Ling Gan Wu Wei Jiang Xin Tang - 苓甘五味薑辛湯 - Poria, Licorice, Schisandra, Ginger and Asarum Decoction

Author: Zhang Zhong-Jing, 張仲景

Year: c. 220

Source: Essentials from the Golden Cabinet (Jin Gui Yao Lue, 金匱要略)

Category: Formulas that Dispel Phlegm

Pattern: Cold thin mucus due to Yang deficiency and ascendant Yin

Key Symptoms: Cough and wheezing with profuse sputum that is thin, watery and white accompanied by a feeling of discomfort in the chest and diaphragm

Tongue: White slippery coating
Pulse: Wiry, slippery

Ingredients

Fu Ling

12g

Gan Cao

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.

Gan Jiang

Xi Xin

Pinyin: Xi Xin Chinese: 细辛 Pharmaceutical: Herba cum Radix Asari Taxonomy: Asarum sieboldii English: Chinese Wild Ginger
Tastes: Pungent, warm, slightly toxic Meridians Entered: Lung, Kidney and Heart
Actions & Indications: Releases Exterior Wind and Cold As an adjunctive for any exterior Wind-Cold especially with Dampness in Lung or underlying Yang Deficiency Frequently used for Wind-Cold when the dominant symptoms are head and body aches Disperses Wind-Cold and Internal Cold and alleviates pain Pain due to Wind and/or Cold anywhere in the body, particularly headache, painful obstruction, abdominal pain or headache due to obstruction of Fluids and Blood by Cold, often with anhydrous Wind-Cold-Damp Bipain Warms the Lungs and transforms Phlegm and Thin Mucus (circulates water) Cough and Qi which surges upward and fullness in the chest in the chest with continuous cough from clumped Qi in the chest and diaphragm marked by copious, watery sputum due to Phlegm-Damp or Wind-Cold with congested fluids Disperses and unblocks the Qi of the nasal orifices (clears the orifices of the head) Nasal congestion Oral pathology Loss of consciousness Promotes healing of oral ulcerations Oral lesions or ulcerations Relieves toothache Toothache 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: 1-3g in decoction. Cautions: Traditionally contraindicated for headache due to hyperactivity of yang caused by yin deficiency and dry cough caused by lung dryness hurting yin. It is incompatible with Li Lu. While not prohibited in the UK, the RCHM has enacted a voluntary ban by use due to possible fears of aristolochic acid. It is usually substituted with Gui Zhi and Qiang Huo for channel problems, Zi Su Ye and Bai Qian for lung issues, Gao Ban and Bai Zhi for treating the head and Cong Bai and Bai Zhi for the sinuses.

Wu Wei Zi

6-12g

Subsitutions:
In the UK Xi Xin may be substituted with Zi Su Ye and Bai Qian.

Preparation: Decoction.

Actions: Warms the Lungs and transforms congested fluids

Notes:
One liang is taken as 3g in modern sources but in Eastern Han times it was equivalent to 13.875g. This means that the dosages in classical formulae could have been more than 4x what is given today making them far higher than recommended safe dosages today but prompts consideration of what an effective dose may be (He, 2013).

Research Links:

American Dragon

TCMWiki

Journal of Chinese Medicine

National Resource Centre for Chinese Materia Medica, China

TCM-ID Integrated Database, East China Normal University

TCM-ID Information Database, National University of Singapore

Pubmed

Science Direct

Google Scholar

Bai Du (Chinese)

A+ Medical Encyclopedia (Chinese)

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.

Herb Formulas Notebook

苓 甘 五 味 薑 辛 湯  Ling Gan Wu Wei Jiang Xin Tang

Poria, Licorice, Schisandra, Ginger and Asarum Decoction