Source: Discussion of Illnesses, Patterns and Formulas Related to the Unification of the Three Aetiologies (1174)
Category: Formulas that Drain Downward
Pattern: Phlegm lurking above and below the diaphragm
Key Symptoms: Sudden excruciating pain in the throax, neck and lower back that evolves into a burning, piercing pain
Secondary Symptoms: Cold and painful extremities, unrelenting severe headache, lethargy and fatigue with a desire to sleep, loss of appetite and thirst, coughing up of thick sticky sputum, rattling sound in the throat at night or excessive salivation.
Tongue: Sticky and greasy coating
Pulse: Wiry and slippery
Ingredients
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Gan Sui
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Pinyin: Gan Sui
Chinese: 甘遂
Pharmaceutical: Radix Euphorbia Kansui
English: Sweet Spurge Root |
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Tastes: Bitter, cold, toxic
Meridians Entered: Lung, Kidney, and Large Intestine |
Actions & Indications:
- Drains water downward and eliminates congested fluids and thin mucus
Severe accumulation of fluid in the chest and abdomen Generalized oedema, facial oedema and abdominal distention
- Expels Phlegm
Epilepsy due to Phlegm Blocking the Heart Orifices Seizures from Wind-Phlegm Withdrawal mania from recalcitrant Phlegm congealing and clumping
- Clears Heat, reduces swelling and disperses hardenings
Swollen, painful, nodular Damp-Heat skin lesions (topical-appropriate for early stages, with oral ingestion of herbs that clear Heat and resolve toxicity)
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Standard Dosage: 0.5-1g in powder form. The active form does not dissolve in water so decoction should be avoided.
Cautions: It is contraindicated to the pregnant women and those anxious about their health. It is antagonistic to Gan Cao. |
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Hong Da Ji
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Pinyin: Hong Da Ji
Chinese: 紅大戟
Pharmaceutical: Radix Knoxiae
English: Knoxia Root |
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Tastes: Bitter, cold, slightly toxic
Meridians Entered: Lung, Spleen and Kidney |
Actions & Indications:
- Drains water downward and drives out thin mucus
Relatively moderate accumulation of Fluids in the chest and flanks with labored breathing, dull pain in the lateral aspect of the chest, expectoration of thick sputum and a thick, greasy tongue coat
For very severe conditions, use Jing Da Ji
- Reduces swelling and dissipates nodules
Topically for red, swollen, painful and toxic sores or scrofula
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Standard Dosage: 1-3g in decoction or 0.3-1g as powder, pills or soaked in wine.
Cautions: It is contraindicated to the weak and pregnant women. |
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Bai Jie Zi
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Pinyin: Bai Jie Zi
Chinese: 白芥子
Pharmaceutical: Semen Brassicae Albae
Taxonomy: Brassica syn. Sinapis alba
English: Mustard Seed |
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Tastes: Pungent, warm
Meridians Entered: Lung and Stomach |
Actions & Indications:
- Warms the Lungs, regulates Qi and expels Phlegm
Accumulation of Cold-Phlegm with cough with copious thin sputum, chest distention and pain, especially in chronic disorders
Main ingredient of San Fu Moxibustion (三伏灸) where it is ground, mixed with ginger juice and other herbs, and applied topically for the irritant properties to replace the heat of lighted herbs. It is done to treat respiratory disorders that get worse in winter and performed on the three Fu (Yang Metal) days over the 3 months of summer.
- Promotes Qi movement, dissipates nodules, unblocks the collaterals and alleviates pain
Phlegm-Dampness Accumulating in the Channels Yin flat abscess Spreading sores Phlegm nodules (scrofula)
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Standard Dosage: 3-6g in decoction.
Cautions: This herb has strong stimulation to the skin mucosa and will easily cause redness swelling and blisters. Therefore, it is prohibited for those with digestive tract ulcer and bleeding and skin allergies. Do not use in high doses. |
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Subsitutions:
In the UK Gan Sui must be substituted and Hong Da Ji may also need to be replaced. Few other things have their harsh expelling action but Qian Niu Zi and/or Ting Li Zi, some elements of Wu Ling San or Da Cheng Qi Tang might be able to suffice for a less acute presentation depending on whether purging through the bowel or urine is desirable. Urgent cases may require referral to hospital.
Preparation: Ground into powder and formed into small pills to be taken in 1-3g doses at bedtime with warm water.
Actions: Dispels Phlegm and expels thin mucus
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.