【Source】

《Qian Jin Yao Fang (Prescriptions Worth a Thousand Gold, 652 AD)》, 《San Yin (Treatise on the Three Categories of Causes of Diseases, 1174 AD)》 Volume 9.

 【Composition】

Pinellia Tuber, Immature Bitter Orange, Bamboo Shavings, Aged Tangerine Peel, Licorice Root, Poria Mushroom, Fresh Ginger, Jujube
(8 ingredients)

 【Ingredient Categories】

<Regulating Qi>: Aged Tangerine Peel, Immature Bitter Orange

<Tonifying Spleen and Middle Jiao>: Jujube, Licorice Root

<Acrid-Warm Exterior-Releasing>: Fresh Ginger

<Tonifying Spleen and Promoting Diuresis>: Poria Mushroom

<Resolving Phlegm>: Bamboo Shavings, Pinellia Tuber

【Formula Principles】

《Medical Formulas》: Medicine for Foot Shaoyang (Gallbladder Meridian) and Yangming (Stomach Meridian). (Dai’s commentary: Phlegm in the Gallbladder meridian, spirit unable to return to its abode, also causes insomnia).

(1) The acrid-warm nature of Tangerine Peel (Chen Pi), Pinellia (Ban Xia), and Fresh Ginger (Sheng Jiang) is used to guide phlegm, stop vomiting, and thereby warm the gallbladder.

(2) Immature Bitter Orange (Zhi Shi): Breaks stagnation.

(3) Poria (Fu Ling): Drains dampness.

(4) Licorice Root (Gan Cao): Harmonizes the middle jiao.

(5) Bamboo Shavings (Zhu Ru): Dispels stagnation in the stomach-earth, clears dryness in the lung-metal. Cooling lung-metal thus calms ‘Jia’ wood (Gallbladder-wood). In this way, it is neither cold nor dry, and the gallbladder remains warm. (The gallbladder is ‘Jia’ wood, and metal can restrain wood).

(6) The classics also state: “If the stomach is not harmonious, one cannot sleep peacefully.” It also says: “When Yang Qi is full and cannot enter Yin, and Yin Qi is deficient, the eyes cannot close.” Pinellia (Ban Xia) can harmonize the stomach and facilitate the communication between Yin and Yang, which is why the Nei Jing (Inner Canon) uses it to treat insomnia. Er Chen Tang (Two Aged Ingredients Decoction) not only warms the gallbladder but also harmonizes the stomach. 《Deletions and Additions》: This formula uses Er Chen Tang to treat all phlegm-dampness. Adding Bamboo Shavings (Zhu Ru) to clear heat, Fresh Ginger (Sheng Jiang) to stop vomiting, and Immature Bitter Orange (Zhi Shi) to break rebellious qi, they complement each other.

Although it doesn’t directly treat the gallbladder, the gallbladder harmonizes itself because the phlegm-heat in the gallbladder is cleared. The name “Warm” refers to “gentle warmth,” not “warmth against cold.” If it were meant to warm a truly cold and timid gallbladder, not only would there be no gallbladder-warming ingredients in the formula, but there would also be stomach-cooling herbs.

Easy Reading of Complete Formulas: Among the six fu-organs, all purge rather than store, except for the gallbladder, which is a pure and clear organ, with no entry or exit, residing with the liver and forming an interior-exterior relationship with it. The liver stores the ethereal soul (Hun), and at night, the soul returns to the liver. If there is evil in the gallbladder, how could it not affect the liver? Moreover, the gallbladder is ‘Jia’ wood, symbolizing spring. If the gallbladder is deficient, it cannot fulfill its function of growth and development, thus the earth (spleen) cannot be supported by wood. If the earth is not unblocked, phlegm and saliva easily generate.

Phlegm is the mother of all diseases, and where there is deficiency, evil takes root, hence the symptoms of fright and palpitations. This formula primarily uses Er Chen Tang, Bamboo Shavings (Zhu Ru), Immature Bitter Orange (Zhi Shi), and Fresh Ginger (Sheng Jiang) to harmonize the stomach, resolve phlegm, break qi stagnation, and dispel depression. There are no actual gallbladder-warming herbs within it. It is named “Warm the Gallbladder” because the gallbladder is ‘Jia’ wood, and it is always desirable for it to be like the gentle warmth of spring. 《Chinese Encyclopedia of Medicine》: The original formula of this prescription, Er Chen Tang, removes stagnant water in the stomach.

Bamboo Shavings (Zhu Ru) clears stomach heat and has an analgesic effect. Immature Bitter Orange (Zhi Shi) removes epigastric fullness and discomfort and has a calming effect. If Coptis (Huang Lian) and Sour Jujube Seed (Suan Zao Ren) are added to this formula, it can further calm excited nerves.

 【Functions】

Warms the gallbladder and harmonizes the stomach, resolves phlegm and stops vomiting.

 【Indications】

(1) Phlegm-heat disturbing internally, deficiency of heart and gallbladder qi, vexation and insomnia, vexing insomnia, frequent strange dreams at night, or vomiting and hiccupping, palpitations and restlessness, epilepsy, etc. 《Medical Formulas》: Insomnia due to gallbladder deficiency with phlegm-heat, vexation and palpitations, bitter taste in the mouth, vomiting phlegm. 《Deletions and Additions》: Hot vomiting with bitter taste, vexation, palpitations and insomnia, rebellious phlegm qi.

 【Applications】

Used for individuals with a slightly deficient and lax constitution, experiencing insomnia due to deficiency with gastroptosis or gastric atony. Also for palpitations, hyperactive heart palpitations, qi stagnation syndrome, stomach disorders, and other conditions.

 【Contraindications】

Not suitable for conditions like vomiting, hiccupping, and epilepsy caused by cold phlegm.

 【Mnemonic】

Er Chen Tang + “Zhi Yong Da Zhu” (a mnemonic for adding Immature Bitter Orange (枳), Jujube (大), and Bamboo Shavings (竹)).

 【Modifications】

Medical Formulas:

(1) Heart deficiency: add Ginseng, Sour Jujube Seed.

(2) Internal vexation and heat: add Coptis, Ophiopogon Tuber.

(3) Dry mouth and tongue: remove Pinellia, add Ophiopogon Tuber, Schisandra Berry, Trichosanthes Root.

(4) Unresolved exterior heat: add Bupleurum Root.

(5) Internal deficiency with spontaneous loose stools: remove Immature Bitter Orange, add Atractylodes Rhizome.

(6) Internal repletion with vexation: add carbonized Gardenia Fruit. (1) For severe heat: add Coptis to clear heat. (2) For exuberant fire and phlegm obstruction, obscuring the sensory orifices, leading to madness/mania: add Acorus, Turmeric Tuber, Rhubarb, Mirabilite to clear heat and open the orifices. (3) For Qi deficiency: add Ginseng, Astragalus Root to tonify qi. (4) For deficiency of Yin blood: add Chinese Angelica Root, Prepared Rehmannia Root to nourish blood. (5) For restless spirit, severe palpitations and insomnia: add Sour Jujube Seed, Polygala Root to soothe the liver and calm the spirit.

 【Pharmacology】

Mainly has effects such as phlegm resolution, sedation, anti-ulcer, and anti-emetic actions.