【Source】

《Shang Han Lun》 (Treatise on Cold Damage Disorders)

 【Ingredients】

Ban Xia, Huang Qin, Gan Jiang, Ren Shen, (Zhi)Gan Cao, Huang Lian, Da Zao
(7)

 【Categorization of Ingredients】

<Tonifies Spleen and Middle Jiao>: Da Zao, Gan Cao

<Clears Heat and Dries Dampness>: Huang Lian, Huang Qin

<Tonifies Qi>: Ren Shen

<Warms the Interior>: Gan Jiang

<Resolves Phlegm>: Ban Xia

【Formula Principles】

《Yi Fang》: This is a formula for the Hand Shaoyin and Foot Taiyin meridians. Cheng Shi says: When there is obstruction (fou) but no smooth flow (tai), it constitutes pi (glomus/fullness). Bitterness first enters the Heart [meridian/system], so a formula that ‘purges the Heart’ (referring to the epigastrium, xīnxià or ‘below the heart’) must be bitter. (1) Therefore, Huang Lian is the sovereign, and Huang Qin is the minister, to descend Yang and ascend Yin. (2) Pungent flavor moves Qi, and resolving pi necessarily requires pungent herbs. Therefore, Ban Xia and Gan Jiang are assistants, to separate Yin and move Yang. (3) To connect the upper and lower, and facilitate the interchange of Yin and Yang, the Middle Jiao must be harmonized. Therefore, Ren Shen, Gan Cao, and Da Zao are envoys, to tonify the Spleen and harmonize the Middle, whereupon the pi (glomus) and heat will resolve, and profuse sweating will bring relief.
《Shan Bu》: Wang Youyuan says: On the fifth or sixth day of cold damage (Shang Han), when the Chai Hu pattern is present, but other purgative herbs are used, pi (glomus/fullness) forms. This formula is like <a href=’https://whatsintcm.com/en/dt_articles/xiao-chai-hu-tang-minor-bupleurum-decoction/‘>Xiao Chai Hu Tang, but Gan Jiang replaces Sheng Jiang, and Huang Lian replaces Chai Hu. The latter (Xiao Chai Hu Tang) harmonizes the exterior and interior, while this formula penetrates and connects the upper and lower (Jiaos). Ban Xia is considered the sovereign because pi (glomus) often arises from vomiting, and Ban Xia‘s pungent quality breaks stagnation and stops vomiting.
《Cheng Fang Bian Du》: It is said that where there is hardness/firmness, there must be lurking Yang (heat). Therefore, the bitter taste of Huang Qin and Huang Lian is used to descend it and clear it with cold properties. Furthermore, both herbs are drying in nature, making them suitable for conditions caused by damp-heat. However, sticky, turbid dampness and external pathogens, when mixed, cannot be removed solely by bitter-descending and directly draining herbs. Therefore, Gan Jiang, with its greatly pungent and hot nature, must be used to disperse them. One ascends, one descends; one is bitter, one is pungent. And Ban Xia communicates Yin and Yang, moves damp-turbidity, disperses pathogens, and harmonizes the Stomach, thereby achieving the effect of treating pi. Gan Cao, Ren Shen, and Da Zao are used because the illness stems from internal deficiency, and also out of concern that the bitter, pungent, opening, and draining herbs might be excessive. Therefore, these herbs support the Zheng Qi (righteous Qi) and assist in transformation.
《Handian》: Ban Xia removes retained water in the stomach; when combined with Gan Jiang, it also stops nausea and vomiting. Huang Lian and Huang Qin together clear inflammation in the gastrointestinal tract; both are bitter stomachics. Ren Shen combined with Gan Jiang promotes blood circulation in the gastrointestinal tract and aids in the recovery of function. Gan Cao and Da Zao harmonize the various herbs and enhance their synergistic effects.

 【Functions】

Harmonizes the Stomach and descends rebellious Qi, opens stagnation and resolves glomus, eliminates fullness.

