: Sweet, cold

Meridian Tropism

: HT, LU, ST

Actions:

Clears heat, transforms phlegm, and penetrates to the channels; transforms phlegm-heat and stops cough

Application

– For phlegm obstructing the heart orifices, signs include fainting, paralysis of the hands or feet, or hemiplegia – For cough due to phlegm-heat, used with gua lou, pi pa ye

Dosage:

30-60g

Attentions:

cough due to cold or loose stools due to spleen deficiency

Caulis bambusae in taenis (Zhu ru)

• • • • •

Taste and Property

: Sweet, slightly cold

Meridian Tropism

: GB, LU, ST

Actions:

Clears and transforms phlegm-heat, clears heat and stops vomiting

Application

– For heat in the lungs with viscous sputum, stifling sensation in the chest, or coughing up blood, also for gallbladder fire harboring phlegm and phlegm-heat, used with zhi shi, ban xia, i.e. wen dan tang – For vomiting of bitter or sour matter due to heat in the stomach with bad breath, aversion to heat, and a yellow, greasy tongue, used with huang lian, chen pi together

Dosage:

4.5-9g

Pumice (Fu hai shi)

• • • • •

Taste and Property

: Salty, cold

Meridian Tropism

: LU

Actions:

Clears heat form the lungs and transforms heat; softens hardness and dissipates phlegm nodules; promotes urination

Application

– For heat accumulation in the lungs with sputum that is viscous and difficult to expectorate, or with coughing of blood, used with dan nan xing, chuan bei mu, bai jie zi – For scrofula and similar disorders caused by phlegm-fire, used with mu li hai zao, zhe bei mu – For hot or stony painful urinary dribbling, used with mu tong, hua shi, che qian zi

Dosage:

6-10g

Concha Meretricis (Hai ge ke)

• • • • •

Taste and Property

: bitter, salty, cold

Meridian Tropism

: LU, ST

Actions:

Clears heat and transforms phlegm; softens hardness and dissipates nodules; promotes urination and expels dampness, controls acidity and stops pain

Application

– For cough and wheezing due to phlegm-heat or constrained clumping of phlegm-fire, used with huang qin, gua lou, jie geng – For phlegm-fire goiter and scrofula, used with kun bu, hai zao – For turbid painful urinary dribbling, edema and vaginal discharge – For epigastric pain and acid regurgitation. Currently used for pain due to excess stomach acid as well as gastric and duodenal ulcers, used with hai piao xiao, yan hu suo, mu li, gan cao

Dosage:

6-15g

Thallus Laminariae (Kun bu)

• • • • •

Taste and Property

: Salty, cold

Meridian Tropism

: LV, ST, KI

Actions:

reduces phlegm and softens hardness; promotes urination and reduces swelling

Application

– For various kinds of nodules in the neck, such as scrofula or goiter, or a sensation of fullness and obstruction in the chest caused by phlegm, used with hai zao – Promote urination and reduces swelling, this action is weak, it is used as an adjunctive herb for edema

Dosage:

6-15g

Sargassum (Hai zao)

• • • • •

Taste and Property

: Bitter salty, cold

Meridian Tropism

: LV, ST, KI, LU

Actions:

reduces phlegm and softens hardness; promotes urination and reduces edema

Application

– For neck nodules, such as scrofula or goiter, aslo used for bulging disorders, especially those involving the scrotum and testicles, used with kun bu, zhe bei mu, i.e. hai zao yu hu tang – an adjunctive herb for edema

Dosage:

6-15g

Semen Sterculiae (Pang da hai)

• • • • •

Taste and Property

: Sweet, cold

Meridian Tropism

: LI, LU

Actions:

clears and disseminates lung qi; moistens the intestines and unblocks the bowels; encourages the expression of rashes

