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 Dispel Phlegm
Pattern: Phlegm-Heat clogging the chest and diaphragm, or Food Stagnation in the upper epigastrium
Key Symptoms: Irritability, focal distention in the chest and an urge to vomit
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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Zhi Zi
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Pinyin: Zhi Zi
Chinese: 栀子
Pharmaceutical: Fructus Gardeniae
Taxonomy: Gardenia jasminoides
English: Gardenia Fruit |
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Tastes: Bitter and cold
Meridians Entered: Heart, Liver, Stomach and Lung |
Actions & Indications:
- Clears Heat, reduces Fire and eliminates irritability in the San Jiao
Excess Heat in the Heart, Stomach and Liver with high fever, irritability, restlessness, a stifling sensation in the chest, insomnia or delirious speech, eye problems, anger, jaundice
- Clears Heat and resolves Dampness (Drains Damp-Heat)
Damp-Heat in the Lower Jiao with painful urinary dysfunction (Lin Syndrome)
Damp-Heat in the Liver/Gallbladder with jaundice
Damp-Heat in the San Jiao
Damp-Heat in the Gallbladder and San Jiao channels of the face affecting the nose and eyes or causing sores in the mouth or facial region
- Cools the Blood and relieves toxicity (stops bleeding by astringing)
Heat in the Blood with epistaxis, hematemesis, hemafecia or hematuria (partially charred)
- Reduces swelling and invigorates the Blood
Blood Stagnation due to trauma (topical)
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Standard Dosage: 5-15g in decoction.
Cautions: Being strongly bitter in flavor and cold in nature, it is not good for deficiency-cold syndrome because it can easily impair spleen and stomach. It is contraindicated in case of loose stool due to spleen deficiency. |
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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 as a draft. 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.
