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© Endeavour College of Natural Health endeavour.edu.au 1 Chinese Herbal Formulae CMHB221 Session Eleven Eliminate phlegm Chinese herbal formulae Chinese Medicine Department
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CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

Aug 26, 2018

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Page 1: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 1

Chinese Herbal Formulae CMHB221

Session Eleven

Eliminate phlegm Chinese herbal formulae

Chinese Medicine Department

Page 2: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 2

CMHB221

Chinese Herbal Formulae

Session Eleven

Eliminate Phlegm Chinese herbal formulae:

o English name; Pin yin name and Chinese name

o Composition; dosage and administration

o Functions and indications

o Analysis and explanation of the formula

o Cautions and contraindications

Relieve Food Stagnation Chinese herbal formulae:

o English name; Pin yin name and Chinese name

o Composition; dosage and administration

o Functions and indications

o Analysis and explanation of the formula

o Cautions and contraindications

Page 3: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 3

Session Aims

o Discuss the Chinese herbal formulae’s through the investigation of actions, dosage,

preparation/cooking and contraindications for the following medical actions:

• ‘Eliminate Phlegm’ Chinese herbal formulae.

• ‘Food Abating’ Chinese herbal formulae; and

o Identify and group the major common differentiating actions of the herbal constituents of

each formula; and

o Discuss some of the conventional biomedical usages for the each of Chinese herb

formulae’s discussed and identify all potential interactions.

Page 4: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 4

Key Formulae

Eliminate Phelgm Formulae

o Er Chen Tang

o Wen Dan Tang

o Ban Xia Bai Zhu Tian Ma Tang

o Zhi Sou San

Food Abating Formulae

o Bao He Wan

o Jian Pi Wan

Page 5: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 5

What you need to know after this session

The composition for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San and Bao He Wan

The functions(actions) ; indications and contraindications for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and

Jian Pi Wan

The key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and

Jian Pi Wan

All key clinic symptoms for

Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San ,

Bao He Wan and Jian Pi Wan

The significance of using “Lian Qiao” in Bao He Wan

Page 6: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 6

Er Chen Tang | Two Age Ingredient Decoction

(二陈汤)Source: Tai Ping Hui Min He Ji Ju Fang ( Formulas of Tai PinHui Min

Pharmaceutical Bureau)

Composition: Ban Xia , Chen Pi, Fu Ling, Zhi Gan Cao, Sheng Jiang, Wu Mei

Administration: All the drugs should be decocted in water for oral use, generally, Wu Mei may not be used.

Functions: Dry dampness and remove phlegm, regulate Qi and harmonize the middle Jiao

Indications: Damp-phlegm syndrome manifested by cough with profuse sputum, nausea, vomiting, fullnessand suffocation sensation in the chest and diaphragm, dizzness, palpitation, white and moist or thin greasycoating of the tongue and slippery pulse

Contraindications: dryness or yin xu; Yin xu with phlegm-damp

Biomedical Indications: Mucolytic; Expectorant; Anti-emetic

Dosage: 8-12 pills at 3 x / day (away from food) where possible

Page 7: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 7

Er Chen Tang | Two Age Ingredient Decoction

TCM Dx: Phlegm-Damp

o Chronic mucous congestion

o Phlegm nodules

o Dizziness

o Nausea and vomiting

o Fullness in the chest

o Chronic productive cough

o Tongue: Swollen tongue, with a thick, greasy, white coat.

o Pulse: Slippery, wiry or soft pulse

Page 8: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 8

Herb Hierarchy Dosage Temp Taste Group Action

Ban Xia Chief 51.mg Warm

Neutral

Pungent Eliminate

Phlegm

Drains damp-cold; Transforms phlegm; Descends qi; Stops vomiting; Tonifies/harmonises

spleen; Stops bleeding; Eczema, burns, sores.

Chen Pi Deputy 51.5mg Warm Bitter

Pungent

Regulate Qi Move and regulates the qi; Transforms phlegm; Dries damp; Tonifies qi; Directs qi

downwards; Dislodges phlegm.

Fu Ling Assistant 31mg Neutral Sweet Expel Damp Promote urination; Drains damp; Harmonize and strengthen the spleen; Calms and anchors

the spirit; Dislodges the phlegm; Disperse swelling.

Sheng Jiang Assistant 10.3mg Warm Pungent Release

Exterior

Release the exterior; Dispels cold; Transforms phlegm; Calms vomiting; Stops cough;

Detoxifies and disinfects.