Application

– For sore throat, hoarseness, phlegm-heat cough, and constrained lung qi. Used along as a tea for hoarseness, used with chai tui, jie geng, bei mu – For mild to moderate constipation due to heat clumping in the intestines, often with concurrent headache, red eyes, and fever – Used adjunctively, as an external wash, for incomplete expression of rashes

Dosage:

2-3 pieces

• • • • • •

Ban Xia (Pinellia Rhizome)

Taste and Property:

Pungent, warm and toxic

Meridian Tropism

: Spleen, stomach and lung

Actions

: Dry dampness to dissolve phlegm, lower rising of the stomach qi to relieve vomiting and disperse stagnancy and dissipate nodules

Application:

– Much phlegm with cough and dyspnea due to accumulation of phlegm following failure of the spleen to transform water: This herb serves as an important herb for damp phlegm, often used with Chen Pi and Fu Ling, i.e. Er Chen Tang. For cold phlegm used with Xi Xin and Gan Jiang additionally, while for hot phlegm, used with Huang Qin, Zhi Mu and Gua Lou additionally.

– Nausea or vomiting due to rising of the stomach qi: Mainly used to treat vomiting due to retention of cold water, used with Sheng Jiang, I,e, Xiao ban Xia Tang • For vomiting due to stomach deficiency: Used with Ren Shen and Bai Mi • For vomiting due to stomach heat: Huang Lian and Zhu Ru • For morning sickness: Su Geng and Sha Ren – Obstructing feeling in the chest with vomiting due to interlocking of phlegm heat: Used with Huang Lian and Gua Lou, i.e. Xiao Xian Xiong Tang – Hystericus Globus: With Hou Po, Su Ye an Fu Ling: Ban Xia Hou Pu Tang – Goiter or scrofula: With Zhe Bei, Kun Bu and Hai Zao

Dosage

: 5-10g

Attentions

: Incompatible with Wu Tou, being warm and dry, this herb should be used with a great care for dry cough due to yin deficiency, bleeding and hot phlegm

• • • • •

Rhizoma Arisaematis (Tian nan xing)

Taste and Property

: Bitter, acrid, warm, toxic

Meridian Tropism

: LV, LU, SP

Actions:

dries dampness and expels phlegm; disperses wind phlegm and stops spasms; reduces swelling and alleviates pain

Application

– For cough and stifling and distended sensation in the chest due to stubborn phlegm, this herb is extremely drying in nature, used with zhi ban xia, chen pi, zhi shi, i.e. dao tan tang – For obstruction due to wind-phlegm, usually in the channels, with dizziness, vertigo, numbness in the limbs, facial paralysis, spasms in the hands or feet, stroke, seizures, used with fang feng, tian ma, bai zhi, i.e. yu zhen san – Used topically for such problems as deep-rooted sores, ulcer, and carbuncles. Also fro swelling due to traumatic injury and joint pain secondary to phlegm

Dosage:

3-9g

Rhizoma Arisaemae cum Felle Bovis (Dan nan xing)

• • • • •

Taste and Property

: Bitter, cool

Meridian Tropism

: LV, LU, SP

Actions:

transforms phlegm-heat, extinguishes wind, and stops tremors

Application

– For tremors, seizures, or stroke due to phlegm-heat, it is often used for childhood seizures due to phlegm-heat with niu huang, huang lian , tian ma, quan xie

Dosage:

3-6g

Rhizoma Typhonii gigantei (Bai fu zi)

• • • • • •

Taste and Property

: Pungent, sweet, warm and toxic

Meridian Tropism

: LV, SP, ST

Actions

: dry dampness to dissolve phlegm, disperse wind to relieve convulsion and detoxicate to dissipate nodules

Application

: – Wind phlegm, deviation of eyes and mouth, tetanus and migraine – Convulsion due to deviation of mouth and eyes: Used with Nan Xing, ban Xia, Tian ma and Fang Feng – Migraine: Used with Bai Zhi and Chuan Xiong – Snake bite or scrofula: External application of the raw herb

Dosage

: 3-5g

Attention

: Not suggested for pregnant woman. The raw one is not used orally.