 【Indications】

Disharmony of Stomach Qi, disharmony of the gastrointestinal tract, disordered ascent and descent, presenting with epigastric glomus and fullness (below the heart), which is soft to the touch and not painful upon pressure, nausea, dry heaves or vomiting, poor appetite, borborygmus with diarrhea, and a thick, greasy tongue coating (either white or yellow). Suitable for conditions caused by Spleen deficiency generating dampness and phlegm, with intermingled cold and heat binding in the epigastrium, and disharmony of Stomach Qi in the Middle Jiao, presenting with glomus and fullness in the chest and epigastrium, poor appetite, vomiting, and diarrhea.
《Yi Fang》: For cold damage (Shang Han) where purgation was performed too early, resulting in chest fullness that is not painful (this is pi), accompanied by chills, vomiting, and inability to eat; it is not a Chai Hu pattern.
《Shan Bu》: On the fifth or sixth day of cold damage, if there is vomiting and fever, and the Chai Hu pattern is present, but purgative herbs were used, resulting in fullness but no pain, and epigastric glomus.

 【Applications (Modern)】

Digestive system disorders primarily involving gastric ulcers, gastritis, enteritis, hyperacidity, gastrectasia, gastroptosis, gastric ulcer, duodenal ulcer, and stomach pain. Also used to treat vomiting, hiccups, morning sickness (hyperemesis gravidarum), chronic cholecystitis, gastrointestinal flu, esophagitis, and other conditions.

 【Mnemonics】

(1) <a href=’https://whatsintcm.com/en/dt_articles/xiao-chai-hu-tang-minor-bupleurum-decoction/‘>Xiao Chai Hu Tang minus Chai Hu plus Huang Lian, Sheng Jiang changed to Gan Jiang. (2) “Half fright writes letter” (Ban Xia Xie Xin – a phonetic pun for Ban Xia Xie Xin Tang) – “Summer dry young people look for Shen Cao” (夏天乾燥青年找參草) which phonetically hints at the ingredients: Ban Xia (夏), Gan Jiang (乾), Huang Qin (青), Huang Lian (連), Ren Shen (參), Gan Cao (草), and Da Zao (implied by context or other mnemonic associations).#

 【Modifications】

(1) If glomus and fullness are severe, remove Da Zao and add Zhi Shi to strengthen the action of resolving glomus. (2) If damp-turbidity is severe, add Huo Xiang, Hua Shi, and Fu Ling to transform dampness and promote diuresis. (3) If cold pathogen is more severe, remove Huang Qin and add Gui Zhi or Rou Gui to enhance the action of warming the interior and dispelling cold. (4) If Gan Jiang is replaced by Sheng Jiang, it becomes <a href=’https://whatsintcm.com/en/dt_articles/sheng-jiang-xie-xin-tang-ginger-heartburn-decoction/‘>Sheng Jiang Xie Xin Tang from 《Shang Han Lun》, which treats intertwining water and heat, firm glomus below the heart, dry belching with foul food odor, and borborygmus with diarrhea. (5) If Huang Qin is removed and Gui Zhi is added, it becomes <a href=’https://whatsintcm.com/en/dt_articles/huang-lian-tang-coptis-decoction/‘>Huang Lian Tang from 《Shang Han Lun》, which treats heat in the chest, cold in the stomach, vexing fullness in the chest, desire to vomit, abdominal pain, or borborygmus with diarrhea, a white slippery tongue coating, and a wiry pulse. (6) If the dosage of Gan Cao is increased, it becomes <a href=’https://whatsintcm.com/en/dt_articles/gancao-xiexin-tang/‘>Gan Cao Xie Xin Tang from 《Shang Han Lun》, which treats borborygmus with diarrhea, undigested food in stools, firm and full glomus below the heart, nausea, and restless vexation.

 【Pharmacological Actions】

Has anti-gastric ulcer, anti-hypoxia, antiemetic, anti-inflammatory, antipyretic, and analgesic effects, among others.