Gan Cao Envoy 15.5mg Neutral Pungent Tonifying Harmonize/tonifies qi, spleen, stomach; Clears fire/moisten dryness; Detoxifies & disinfects;

Calms/anchors shen.

Wu Mei Assistant 1 piece Sour Astringing Astringing lung-qi, prevent the eliminate herbs ( warm-dryness and acrid dissipation ) from

damaging the healthy qi

Er Chen Tang | Two Age Ingredient Decoction

Page 9: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 9

Herbal Identification

Er Chen Tang | Two Age Ingredient Decoction

Ban Xia Chen Pi Fu Ling

Sheng Jiang Gan Cao

Page 10: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 10

Analysis and explanation of the formula

Chief Herb:

Ban Xia | Pinellia ternata rhizoma)

Temperature: Warm | Neutral; Taste: Pungent

Drying dampness to remove phlegm and reducing upward perversion of Qi to

stop vomiting

Deputy herb:

Chen Pi (Ju Hong) | Ctirus reticulata pericarpium

Temperature: Warm; Taste: Bitter | Pungent

Regulating Qi, drying dampness and removing phlegm

Page 11: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 11

Assistant Herbs: Fu Ling | Poria cocos

Invigorate the spleen and resolve dampness to prevent the gathering of

dampness and production of phlegm

Sheng Jiang | Zingiber officinale rhizoma

Lowering the upward perversion to remove phlegm and also reducing the toxic

effect of Ban Xia

In some version, using small dosage of Wu Mei, to prevent the dispersing of the

lung Qi

Guide herb: Gan Cao | Glycyrrhiza uralensis radix

Harmonizing the middle jiao and invigorating the spleen

Page 12: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 12

Notes

This is a basic recipe to treat phlegm-damp syndrome.

Think about clinically what it can be used for??

Chronic brochitis

Pulmonary emphysema

Chronic gastritis

Pregnant morning sickness

Damp-phlegm syndrome for

Otogenic dizziness

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© Endeavour College of Natural Health endeavour.edu.au 13

13

Chief Combination Modifications

Ban Xia* (Hempen 2009, p.82)

Action CHM Group Reference

Focal distension in the epigastrium and

abdomen, dry heaves, vomiting due to stomach

qi disharmony.

Chen Pi Regulate Qi Hempen 2009, p.488

Epigastric distension, digestive problems due to

heat and cold.

Huang Lian Clear Heat | Dry Damp Hempen 2009, p.172

Productive cough due to dampness and phlegm

or to spleen qi xu.

Chen Pi Regulate Qi Hempen 2009, p.488

Cough, dry heaves, vomiting due to hot phlegm

and rebellious qi

Huang Qin Clear Heat | Dry Damp Hempen 2009, p.184

Cough, dry heaves, distension in the epigastrium

and abdomen due to phlegm

Hou Po Transform Damp Hempen 2009, p.292

Cough due to phlegm Zhe Bei Mu Cool & Transform Hot Phlegm Hempen 2009, p.650

Stifling sensation in the chest, cough, vomiting

due to hot phlegm

Gua Lou Cool & Transform Hot Phlegm Hempen 2009, p.662

Insomnia due to hot phlegm Xia Ku Cao Clear Heat | Cool Fire Hempen 2009, p.140

Bloody sputum, bloody stools Zhi Tian Nan Xing Transform Cold Phelgm Hempen 2009, p.624

Fractures, external injuries Zhi Tian Nan Xing Transform Cold Phelgm Hempen 2009, p.624

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© Endeavour College of Natural Health endeavour.edu.au 14

Wen Dan Tang | Warm the Gall Bladder Decoction

(温胆汤)Source: San Yin Ji Yi Bing Zheng Fang Lun

(Discussion of Pathology Based on the Triple Etiology Doctorine)

TCM actions:

o Clear and transforms phlegm heat

o Regulate qi

o Harmonize the stomach and gallbladder

o Calm the shen

Indications:

Syndrome of disharmony of gallbladder and stomach, phlegm-heat harassing internally.