Flos Inulae (Xuan fu hua)

• • • • • •

Taste and Property

: bitter, acrid, salty, slightly warm

Meridian Tropism

: LV, LU, ST, SP

Actions

: reduces phlegm and promotes the dissipation of pathogenic water, redirects the qi downward and stops vomiting

Application

: – For phlegm and fluids clogging up the lungs or problems due to accumulation of phlegm and thin mucus, used with ban xia, xi xin, i.e. jin fei san for cough and wheezing due to cold and phlegm attacking the lungs with exterior signs, used with jie geng, sang bai pi, huang qin for cough and wheezing due to phlegm-heat – For vomiting, hiccough, and belching, used with dai zhe shi, ren shen, i.e. xuan fu dai zhe tang

Dosage

: 3-9g

Attention

: Not suggested for dry cough due to yin deficiency

Radix et Rhizoma Cynanchi (Bai qian)

• • • • • •

Taste and Property

: acrid, sweet, salty, slightly warm

Meridian Tropism

: LU

Actions

: directs the qi downward, dispels phlegm, and stops cough

Application

: – For cough with copious sputum and gurgling in the throat. This is a very important herb for lung qi blockage and stagnation. It is used for disorders of excess with copious sputum that is difficult to expectorate, as well as wheezing, although slightly warm, it is not drying, used with jie geng, jing jie, i.e. zhi sou san

Dosage

: 3-9g

Attention

: Not suggested for unproductive cough associated with lung deficiency

• • • • • •

Semen Sinapsis seu Brassicae (Bai jie zi)

Taste and Property

: Pungent and warm

Meridian Tropism

: Lung

Actions

; Warm up the lung to dissolve phlegm, benefit flow of qi to dissipate nodules and promote flow of qi and blood in the collaterals to relieve pain

Applications

: – Cough and dyspnea with distending pain int he chest and hypochondrium due to accumulation of cold phlegm, often used with Su Zi and Lai Fu Zi, i.e. San Zi Yang Qin Tang for cough due to cold phlegm. For distending pain in the chest and hypochondrium due to retention of phlegm, used with Gan Sui and Da Ji, i.e Kong Xian Dan – Pain and numbness of the limbs due to stagnation of phlegm dampness in the meridians: Often used with Mo Yao, Gui Xin and Mu Xiang, i.e. Bai Jie Zi San – Subcutaneous swelling due to acumulation of phlegm dampness: Used with Lu Jiao Jiao, Rou Gui, Pao Jiang and Shu Di, i.e. yang He Tang

Dosage

: 3-10g

Attention

: This herb may cause blister when used externally, so not applicable for patients with skin allergy

Jie Geng (Platycodon Root)

• • • • •

Taste and property

: Bitter, pungent and neutral

Meridian tropism

: Lung

Actions

: Open the lung qi, dissolve phlegm and drain pus

Application

– Cough with much phlegm, difficult discharge of the phlegm obstructing feeling in the chest and diaphragm, sore throat and hoarseness. Cough with much phlegm due to wind cold: Used with Xing Ren, Su Ye and Chen Pi, i.e. Xing Su San. Cough with sore throat and hoarseness due to wind heat: Used with Sang ye, Ju Hua and Xing Ren, i.e. Sang Ju Yin. Chets distension due to stagnation of qi and obstruction of phlegm: Used with Zhi Ke and Gua Lou Pi – Lung abscess marked by chest pain, cough with pus and blood: This herb can drain pus when used with gan Cao, i.e. Jie Geng Tang. At present It is usually used with Yu Xing Cao, Yi Yi ren, etc.

