【Source】

《Formulas from the Bureau of National Medical Service of the Taiping Era》

 【Ingredients】

Chen Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens)
(5)

 【Category】

<Regulating Qi>：Chen Pi (Citri Reticulatae Pericarpium)

<Tonifying Spleen and Middle Jiao>：Gan Cao (Glycyrrhizae Radix et Rhizoma)

<Releasing Exterior with Acrid and Warm Herbs>：Sheng Jiang (Zingiberis Rhizoma Recens)

<Tonifying Spleen and Promoting Diuresis>：Fu Ling (Poria)

<Transforming Phlegm>：Ban Xia (Pinelliae Rhizoma)

【Formula Analysis】

《Medical Formulas》: This formula acts on the Foot Taiyang and Yangming meridians. (1) Ban Xia: Acrid and warm in nature, slippery in texture, and drying in property. It promotes water circulation and resolves phlegm, serving as the chief herb. (2) Phlegm arises from Qi stagnation. When Qi flows smoothly, phlegm descends. Therefore, Ju Hong (Citri Erythrocarpae Pericarpium) is used to regulate Qi. (3) Phlegm is produced by dampness. When dampness is eliminated, phlegm disappears. Thus, Fu Ling is used as a deputy herb to drain dampness. (4) When the Middle Jiao is disharmonious, phlegm and saliva accumulate. Gan Cao is used as an assistant herb to harmonize the Middle Jiao and tonify the Earth element. 《San Bu》: Li Zhongzi said: Obese people tend to have more dampness. Dampness combines with heat to produce phlegm, and fire carries Qi upward. The acrid nature of Ban Xia promotes urination and defecation to eliminate dampness. The acrid nature of Chen Pi unblocks the Triple Burner and regulates Qi. Fu Ling assists Ban Xia to achieve the effect of drying dampness. Gan Cao assists Chen Pi to harmonize the formula. Cheng Wuji said: Ban Xia promotes the circulation of water Qi and moistens kidney dryness. The Classic states: “Use acridity to moisten it.” By promoting water circulation, the Earth element naturally dries, not because Ban Xia is inherently drying. Some say: If there is phlegm with thirst, replace Ban Xia with Bei Mu (Fritillariae Cirrhosae Bulbus). Wu Kun said: If there is thirst and a desire to drink, with frequent urination, replace it. If one cannot drink water and has difficult urination, even if thirsty, Ban Xia should be used. This is because dampness is the root cause, and heat is the superficial manifestation. It is a case of dampness reaching its extreme and overcoming its own transformation, not a true heat pattern. Furthermore, people in the Southeast region tend to generate phlegm due to damp-heat. Therefore, Zhu Zhenheng often adds Zhi Shi (Aurantii Fructus Immaturus) and Sha Ren (Amomi Fructus) to the formula, calling it Zhi Shi Er Chen Tang, which is more potent. Ancient sages said: Er Chen Tang is a wonderful formula for treating phlegm, suitable for both upper and lower, left and right. However, it can only treat the superficial aspect of substantial phlegm and cannot treat the root cause of deficient phlegm. The root cause of deficient phlegm lies in the Spleen and Stomach, which should be carefully considered. 《Han Dian》: This formula is based on Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia and Poria Decoction), with the addition of Chen Pi and Gan Cao. Ban Xia is the chief herb, drying dampness and resolving phlegm. Fu Ling is the assistant herb, removing water. Chen Pi is the deputy herb, regulating Qi and descending phlegm. Gan Cao is the envoy herb, tonifying the Spleen and Stomach. This formula is one of the fundamental formulas for later generations, and most prescriptions for treating phlegm-retention are based on this formula.

 【Functions】

Dries dampness and transforms phlegm, regulates Qi and harmonizes the Middle Jiao.

 【Indications】

Phlegm-retention (water toxicity), various symptoms of cold-dampness and turbid phlegm in the Stomach. Abundant white phlegm, nausea and vomiting caused by water retention in the Stomach, chest and diaphragm distention, nausea, vomiting, dizziness, palpitations, discomfort in the epigastric region, white and moist tongue coating. 《Medical Formulas》: All phlegm-retention diseases, cough, distention, vomiting, nausea, dizziness, and palpitations. 《San Bu》: Damp-phlegm in obese individuals, causing dyspnea, cough, distention, and fullness.

 【Applications】

Vomiting, nausea, dizziness, headache, morning sickness, Qi stagnation, food stagnation, hangover, cerebral hemorrhage, etc.

 【Mnemonic】

Two corrupt officials—ordered to confiscate property (Chen, Xia, Ling, Cao, Jiang). (Chen = Chen Pi, Xia = Ban Xia, Ling = Fu Ling, Cao = Gan Cao, Jiang = Sheng Jiang)