Biomedical Indications:

o Sedative

o Tranquilizer

o Expectorant

Contraindications: Yin or blood deficiency type shen disturbance

Caution: Nil noted

Toxicology: Nil noted

Dosage: 8-12 pills at 3 x / day (away from food) where possible

Composition: Er Chen Tang minnus Wu Mei and plus Zhu Ru; Zhi Shi; Da Zhao

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© Endeavour College of Natural Health endeavour.edu.au 15

Wen Dan Tang | Warm the Gall Bladder Decoction

TCM Dx: Phlegm-Heat

o Insomnia, waking early in the morning

o Restlessness, irritability

o Bitter taste in the mouth

o Indeterminate gnawing hunger

o Tinnitus

o Anxiety, nervousness, timidity, fearfulness

o Dizziness, vertigo

o Nausea, vomiting

o Palpitations

o Fullness or stuffiness in the chest

o Tongue: Greasy, white or yellow tongue coating

o Pulse: Slippery or wiry

Page 16: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 16

Herb Hierarchy Dosage Temp Taste Group Action

Ban Xia Chief 6gm Warm

Neutral

Pungent Eliminate

Phlegm

Drains damp-cold; Transforms phlegm; Descends qi; Stops vomiting; Tonifies/harmonises

spleen; Stops bleeding; Eczema, burns, sores.

Zhu Ru Deputy 6gm Cold Sweet Stop

Vomiting

Stops vomiting; Cools heat; Transforms phlegm; Cools blood; Stops cough; Descends the

qi.

Zhi Shi Assistant 6gm Cold Bitter Regulate Qi Moves and regulates qi; Dispels cold; Directs qi downwards; Expels phlegm; Breaks up

lumps.

Chen Pi Assistant 9gm Warm Bitter

Pungent

Regulate Qi Move and regulates the qi; Transforms phlegm; Dries damp; Tonifies qi; Directs qi

downwards; Dislodges phlegm.

Fu Ling Assistant 4.5gm Neutral Sweet Expel Damp Promote urination; Drains damp; Harmonize and strengthen the spleen; Calms and anchors

the spirit; Dislodges the phlegm; Disperse swelling.

Da Zao Envoy 3-4pcs Warm Sweet Tonify Harmonize/tonifies qi, spleen, stomach; Moistens dryness; Generates fluids; Calms/anchors

shen; Tonifies blood.

Sheng Jiang** Envoy 3gm Warm Pungent Release

Exterior

Release the exterior; Dispels cold; Transforms phlegm; Calms vomiting; Stops cough;

Detoxifies and disinfects.

Gan Cao** Envoy/As

sistant

3gm Neutral Pungent Tonifying Harmonize/tonifies qi, spleen, stomach; Clears fire/moisten dryness; Detoxifies & disinfects;

Calms/anchors shen.

Wen Dan Tang | Warm the Gall Bladder Decoction

Page 17: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 17

Herbal Identification

Wen Dan Tang | Warm the Gall Bladder Decoction

Ban Xia Chen Pi Fu Ling Sheng Jiang

Gan Cao Zhu Ru Zhi Shi Da Zao

Page 18: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 18

Chief Combination Modifications

Zhu Ru* (Hempen 2009, p.78)

Action CHM Group Reference

Cough with viscous phlegm. Huang Qin Clear Heat | Drain Damp Hempen 2009, p.184

Cough due to lung heat. Gua Lou Cool & Transform Hot Phlegm Hempen 2009, p.662

Huang Qin Clear Heat | Drain Damp Hempen 2009, p.184

Insomnia, palpitations, motion sickness due to hot

phlegm.

Ban Xia Stop Vomiting Hempen 2009, p.82

Zhi Ke Regulate Qi Hempen 2009, p.482

Hiccoughs, stomach qi xu Dang Shen Tonify Qi Hempen 2009, p.710

Gan Cao Tonify Qi | Balance Hempen 2009, p.716

Irritability, thirst, vomiting with yin xu due to heat or

fire.

Lu Gen Clear Heat | Drain Fire Hempen 2009, p.138

Vomiting due to stomach qi xu with heat. Chen Pi Regulate Qi Hempen 2009, p.488

Sheng Jiang Release Exterior (Warming) Hempen 2009, p.46

Ren Shen Tonify Qi Hempen 2009, p.714

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© Endeavour College of Natural Health endeavour.edu.au 19

Ban Xia Bai Zhu Tian Ma Tang | Pinellia, Atractylodes and Gastrodia Decoction

(半夏白术天麻汤)Source: Yi Xue Xin Wu ( A Summary on Medicine from Clinical Practice)

Composition: Ban Xia , Chen Pi, Fu Ling, Bai Zhu, Tian Ma, Gan Cao, Sheng Jiang, Da Zao

Administration: All the drugs should be decocted in water for oral use, generally, Wu Mei may not be used.