Dosage

: 3-10g

Semen Armeniacae (Xing ren)

• • • • •

Taste and Property

: Bitter and slightly warm, slightly toxic

Meridian Tropism

: Lung and Large Intestine

Actions

: Relieve cough and asthma, moisten the intestine to promote bowel movement

Applications

: – Cough and asthma: This herb can treat different cough and asthma when used with different herbs • Cough due to wind heat: Used with Sang Ye and Ju Hua—Sang Ju Yin • Cough due to dry heat: Used with Sang Ye, Bei Mu and Sha Shen—Sang Xing Tang • Cough and asthma due to lung heat: Used with Ma Huang and Shi Gao—Ma Xing Shi Gan Tang – Constipation due to intestinal dryness: Often used with Huo Ma Ren, Dang Gui and Zhi Ke —Run Chang Wan

Dosage

: 3-10g. Because of its slight toxin, avoid using the herb at a large dosage

Radix Asteris (Zi wan)

• • • • •

Taste and Property

: Bitter and sweet, slightly warm

Meridian Tropism

: Lung

Actions

: Dissolve phlegm to relieve cough

Applications

: – Cough with much phlegm in wind cold exterior pattern: Use with Jing Jie, Bai Qian and Chen Pi – Chronic cough with blood in the sputum due to lung deficiency: Used with Zhi Mu, Chuan Bei and E Jiao, i.e. Zi Wan Tang

Dosage

: 5-10g

Flos Farfarae Tussilago (Kuan dong hua)

• • • • •

Taste and Property

: Pungent and warm

Meridian Tropism

: Lung

Actions

: Moisten the lung, induce qi to flow downwards, relieve cough and dissolve phlegm

Applications

: – This is a very important herb for relieving cough, often used together with Zi Wan, more suitable for cough due to cold. It can also be used to treat other cough when works together with other herbs

Dosage

: 5-10g

Fructus Perillae (Su zi)

• • • • •

Taste and Property

: Pungent and warm

Meridian tropism

: Lung and Large Intestine

Actions

: Relieve cough and asthma and moisten the intestine to promote bowel movement

Applications:

– Cough and asthma due to accumulation of phlegm: Often used with Bai Jie Zi and Lai Fu Zi, i.e San Zi Yang Qin Tang. For that with stuffiness and fullness in the chest and diaphragm, used with Hou Po, Chen Pi and Ban Xia, i.e. Su Zi Jiang Qi Tang – Constipation due to intestinal dryness: Often used with Huo Ma Ren, Gua Lou Ren and Xing Ren

Dosage

: 5-10g

Folium Eriobotryae (Pi pa ye)

• • • • •

Taste and Property

: bitter, neutral

Meridian tropism

: Lung and stomach

Actions

: transforms phlegm, clears lung heat, and redirects lung qi downward, harmonizes the stomach, clears stomach heat, and redirects stomach qi downward

Applications:

– For lung heat or lung dryness patterns with cough and wheezing, used with sang bai pi, bai bu, jie geng – For nausea, vomiting, hiccough, and belching due to stomach heat, used with huang qin, xiang fu

Dosage

: 6-15g

Radix Stemonae (Bai bu)

• • • • •

Taste and Property

: Sweet, bitter and bland

Meridian Tropism

: Lung

Actions

: Moisten the lung to relieve cough, kill flee and worms

Applications

: – Cough: Both acute and chronic – Flee or pinworm – Urticaria, dermatitis, etc.

Dosage

: 5-10g

Cortex Mori (Sang bai pi)

• • • • •

Taste and Property

: Sweet and cold

Meridian Tropism

: Lung

Actions

: Purge the lung heat to relieve asthma, induce diuresis to relieve swelling

Applications

Bai San – Hypertension : – Cough and asthma with much phlegm due to lung heat: Often used with Di Gu Pi and Gan Cao, i.e. Xie – Edema or oliguria of the excess type: Often used with Da Fu Pi, Fu Ling Pi, Sheng Jiang Pi, i.e. Wu Pi Yin

Dosage:

10-15g

Formulas that Transform Phlegm

• • • • • • Formulas that dry dampness and expel phlegm – *Two-Cured Decoction (er chen tang) Formulas the clear heat and transform phlegm – Warm the Gallbladder Decoction (wen dan tang) – Clear the Qi and Transform Phlegm Pill (qing qi hua tan wan) – Minor Sinking into the Chest Decoction (xiao xian xiong tang) Formulas that moisten dryness and transform phlegm – Fritillaria and Trichosanthes Fruit Powder (bei mu gua lou san) Formulas that transform phlegm and dissipate nodules – Sargassum Decoction for the Jade Flask (hai zao yu hu tang) Formulas that warm and transform cold-phlegm – Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction (ling gui zhu gan tang) – Poria, Licorice, Schisandra, Ginger, and Asarum Decoction (ling gan wu wei jiang xin tang) – Three-Seed Decoction to Nourish One's Parents (san zi yang qin tang) Formulas that transform phlegm and extinguish wind – Stop Coughing Powder (zhi sou san) – Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction (ban xia bai zhu tian ma tang)

Er Chen tang (Two-Cured decoction)

Ingredients:

Ban xia, Chen pi (Ju hong), Fu ling, Gan cao, sheng jiang, wu mei

Actions and indications of the formula

• Actions – Dry dampness, transform phlegm, regulate qi and harmonize the middle jiao • Indications – Cough with copious white sputum that is easily expectorated, focal distention and a stifling sensation in the chest and diaphragm, palpitations, nausea or vomiting, dizziness, a swollen tongue with a white, thick, greasy coating and a slippery pulse.

Analysis of Formula

• Chief: Ban xia, chen pi – Ban xia: dry dampness, expel phlegm, and cause the rebellious stomach qi descend. – Chen pi: revive spleen and facilitate the flow of qi in the middle jiao. • Deputy: Fu ling – Fu ling: tonify spleen and drain dampness • Assistant: Zhi gan cao – Regulate middle jiao • Envoy: sheng jiang, wu mei – Sheng jiang: control nausea – Wu mei: counterbalance the dispersing tendency of the chief herb and prevents the dissipation of lung qi

Modern application and attentions

• Modern application: – Upper respiratory tract infection, chronic bronchitis, goiter, chronic gastritis, peptic ulcer, and meniere’s disease • Modification: – For damp-heat in the middle jiao, add huang lian, huo xiang, hou po – For damp-heat in the lower jiao, add ku shen, huang bai, hua shi – For spleen and kidney yang deficiency, add rou gui, fu zi – For chronic phlegm in the channels and flesh leading to rubbery nodules, add mu li, xuan shen, hai zao • Attentions: not for in deficiency

Warm the Gallbladder Decoction (wen dan tang)

Ingredients

: Zhu ru 6g, Zhi shi 6g, Ban xia 6g, Chen pi 9g, Fu ling 4.5g, Gan cao 3g, Sheng jiang 3-6g

Actions and indications of the formula

• •

Actions

– Clears gallbladder heat, regulates qi, reduces phlegm, regulates the stomach.

Indications

– Dizziness, vertigo, nausea or vomiting, indeterminate gnawing hunger, insomnia, palpitations, anxiety, a bitter taste in the mouth, slight thirst, A greasy yellow tongue coating, and a slippery or rapid pulse

Analysis of Formula

• Chief : Zhu ru – Clear heat and phlegm from the gallbladder and stomach and reverse the rebellious flow of qi • Deputy: Zhi shi – Expel local distention and reverse the flow of rebellious qi • Assistant: Chen pi, Ban xia and Fu ling, Gan cao – Dry dampness and expel phlegm while regulating the qi and harmonizing its circulation in the stomach – Strengthen spleen, leach out dampness, and harmonize the function of middle burner.