 【Modifications】

《Medical Formulas》: (1) Wind-phlegm: Add Nan Xing (Arisaematis Rhizoma), Bai Fu (Typhonii Rhizoma), Zao Jiao (Gleditsiae Fructus), and Zhu Li (Bambusae Succus). (2) Cold-phlegm: Add Ban Xia and ginger juice. (3) Fire-phlegm: Add Shi Gao (Gypsum) and Qing Dai (Indigo Naturalis). (4) Damp-phlegm: Add Cang Zhu (Atractylodis Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma). (5) Dry-phlegm: Add Gua Lou (Trichosanthis Fructus) and Xing Ren (Armeniacae Semen). (6) Food-phlegm: Add Shan Zha (Crataegi Fructus), Mai Ya (Hordei Fructus Germinatus), and Shen Qu (Massa Fermentata). (7) Old-phlegm: Add Zhi Shi (Aurantii Fructus Immaturus), Hai Shi (Pumex), and Mang Xiao (Natrii Sulfas). (8) Qi-phlegm: Add Xiang Fu (Cyperi Rhizoma) and Zhi Ke (Aurantii Fructus). (9) Phlegm in the hypochondrium, between the skin and membranes: Add Bai Jie Zi (Sinapis Semen). (10) Phlegm in the four limbs: Add Zhu Li (Bambusae Succus). (1) Wind-phlegm: Add Nan Xing, Bai Fu, and Zao Jiao to dispel wind and transform phlegm. (2) Cold-phlegm: Add Ban Xia and ginger juice to warm and transform cold-phlegm. (3) Fire-phlegm: Add Shi Gao and Qing Dai to clear heat. (4) Damp-phlegm: Add Cang Zhu and Bai Zhu to dry dampness. (5) Dry-phlegm: Add Gua Lou and Xing Ren to moisten dryness and transform phlegm. (6) Food-phlegm: Add Shan Zha, Mai Ya, and Shen Qu to aid digestion. (7) Old-phlegm: Add Zhi Shi, Hai Fu Shi (Pumex), and Mang Xiao to soften hardness and transform phlegm. (8) Qi-phlegm: Add Xiang Fu and Zhi Ke to move Qi and transform phlegm. (9) Hypochondrial phlegm: Add Bai Jie Zi to warm and transform phlegm between the skin and membranes. (10) Phlegm in the four limbs: Add Zhu Li to clear and transform heat-phlegm. (11) Cough with thin, clear, and abundant sputum or foamy sputum, chest tightness, shortness of breath, easily triggered by cold weather, aversion to cold, pale or dull complexion, preference for hot drinks, dizziness or palpitations, white and greasy thick tongue coating: combine Er Chen Tang (Two-Cured Decoction) for drying dampness and transforming phlegm with Xing Ren (Apricot Kernel) and Bai Jie Zi (White Mustard Seed) to warm and transform phlegm-dampness, descend rebellious Qi and calm asthma, and Rou Gui (Cinnamomi Cortex) and Fu Zi (Aconiti Lateralis Radix Praeparata) to warm the Kidneys and assist Qi reception. (12) Cough with thick sounds, copious sputum, dyspnea, or vomiting of phlegm and saliva: add Hou Po (Magnoliae Officinalis Cortex), Xing Ren, and Bai Jie Zi to warm and transform cold-phlegm. (13) Chronic cough and dyspnea: add Gui Zhi (Cinnamomi Ramulus) and Bai Zhu to warm the Spleen and transform phlegm. (14) Coughing with shortness of breath and inability to lie down; if due to cold: add Xi Xin (Asari Radix et Rhizoma), Gan Jiang (Zingiberis Rhizoma), and Wu Wei Zi (Schisandrae Chinensis Fructus) to warm and transform cold-phlegm. (15) Dizziness and vertigo: add Bai Zhu and Ze Xie (Alismatis Rhizoma) to strengthen the Spleen and resolve phlegm. (16) Coughing up yellow sputum, dry mouth and tongue: add Gua Lou, Bei Mu, and Tian Zhu Huang (Bambusae Concretio Silicea) to clear heat and transform phlegm. (17) Wind-phlegm disease, sudden fainting, phlegm sounds in the throat, brief awakening, but with dizziness and vertigo resembling stroke: add Bai Zhu, Tian Ma (Gastrodiae Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma), and Ze Xie to strengthen the Spleen, calm Liver-wind, and transform phlegm. (18) Deficient phlegm, fatigue and weakness, shortness of breath, reluctance to speak: add Dang Shen (Codonopsis Radix), Bai Zhu, and Da Zao (Ziziphi Jujubae Fructus) to strengthen the Spleen and tonify Qi. (19) Stagnant phlegm, difficult to expectorate, coughing with chest pain extending to the hypochondria, thick sputum that is relieved by coughing up: add Bei Mu, Xiang Fu, Chuan Xiong, Gua Lou Ren (Trichosanthis Semen), Sang Bai Pi (Mori Radicis Cortex), and Yan Hu Suo (Corydalis Rhizoma). (20) Common cold with slight fever, aversion to cold, cough, nasal congestion, and clear nasal discharge, belonging to wind-cold: add Xing Ren, Jing Jie (Schizonepetae Herba), and Zi Su Ye (Perillae Folium) to release the exterior with acrid-warm herbs, stop coughing, and transform phlegm; if heat is more prominent than cold, with yellow and turbid nasal discharge, dry mouth, bitter taste: add Huang Qin (Scutellariae Radix), Chai Hu (Bupleuri Radix), Fang Feng (Saposhnikoviae Radix), Tian Hua Fen (Trichosanthis Radix), and Ge Gen (Puerariae Lobatae Radix) to release the exterior with acrid-cool herbs. (21) Hernia (inguinal hernia): if due to heat, add Chuan Lian Zi (Meliae Toosendan Fructus), Yan Hu Suo, Huang Bai (Phellodendri Chinensis Cortex), and Ju He (Citri Reticulatae Semen) to clear heat and soothe the Liver; if due to cold, add Wu Zhu Yu (Evodiae Fructus) and Gan Jiang to dispel cold and warm the Liver. (22) Constipation: add Da Huang (Rhei Radix et Rhizoma) (size of a chess piece) 2 pieces. Unstoppable diarrhea: add Rou Dou Kou (Myristicae Semen) and He Zi (Terminaliae Fructus), remove Hou Po; thirst: add Gan Ge and Wu Mei (Mume Fructus); nausea and vomiting: add Huo Xiang (Agastaches Herba), Wu Mei, and Ban Xia; in summer, add stir-fried Huang Lian (Coptidis Rhizoma) and Bai Bian Dou (Dolichoris Semen); in winter, add simmered Gan Jiang. If there is fire, add Gua Lou Shuang.