Functions: Resolve phlegm, calm wind, invigorate the spleen and dry dampness

Indications: Upward disturbance of wind-phlegm, marked by dizziness and vertigo, headache, suffocationin the chest, nausea, white greasy tongue coating, and wiry slippery pulse

Contraindications: Dizziness and vertigo patterns associated with liver fire or blood xu

Biomedical Indications: Sedative; Calminative

Dosage: 8-12 pills at 3 x / day (away from food) where possible

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© Endeavour College of Natural Health endeavour.edu.au 20

Ban Xia Bai Zhu Tian Ma Tang | Pinellia, Atractylodes and Gastrodia Decoction

(McClean 2003, p574)

TCM Dx: Phlegm-Wind

o Increased desire to sleep

o Heavy sensation in the body

o Poor appetite

o Foggy head

o Heaviness in the head as though it is wrapped in a wet cloth

o Dizziness and vertigo

o Frontal headache

o Tinnitus

o Nausea and vomiting

o Fullness in the chest

o Tongue: Thick greasy white tongue coating

o Pulse: Slippery, wiry

Page 21: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 21

Herb Hierarchy Dosage Temp Taste Group Action

Ban Xia Chief 4.5gm Warm

Neutral

Pungent Eliminate

Phlegm

Drains damp-cold; Transforms phlegm; Descends qi; Stops vomiting; Tonifies/harmonises

spleen; Stops bleeding; Eczema, burns, sores.

Tian Ma Chief 3gm Warm Sweet Calm Liver Extinguish Wind; Clears wind heat; Calms and anchors the shen; Unblocks channels;

Relieves pain; Settles tremors and convulsions; Dislodges wind phlegm.

Bai Zhu Deputy 9gm Warm Bitter

Sweet

Tonify Harmonize & tonifies qi, spleen and stomach; Dries damp; Promotes urination; Stabilizes

the exterior; Calms the fetus.

Fu Ling Assistant 3gm Neutral Sweet Expel Damp Promote urination; Drains damp; Harmonize and strengthen the spleen; Calms and anchors

the spirit; Dislodges the phlegm; Disperse swelling.

Chen Pi** Assistant 3gm Warm Bitter

Pungent

Regulate Qi Move and regulates the qi; Transforms phlegm; Dries damp; Tonifies qi; Directs qi

downwards; Dislodges phlegm.

Sheng Jiang Envoy 1 slice Warm Pungent Release

Exterior

Release the exterior; Dispels cold; Transforms phlegm; Calms vomiting; Stops cough;

Detoxifies and disinfects.

Da Zao Envoy 2pcs Warm Sweet Tonify Harmonize/tonifies qi, spleen, stomach; Moistens dryness; Generates fluids; Calms/anchors

shen; Tonifies blood.

Gan Cao Envoy 1.5gm Neutral Pungent Tonifying Harmonize/tonifies qi, spleen, stomach; Clears fire/moisten dryness; Detoxifies & disinfects;

Calms/anchors shen.

Ban Xia Bai Zhu Tian Ma Tang | Pinellia, Atractylodes and Gastrodia Decoction

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© Endeavour College of Natural Health endeavour.edu.au 22

Herbal Identification

Wen Dan Tang | Warm the Gall Bladder Decoction

Ban Xia Chen Pi Fu Ling Sheng Jiang

Gan Cao Bai Zhu Tian MaDa Zao

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© Endeavour College of Natural Health endeavour.edu.au 23

Notes

In the formula, using Ban Xia and Tian Ma to treat Wind-phlegm

Bai Zhu and Fu Ling to invigorate spleen and dry dampness

The combination of the all drugs plays the effects of resolving phlegm,

stopping wind and relieving dizziness

Group discussion: clinic applications for Ban Xia Bai Zhu Tian Ma Tang ??

Page 24: CMHB221 Chinese Herbal Formulae key clinic symptoms/signs for Er Chen Tang , Wen Dan Tang , Ban Xia Bai Zhu Tian Ma Tang , Zhi Sou San , Bao He Wan and Jian Pi Wan All key clinic symptoms

© Endeavour College of Natural Health endeavour.edu.au 24

24

Chief Combination Modifications

Ban Xia* (Hempen 2009, p.82)

Action CHM Group Reference

Focal distension in the epigastrium and

abdomen, dry heaves, vomiting due to stomach

qi disharmony.

Chen Pi Regulate Qi Hempen 2009, p.488

Epigastric distension, digestive problems due to

heat and cold.

Huang Lian Clear Heat | Dry Damp Hempen 2009, p.172

Productive cough due to dampness and phlegm

or to spleen qi xu.