• Envoy: Sheng jiang – harmonize stomach, stop vomiting

Modern application and modifications

• Modern application: – Chronic tracheitis, bronchitis, pulmonary emphysema, chronic gastritis, peptic ulcer, chronic hepatitis, insomnia, timidity, neurosis, schizophrenia • Modifications: – For severe vertigo, add bai shao, dai zhe shi and huang qin – For severe heat, add huang lian – For insomnia, add hu po, suan zao ren, mu li – For tinnitus and hearing loss due to retention of damp-heat in the gallbladder, add chai hu, gou teng, ju hua, shi chang pu, tong cao

Clear the Qi and Transform Phlegm Pill (qing qi hua tan wan)

Ingredients

: dan nan xing, ban xia, gua lou ren, huang qin, chen pi, xing ren, zhi shi, fu ling

Actions and indications of the formula

• •

Actions

– Clears heat, transforms phlegm, directs rebellious qi downward, and stops coughing

Indications

– Coughing of yellow, viscous sputum that is difficult to expectorate, focal distention and a feeling of fullness in the chest and diaphragm, nausea, a red tongue with a greasy, yellow coating, and a slippery, rapid pulse. In severe cases, there may also be difficulty in breathing

Analysis of Formula

• Chief: Dan nan xing – Treats blockage caused by a combination of fire and phlegm • Deputy: Huang qin, gua lou ren – Drains lung fire while transforming and clearing phlegm heat • Assistant: – Zhi shi, chen pi: regulate qi, when combined, they are effective in dispelling the focal distention and dissipating the clumps of phlegm – Fu ling, ban xia: transform phlegm and strengthen spleen – Xing ren: facilitates the flow of qi in the lung and expels phlegm

Modern application and modifications

• Modern application: – Acute and chronic bronchitis and pneumonia • Modifications: – For high fever, add shi gao, zhi mu – For copious sputum, add yu xing cao, tian hua fen

Minor Sinking into the Chest Decoction (xiao xian xiong tang)

Ingredients

: gua lou, huang lian, ban xia

Actions and indications of the formula

• •

Actions

– Clears heat, transforms phlegm, expands the chest, and dissipates clumps

Indications

– Focal distention (with or without nodules) in the chest and epigastrium that are painful when pressed, coughing up yellow and viscous sputum, constipation, a bitter taste in the mouth, a yellow greasy tongue coating, and a slippery pulse that is either floating or rapid

Analysis of Formula

• Chief: Gua lou – Expands the chest, dissipates clumps, clears heat, and dispels phlegm • Deputy: Huang lian – clears heat from upper and middle jiao. • Assistant: Ban xia – Directs rebellious qi downward, harmonizes the stomach, transforms phlegm, eliminates focal distention and dissipates clumps

Modern application and modifications

• Modern application: – Bronchitis, pleurisy, cholecystistis, icteric hepatitis, acute or chronic gastritis, peptic ulcer, angina pectoris and intercostal neuralgia • Modifications: – For vomiting, add zhu ru, sheng jiang – For indeterminate gnawing hunger, add zhi shi, zhi zi • Attentions: – Contraindicated in cases with significant spleen and stomach deficiency

Fritillaria and Trichosanthes Fruit Powder (bei mu gua lou san)

Ingredients

: bei mu, gua lou, tian hua fen, fu ling, ju hong, jie geng

Actions and indications of the formula

• •

Actions

– Moistens the lungs, clears heat, regulates the qi, and transforms phlegm

Indications

– Cough with deep-seated sputum that is difficult to expectorate, wheezing, a dry and sore throat, a red and dry tongue with little coating and a rapid and thin but strong pulse

Analysis of Formula

• Chief: Bei mu – Moistens the lung, clears heat, transforms phlegm, and stops coughing • Deputy: gua lou – clears heat, moistens dryness, regulates the qi, and expels phlegm in order to remove the obstruction from the chest and diaphragm. • Assistant: – Tian hua fen: clears heat, generates fluids and transforms phlegm – Fu ling: strengthens the spleen, – Ju hong: regulates the qi. – Jie geng: encourages the proper flow of lung qi and treats problems of the throat

