Herb Formulas Notebook

Wen Dan Tang

Warm Gallbladder Decoction


Author: Chen Yan

Year: 1174

Source: Discussion of Illnesses, Patterns and Formulas Related to the Unification of the Three Etiologies


Category: Formulas that Dispel Phlegm

Pattern: Heart and Gall Bladder Deficiency causing Cold to obstruction the Qi Dynamic and generate Phlegm disturbing the Shen; Stomach and Gallbladder Disharmony with severe Phlegm-Heat obstructing the Qi dynamic

Key Symptoms: Timidity and fright at external events, dream-disturbed sleep with strange dreams or unusual delusions.
Secondary Symptoms: Shortness of breath, palpitations, exhaustion; recurrent spontaneous sweating with puffy swelling of the four limbs; inability to taste food; vexation, oppression and no sense of peace, whether lying or sitting. Also used for nausea or vomiting with indeterminate gnawing hunger, seizures accompanied by copious sputum, dizziness with a bitter taste in the mouth and focal distention of the chest.

Tongue: Pale or slightly red with a greasy white coating
Pulse: Wiry or slippery
Abdomen: Splashing sounds in the upper abdomen, focal distention in epigastric region, pulsation in the umbilical region


Ingredients

Zhu Ru 60g
Zhi Shi 60g (bran fried)
Zhi Ban Xia 60g
Chen Pi 90g
Fu Ling 45g
Zhi Gan Cao 30g
Sheng Jiang 5 sl
Da Zao 1pc


Preparation: Grind the first 6 ingredients into powder and take in doses of four large teaspoons (approx 15-20g), decocted in 1.5 cups of water with the 5 slices of Sheng Jiang and 1 Da Zao until reduced to 1 cup. Remove dregs and take before meals.


Actions: Regulates the Qi, transforms Phlegm, clears the Gallbladder, harmonises the Stomach



Notes:
There has been much debate about the name and action of this formula since it appears to have no herbs that enter the Gall Bladder or even the Liver, most of the herbs are cooling instead of warming and it appears to mainly treat Phlegm-Heat from constraint. One suggestion for this is that the Gall Bladder is in charge of making decisions and judgements (Su Wen ch. 8 & 9) so chronic failure of the Gall Bladder to fulfil this function results in stagnation and Phlegm-Heat in all the other systems. Hence the formula clears Phlegm and Heat from the Lungs, Stomach, Heart and Intestines, draining fluid through the Kidneys and correcting the imbalance. This is hoped to help guide the Gall Bladder in what decisions it should make and restart its judgement making process. This might also suggest it can be used where there appear to be symptoms of Phlegm-Heat but signs, like the tongue and pulse, point to a root cause of Cold or Deficiency.

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Ploberger (2017), in Westliche und traditionell chinesische Heilkräuter, offers the following alternative using western herbs:

Radix Inulae(Elecampane)4g(Emperor)
Herba et Radix Taraxaci(Dandelion)4g(Envoy)
Pericarpium Citri ret.(Orange peel)5g(Assistant)
Radix Glycyrrhizae(Licorice root)4g(Assistant)
Rhizoma Pinelliae(Pinellia)4g(Assistant)
Herba Millefolii(Yarrow)3g(Assistant)
Stigmata Maydis(Zea Corn-Silk)4g(Assistant)
Rhizoma Zingiberis recens(Fresh Ginger)2g(Envoy)

A typo has missed the dosage for orange peel in the original book so it has been estimated for this formula. I have put it reasonably high due to it being the chief herb in his version of Er Chen Tang, upon which formula is based, despite only being an assistant.



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