Chen Pi Regulate Qi Hempen 2009, p.488

Cough, dry heaves, vomiting due to hot phlegm

and rebellious qi

Huang Qin Clear Heat | Dry Damp Hempen 2009, p.184

Cough, dry heaves, distension in the epigastrium

and abdomen due to phlegm

Hou Po Transform Damp Hempen 2009, p.292

Cough due to phlegm Zhe Bei Mu Cool & Transform Hot Phlegm Hempen 2009, p.650

Stifling sensation in the chest, cough, vomiting

due to hot phlegm

Gua Lou Cool & Transform Hot Phlegm Hempen 2009, p.662

Insomnia due to hot phlegm Xia Ku Cao Clear Heat | Cool Fire Hempen 2009, p.140

Bloody sputum, bloody stools Zhi Tian Nan Xing Transform Cold Phelgm Hempen 2009, p.624

Fractures, external injuries Zhi Tian Nan Xing Transform Cold Phelgm Hempen 2009, p.624

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© Endeavour College of Natural Health endeavour.edu.au 25

Zhi Sou San | Anti-Tussive Powder

(止嗽散)Source: Yi Xue Xin Wu ( A Summary on Medicine from Clinical Practice)

Composition: Bai Bu , Bai Qian, Zi Yuan, Chen Pi, Jing Jie, Gan Cao, Jie Geng

Administration: All the drugs should be decocted in water for oral use, generally, Wu Mei may not be used.

Functions: Relieve cough, resolev phlegm, expel exterior syndrome and promote lung’s dispersing function

Indications: Cough due to exogenous factors, itching sensation in the throat, difficult to spit out sputum, orwith slight aversion to clod, fever, thin white tongue coating.

Contraindications: Cough due to wind cold or cough due to lung yin xu

Biomedical Indications: Antitussive;Mucolytic

Dosage: 8-12 pills at 3 x / day (away from food) where possible

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© Endeavour College of Natural Health endeavour.edu.au 26

Zhi Sou San | Anti-Tussive Powder

TCM Dx: Cough due to external pathogenic invasion

o Itchy throat

o Coughing

o Chills

o Fever

o Aversion to wind

o Sputum

o Tongue: Thin white coat

o Pulse: Floating

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© Endeavour College of Natural Health endeavour.edu.au 27

Herb Hierarchy Dosage Temp Taste Group Action

Zi Wan Chief 12gm Warm Pungent

Bitter

Stop Cough Transforms cold phlegm; Stops cough; Direct qi downwards; Disperses cold; Moistens

dryness.

Bai Bu Chief 12gm Neutral Sweet

Bitter

Stops Cough Moistens dryness; Stops cough; Detoxifies and disinfects; Anti-parasitic.

Bai Qian Deputy 12gm Warm Pungent

Sweet

Transforms

Cold Phlegm

Directs qi downwards; Dispels cold; Dislodges phlegm; Stops cough; Stops wheeze.

Jie Geng Deputy 12gm Warm Pungent

Bitter

Transform

Phlegm

Moves/regulates/raises qi; Stops cough; Dislodges phlegm; Dispels wind-damp, wind-heat;

Drains damp-heat; Eczema, burns, ulcers; Astringent.

Chen Pi Assistant 6gm Warm Bitter

Pungent

Regulate Qi Move and regulates the qi; Transforms phlegm; Dries damp; Tonifies qi; Directs qi

downwards; Dislodges phlegm.

Jing Jie Assistant 12gm Warm Pungent

Aromatic

Release

Exterior

Expels cold/wind; Release exterior; Vents rashes; Alleviates itching; Stops bleeding;

Eczema, burns, sores.

Gan Cao Envoy 6gm Neutral Pungent Tonifying Harmonize/tonifies qi, spleen, stomach; Clears fire/moisten dryness; Detoxifies & disinfects;

Calms/anchors shen.

Zhi Sou San | Anti-Tussive Powder

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© Endeavour College of Natural Health endeavour.edu.au 28

Notes

This formula is neutral in nature and good at relieving cough and resolving phlegm,

expelling exterior syndrome and promoting the function of lung in dispersing

Group discussion: clinic applications for Zhi Sou San ??

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29

Chief Combination Modifications

Zi Wan* (Hempen 2009, p.666)

Action CHM Group Reference

Cough with wheeze, profuse sputum Kuan Dong Hua Stop Cough Hempen 2009, p.678

Acute or chronic cough, bloody sputum Bai Bu Stop Cough Hempen 2009, p.676

Cough with phlegm, wheezing, spontaneous

sweating

Wu Wei Zi Stabilize and Bind Hempen 2009, p.850

Chronic cough, heat, purulent sputum Tian Men Dong Tonify Yin Hempen 2009, p.784

Huang Qin Clear Heat, Drain Damp Hempen 2009, p.184

Sang Bai Pi Stop Cough Hempen 2009, p.674

Lung xu with chronic cough, bloody sputum Zhi Mu Clear Heat | Drain Fire Hempen 2009, p.120