Sargassum Decoction for the Jade Flask (hai zao yu hu tang)

Ingredients

: Hai zao, Kun bu, Hai dai, Zhe bei mu, Ban xia, Du huo, Chuan xiong, Dang gui, Qing pi, Chen pi, Lian qiao, Gan cao

Actions and indications of the formula

• •

Actions

– Transform phlegm, soften hard masses, reduce and dissipate goiter

Indications

– Masses in the center of the neck which are rock-like in hardness, immobile, cause no change in the color of the skin, and do not ulcerate. The tongue has a thin, greasy coating, and the pulse is wiry and slippery

Analysis of Formula

• Chief: Hai zao, Kun bu, Hai dai – soften and dissolve masses • Deputy: Zhe bei mu – clear heat and dissipate nodules. • Assistant: – Ban xia, Du huo: expel phlegm – Chuan xiong, Dang gui: invigorate blood and relieve stasis.

– Qing pi, Chen pi: promote the movement of Qi and relieve constraint. – Lian qiao: prevent and clear heat from stagnation of phlegm, Qi and blood. Relieve toxicity. • Envoy: Gan cao – harmonize the action of other herbs and relieve toxicity.

Modern application and modifications

• Modern application: – Simple goiter, hypethyroidism, amd benign tumors of the thyroid • Modifications: – For stifling sensation in the chest, add xiang fu, yu jin – For excessive hunger, add shi gao, zhi mu – For irregular menstruation, add lu jiao jiao, yi mu cao, tu si zi – For hard and firm masses, add chi shao, lu feng fang

Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction (ling gui zhu gan tang)

Ingredients

: Fu ling 12g, Gui zhi 9g, Bai zhu 6g, Zhi gan cao 6g

Actions and indications of the formula

• •

Actions

– Warm and transform phlegm, strengthen spleen and resolve dampness.

Indications

– Fullness in the chest and hypochondria, palpitations, shortness of breath, coughing up clear and watery sputum, and dizziness or vertigo. Pale swollen tongue with a white and slippery or greasy coating, wiry slippery pulse.

Analysis of Formula

• Chief: Fu ling – strengthen spleen and leach out dampness • Deputy: Gui zhi – warm the yang and improve the transforming power of the qi • Assistant: Bai zhu: – strengthen spleen and dry dampness • Envoy: Gan cao – Gan cao: augment qi of middle jiao and actions of other herbs

Modern application and modifications

• Modern application: – Neurosis, rheumatoid arthritis, chronic nephritis, chronic gastritis, chronic bronchitis, hypertension • Modifications: – For belching and vomiting, add Ban xia and Sha ren.

– For focal distention and pain in the epigastrium, add Zhi ke and Hou po – For Hypertension, take with Zhen wu tang

Poria, Licorice, Schisandra, Ginger, and Asarum Decoction (ling gan wu wei jiang xin tang)

Ingredients

: Fu ling 12g, Gan cao 9g, Gan jiang 9g, Xi xin 9g, Wu wei zi 6-12g

Actions and indications of the formula

• •

Actions

– Warm the lung and transform the congested fluids.

Indications

– Coughing with profuse sputum that is thin, watery and white accompanied by a feeling of discomfort in the chest and diaphragm, a white, slippery tongue coating, and a wiry slippery pulse.

Analysis of Formula

• Chief: Gan jiang – warm the lung and spleen, disperse cold and eliminate dampness • Deputy: Xi xin, fu ling – Xi xin: warm and disperse cold in the lung to transform the congested fluids. – Fu ling: strengthen the spleen and leach out dampness • Assistant: Wu wei zi – restrain the leakage of lung qi and prevent its depletion by dispersing actions of other herbs • Envoy: Gan cao – harmonize middle jiao and actions of other herbs

Modern application and modifications

• Modern application: – Chronic obstructive pulmonary disease • Modifications: – For profuse sputum with nausea , add Ban xia.

