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: Phlegm clogging the chest and diaphragm, or food stagnation lodged in the upper epigastrium
Key Symptoms: Firm areas of focal distention in the chest, anguish and vexation, difficult breathing due to a sensation of Qi rushing to the throat
Pulse: Slight floating in distal position
Ingredients
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Gua Di
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Pinyin: Gua Di
Chinese: 瓜蒂
Pharmaceutical: Pedicellus Melo
English: Melon Pedicle |
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Tastes: Bitter, Cold, Toxic
Meridians Entered: Stomach and Spleen |
Actions & Indications:
- Induces vomiting to relieve Phlegm-Heat or retained food
Accumulation above the diaphragm when vomiting is the preferred treatment, including Phlegm-Heat that is constrained in the chest with seizures, mania, throat Bi, wheezing, irritability and/or insomnia
Retained food in the Stomach with distention and chest and epigastric pain (may be used alone)
- Dispels Damp-Heat and relieves jaundice
Damp-Heat jaundice when Dampness predominates
Intranasally, it treats recalcitrant jaundice of the face and eyes with headache and nasal congestion due to Dampness constrained in the head
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Standard Dosage: 2.5-5g in decoction, 0.3-1g as powder.
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Chi Xiao Dou
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Pinyin: Chi Xiao Dou
Chinese: 赤小豆
Pharmaceutical: Vigna angularis
English: Adzuki Bean / Rice Bean |
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Tastes: Sweet, sour and neutral
Meridians Entered: Heart and Small Intestine |
Actions & Indications:
- Promotes urination and reduces oedema
Abdominal swelling and fullness due to oedema, urinary difficulty and leg Qi
- Clears Damp Heat
Mild jaundice due to Damp-Heat
- Disperses Blood Stasis, reduces swelling and reduces Fire toxicity (dispels pus)
Chuang Yung (sores, carbuncles, furuncles)
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Standard Dosage: 10-30g in decoction.
Cautions: Although acting to drain Dampness, Adzuki beans have a high FODMAP score (George Eats, April 2024) suggesting that they are contraindicated in abdominal distention and swelling due to Spleen Dampness. |
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Subsitutions:
In the UK inducing vomiting is not considered an appropriate treatment strategy meaning that Gua Di would have to be replaced with a downward moving Phlegm and Food Stagnation moving formula instead such as Zhi Zhu Wan or Bao He Wan. It is included in this list for reference only, to demonstrate the principle.
Preparation: Grind equal amounts into a powder and take 1-3g at a time with a warm decoction of Dan Dou Chi. If vomiting does not ensue increase the dosage. If it still does not work then tickle the throat with a feather or cotton swab.
Actions: Discharges Phlegm or Food Stagnation through vomiting
Contraindications: Caution should be taken with weak patients due to the ease with which Gua Di can injure the stomach. If vomiting does not cease then administer 0.3-0.6g of Ding Xiang.
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.