Bei Mu Cool and Transform Phlegm Hempen 2009, p.648

Lung yin xu: cough Kuan Dong Hua Stop Cough Hempen 2009, p.678

Bei Mu Cool and Transform Phlegm Hempen 2009, p.648

Mai Men Dong Tonify Yin Hempen 2009, p.802

E Jiao Tonify Yin Hempen 2009, p.770

Bai Qian Transforms Cold Phlegm Hempen 2009, p.628

Gan Cao Tonify Qi / Balance Hempen 2009, p.716

Jie Geng Transforms Cold Phlegm Hempen 2009, p.636

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Tutorial Activity – Case Study 12.1

Patient 10.3 (Female 35 years) presents for the management of dizziness (onset: <2.5 months ago). Further questioningalso determines that the patient suffers from irritability, insomnia (difficulty going to sleep) and strong thirst. She is frequentlytired (4/10) and explains that her doctor has diagnosed her with depression (she is currently medicated with an SSRI). Herdiet is loaded with a preference for cold and damp cold foods (she longs to eat cheese). She also notes that she also has abitter taste in the mouth intermittently throughout the day.

She previously had a preference to exercise and practice yoga, however, for the past four months she has been unable to do this due to feeling not right.

Clinical Assessments:

Other: Nil

Pulse: Slippery and slightly rapid.

Tongue: Thick yellow coating.

o What is the TCM/CM Aetiology and Pathogenesis of the above condition?

o What is the TCM/CM diagnosis?

o What are the TCM/CM treatment principles required here?

o Which herbal formula should be used here?

o What modification should be further made here to enhance the outcomes achieved?

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Bao He Wan | Preserve Harmony Pill

(保和丸)Source: Dan Xi Xin Fa ( Dan Xi’s Experiential Therapy)

Composition: Shan Zha, Shen Qu, Ban Xia , FuLing, Chen Pi, Lian Qiao, Luo Bo Zi (Lai Fu Zi), Mai Ya

Administration: Grind all the above drugs into very fine powder and then mix with water to make into pills.Each time with boiled water or Chao Mai Ya

Functions: Promote digestion and harmonize the stomach

Indications: Retention of food

Dosage: 8-12 pills at 3 x / day (away from food) where possible

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Bao He Wan | Preserve Harmony Pill

(保和丸)

TCM Dx: Food stagnation

o Indigestion, Dyspepsia

o Halitosis

o Belching

o Acid reflux

o Epigastric and upper abdominal distension

o Heartburn

o Flatulence

o Constipation or diarrhoea

o Tongue: Thick coating

o Pulse: Slippery, big or full pulse

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Herb Hierarchy Dosage Temp Taste Group Action

Shan Zha Chief 9-15gm Warm Sour

Sweet

Promote

Digestion

Reduce stagnation; Relieve food stagnation; Harmonise and tonify the spleen; Move and

regulate blood; Break up accumulation; Astringes.

Shen Qu Deputy 9-12gm Warm Sweet

Pungent

Promote

Digestion

Reduce stagnation; Harmonise and tonify the middle jiao; Relieve food stagnation; Move

and regulate qi; Stops lactation.

Lai Fu Zi Deputy 6-9gm Neutral Sweet

Pungent

Promote

Digestion

Reduce stagnation; Harmonise and tonify the spleen; Descends the qi; Dislodges phlegm;

Relieve food stagnation.

Ban Xia Assistant 9-12gm Warm

Neutral

Pungent Eliminate

Phlegm

Drains damp-cold; Transforms phlegm; Descends qi; Stops vomiting; Tonifies/harmonises

spleen; Stops bleeding; Eczema, burns, sores.

Chen Pi Assistant 9-12gm Warm Bitter

Pungent

Regulate Qi Move and regulates the qi; Transforms phlegm; Dries damp; Tonifies qi; Directs qi

downwards; Dislodges phlegm.

Fu Ling Assistant 9-12gm Neutral Sweet Expel Damp Promote urination; Drains damp; Harmonize and strengthen the spleen; Calms and anchors

the spirit; Dislodges the phlegm; Disperse swelling.

Lian Qiao Assistant 3-6gm Cold Bitter

Pungent

Clear Heat Cools heat; Dispels wind heat; Disinfect/detoxify; Breaks up lumps; Cools fire; Moves

regulate qi; Breaks up blood stagnation.