– For abdominal distention, add Zhi ke and Chen pi – For weak patients, add Dong chong xia cao – For persistent cough, add Zi wan, Kuan dong hua

Three-Seed Decoction to Nourish One's Parents (san zi yang qin tang)

Ingredients

: Bai jie zi 6-9g, Su zi 6-9g, Lai fu zi 6-9g

Actions and indications of the formula

• •

Actions

– Direct Qi downward, relax the diaphragm, transform phlegm and reduce food stagnation.

Indications

– Coughing and wheezing, copious sputum, focal distention in the chest, loss of appetite, digestive difficulties, a white, greasy tongue coating, and a slippery pulse.

Analysis of Formula • Bai jie zi: warm and disseminate the Lung qi, reduce phlegm and relax the diaphragm.

• Su zi: direct the Lung qi downward and thereby stop the coughing and wheezing. • Lai fu zi: reduce food stagnation, direct qi downward and transform phlegm

Modern application and modifications

• Modern application: – bronchitis, bronchial asthma, emphysema, pediatric asthma, spasm of diaphragm • Modifications: – For profuse sputum with nausea , add Ban xia.

– For concurrent wind cold , add Qian hu and Zi su ye

Stop Coughing Powder (zhi sou san)

Ingredients

: Jie geng, Jing jie, Zi wan, Bai bu, Bai qian, Gan cao, Chen pi

Actions and indications of the formula

• •

Actions

– Stop cough, transform phlegm, disperse the exterior and disseminate the Lung qi.

Indications

– Coughing with or without slight chills and fever, an itchy throat, a thin, white tongue coating, and a floating pulse.

Analysis of Formula

• Chief: Zi wan, Bai qian, Bai bu – stop cough and transform phlegm • Deputy: Jie geng, Chen pi – facilitate the proper dissemination and descent of lung qi.

• Assistant: Jing jie – release the exterior, eliminate the lingering pathogenic influence • Envoy: Gan cao – Harmonize the actions of other herbs

Modern application and modifications

• Modern application: – Upper respiratory tract infection. • Modifications: – For wind cold symptoms, add Fang feng, Gui zhi, Zi su ye, Sheng jiang – For copious sputum, add er chen tang, Sang bai pi – For a dry, nonproductive cough, omit Jing jie, Chen pi, add Gua lou, Bei mu, Zhi mu, Bai zi ren • Attention: – Not suitable for Yin deficiency or heat in the lungs

Pinellia, Atractylodes Macrocephala, and Gastrodia Decoction (ban xia bai zhu tian ma tang)

Ingredients

: Ban xia 9g, Tian ma 6g, Bai zhu 9g, Ju hong 6g, Fu ling 6g, Gan cao 3g, Sheng jiang 2 slices, Da zao 2 pieces

Actions and indications of the formula

• •

Actions

– Strengthen spleen, transform phlegm, and extinguish wind.

Indications

– Dizziness or vertigo, headache, a stifling sensation in the chest, nausea or vomiting, copious sputum, a white, greasy tongue coating, and a wiry, slippery pulse.

Analysis of Formula

• Chief: – Ban xia: dry dampness, transform phlegm, and direct rebellious qi downward to treat nausea and vomiting – Tian ma: transform phlegm, extinguish wind. • Deputy: bai zhu – Strengthen spleen and dry dampness • Assistant – Fu ling: strengthen spleen and leach out dampness.

– Chen pi: regualte the qi and transform phlegm – Sheng jiang and Da zao: harmonize the stomach and spleen • Envoy: Gan cao – Harmonize the actions of other herbs and regulate the function of middle burner.

Modern application and modifications

• Modern application: – Hypertension • Modifications: – For severe vertigo, add Jiang can and Dan nan xing – For qi deficiency, add Huang qi and Dang shen • Attention: – Contraindicated for vertigo from either ascendant Liver yang or blood deficiency