Mai Ya* Assitant 9.53mg Neutral

Warm

Sweet

Salty

Promote

Digestion

Harmonise and tonify the spleen & stomach; Relieve food stagnation; Break up

accumulation; Stop lactation; Moves and regulates qi; Harmonises and tonifies qi.

Bao He Wan | Preserve Harmony Pill

* Some versions have Mai Ya in the formula

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Herbal Identification

Bao He Wan | Preserve Harmony Pill

Shan Zha

Removing

accumulation of

greasy food

Shen Qu

Promoting

digestion,

removing

accumulated

food

Lai Fu Zi

Removing

accumulated grain

food, easing chest

and relieving

fullness

Ban Xia

Removing

phlegm

Chen Pi

Drying dampness,

removing phlegm,

regulating Qi

Fu Ling

Drain Damp

Lian Qiao

Dispersing the

stagnation and

clearing the heat

MaI ya

Harmonise and tonify the

spleen & stomach

Relieve food stagnation

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Chief Combination Modifications

Shan Zha* (Hempen 2009, p.682)Action CHM Group Reference

Food stagnation, consumption of meat and greasy

foods, diarrhoea, abdominal pain.

Mai Ya Promote Digestion Hempen 2009, p.686

Shen Qu Promote Digestion Hempen 2009, p.688

Abdominal pain, retained lochia, blood stasis. Dang Gui Tonify Blood Hempen 2009, p.768

Chuan Xiong IBC Hempen 2009, p.530

Yi Mu Cao IBC Hempen 2009, p.554

Searing pain in the lower abdomen, hernias, pain,

swelling of the testicles, testicular herniation.

Ju He Regulate Qi Hempen 2009, p.486

Xiao Hui Xiang Warm Interior | Expel Cold Hempen 2009, p.398

Blood stasis, bleeding. Pu Huang Stop Bleeding Hempen 2009, p.616

Qian Cao Gen Stop Bleeding Hempen 2009, p.606

Childhood nutritional impairment due to insufficient

lactation.

Mai Ya Promote Digestion Hempen 2009, p.686

Shen Qu Promote Digestion Hempen 2009, p.688

Epigastric and abdominal distension. Zhi Shi Regulate Qi Hempen 2009, p.484

Abdominal distension or pain, diarrhoea,

dysentery.

Mu Xiang Regulate Qi Hempen 2009, p.480

Rou Dou Kou Stabilise and Bind Hempen 2009, p.840

Bian Dou Tonify Qi Hempen 2009, p.720

Stifling sensation in the chest, blood stasis in the

heart channel.

Dan Shen IBC Hempen 2009, p.570

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Jian Pi Wan | Strengthen the Spleen Pill

(健脾丸)Source: Zheng Zhi Zhun Sheng (Standard for Diagnosis and Treatment)

Composition: Bai Zhu; Mu Xiang; Huang Lian; Gan Cao; Bai Fu Ling; Ren Shen; Shen Qu; Chen Pi;Sha Ren; MaiYa; Shan Zha; Shan Yao; Rou Dou Kou

Administration: All the drugs should be decocted in water for oral use, generally, Wu Mei may not be used.

Functions: Invigorate the spleen, harmonize the stomach, promote digestion and relieve diarrhea

Indications: Retention of food due to weakness of the spleen and stomach, marked by poor appetite,indigestion, distension and fullness in the epigastrium and abdomen, loose stool, greasy coating of the tonguewith light yellow color, forceless or weak pulse

Caution: Breast feeding due to reducing milk production (due to the Mai Ya)

Biomedical Indications: Enhances digestive function ; Digestive; Calminative;Stomachic

Dosage: 8-12 pills at 3 x / day (away from food) where possible

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Jian Pi Wan | Strengthen the Spleen Pill

(健脾丸)

TCM Dx: Spleen Qi Xu with Food stagnation

o Gradual loss of appetite, or decrease in the amount of food that can be consumed before

feeling bloated.

o Fatigue

o Acid reflux, heartburn

o Upper abdominal distension and fullness

o Belching and flatulence

o Tendency to loose stools or diarrhoea

o Tongue: Pale, possibly swollen tongue with a thick tongue coating

o Pulse: Slippery or soft and weak

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Herb Hierarchy Dosage Temp Taste Group Action

Bai Zhu Chief 75gm Warm Bitter

Sweet

Tonify Harmonize & tonifies qi, spleen and stomach; Dries damp; Promotes urination; Stabilizes

the exterior; Calms the fetus.

Fu Ling Chief 60gm Neutral Sweet Expel Damp Promote urination; Drains damp; Harmonize and strengthen the spleen; Calms and anchors

the spirit; Dislodges the phlegm; Disperse swelling.

Ren Shen Deputy 60gm Warm Sweet

Bitter

Tonify Harmonize & tonifies qi and spleen; Raise the Qi; Generate fluid; Calms/anchors shen.

Shan Yao Deputy 45gm Neutral Sweet Tonify Qi

Tonify Yin

Harmonize & tonify Qi, Spleen, Stomach; Tonifies Yin.

Shan Zha Deputy 30gm Warm Sour

Sweet

Promote

Digestion

Reduce stagnation; Relieve food stagnation; Harmonise and tonify the spleen; Move and

regulate blood; Break up accumulation; Astringes.

Shen Qu Deputy 30gm Warm Sweet

Pungent

Promote

Digestion

Reduce stagnation; Harmonise and tonify the middle jiao; Relieve food stagnation; Move

and regulate qi; Stops lactation.

Mai Ya Deputy 30gm Neutral

Warm

Sweet

Salty

Promote

Digestion

Harmonise and tonify the spleen & stomach; Relieve food stagnation; Break up

accumulation; Stop lactation; Moves and regulates qi; Harmonises and tonifies qi.

Mu Xiang Assistant 22.5gm Warm Pungent

Bitter

Regulate Qi Moves and regulates qi; Relieves pain; Tonifies the qi; Dispels cold.

Rou Dou Kou Assistant 30gm Warm Pungent Stabilize and

Bind

Acts as an astringent and collects; Stops diarrhoea; Warms cold; Regulates and moves qi;

Relieves pain.

Chen Pi Assistant 30gm Warm Bitter

Pungent

Regulate Qi Move and regulates the qi; Transforms phlegm; Dries damp; Tonifies qi; Directs qi

downwards; Dislodges phlegm.

Sha Ren Assistant 30gm Warm Aromatic Transform

Damp

Harmonizes and tonifies the spleen; Transforms damp; Move and regulate qi; Tonify and

replenish the qi; Stop diarrhoea; Calms fetus.

Huang Lian Assistant 22.5gm Cold Bitter Clear Heat

Dry Damp

Cools heat; Drain Fire; Clears damp-heat; Detoxifies and disinfects; Stops bleeding;

Eczema, burns and ulceration; Descends yang.

Gan Cao Envoy 22.5gm Neutral Pungent Tonifying Harmonize/tonifies qi, spleen, stomach; Clears fire/moisten dryness; Detoxifies & disinfects;

Calms/anchors shen.

Jian Pi Wan | Strengthen the Spleen Pill

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Herbal Identification

Jian Pi Wan | Strengthen the Spleen Pill

Shan Zha Shen Qu Chen PiMaI ya

Bai Zhu Ren Shen Fu Ling Gan Cao

Si Jun Zi Tang

Tonify Qi, invigorate spleen

and resolve dampness

Shan Yao Rou Dou Kou

Invigorate spleen

Relieve diarrhea

Relieve food stagnation

Promoting digestion

Mu Xiang Sha Ren

regulating Qi , harmonizing stomach

Huang Lain

Clearing away

heat

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Chief Combination Modifications

Bai Zhu* (Hempen 2009, p.708)

Action CHM Group Reference

Deficiency of the middle jiao with cold signs:

abdominal pain, distension, nausea, diarrrhoea

Dang Shen Tonify Qi Hempen 2009, p.710

Gan Jiang Warm Interior Hempen 2009, p.408

Spleen and stomach deficiency with qi stagnation,

lack of appetite, pain and distension of the

epigastrium, fullness

Zhi Ke Regulate Qi Hempen 2009, p.482

Spleen and stomach deficiency with fluid

accumulation, chest obstruction, oedema

Fu Ling Drain damp Hempen 2009, p.334

Damp-cold, painful obstruction, vaginal discharge Cang Zhu Transform Damp Hempen 2009, p.286

Spontaneous sweating Huang Qi Tonify Qi Hempen 2009, p.706

Xiao Mai Nourish Heart & Calm Shen Hempen 2009, p.444

Xiao Mai Stabilize and Bind Hempen 2009, p.854

Restless fetus with internal heat Huang Qin Clear Heat / Dry Damp Hempen 2009, p.184

Restless fetus with qi stagnation, fullness of the

chest and abdomen

Chen Pi Regulate Qi Hempen 2009, p.488

Dampness or phlegm, oedema Fu Ling Drain Damp Hempen 2009, p.334

Rou Gui Interior Warming Hempen 2009, p.394

Da Fu Pi Regulate Qi Hempen 2009, p.478

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