【Source】
《Shang Han Lun》(Treatise on Cold Damage)
【Composition】
Huang Lian (Coptis Rhizome), Ban Xia (Pinellia Rhizome), Gua Lou (Trichosanthes Fruit)
(3)
【Category】
<Clearing Heat and Drying Dampness>：Huang Lian (Coptis Rhizome)
<Transforming Phlegm>：Gua Lou (Trichosanthes Fruit), Ban Xia (Pinellia Rhizome)
【Formula Analysis】
《Yi Fang (Medical Formulas)》: This is a Shao Yang (Gallbladder) medicine. (1)Huang Lian (Coptis Rhizome): Bitter and cold in nature, it drains heat. (2) Gua Lou (Trichosanthes Fruit): Cold and moistening in nature, it clears away impurities. (3)Ban Xia (Pinellia Rhizome): Acrid and warm in nature, it disperses accumulation. (4) Chest-binding (Jie Xiong) is mostly due to the accumulation of phlegm and heat, hence these three substances are used to eliminate phlegm and remove heat. 《Shan Bu (Supplement and Revision)》: Ban Xia (Pinellia Rhizome) disperses, Huang Lian (Coptis Rhizome) drains, and Gua Lou (Trichosanthes Fruit) moistens and clears, all for removing heat and dispersing accumulation in the chest. First, decoct Gua Lou (Trichosanthes Fruit) and administer in three warm doses, all employing a method of treating the upper part of the body gently. Cheng Yingmao said: Huang Lian (Coptis Rhizome) clears heat, Ban Xia (Pinellia Rhizome) guides out fluids, and Gua Lou (Trichosanthes Fruit) moistens dryness, combining to open up accumulated Qi. It is also called “Chest-Binding Depleting Decoction” because although the attack is not severe, it directly drains, removing the substantial pathogenic influences from the chest. 《Cheng Fang Bian Du (Easy Reading of Established Formulas)》: This is due to the intertwining of phlegm and heat, not yet forming Stomach fullness. Observing the floating and slippery pulse, we know the pathogenic influence is in the upper Jiao (Upper Burner), therefore, Ban Xia (Pinellia Rhizome) is used for its acrid and warm properties to disperse accumulation and resolve phlegm, Gua Lou (Trichosanthes Fruit) for its sweet and cold properties to moisten dryness and clear away impurities, and Huang Lian (Coptis Rhizome) for its bitter and cold properties to descend fire and drain heat. This formula can be used to treat cold damage or miscellaneous diseases. It can even be used when the exterior is unresolved and there is phlegm-heat in the interior. 《Han Dian (Chinese Classics)》: This formula is composed of Huang Lian (Coptis Rhizome), Ban Xia (Pinellia Rhizome), Gua Lou (Trichosanthes Fruit), etc. Huang Lian (Coptis Rhizome) has anti-inflammatory and stomach-invigorating effects, and also treats mental restlessness caused by inflammation and congestion. Ban Xia (Pinellia Rhizome) has phlegm-resolving and diuretic effects. Gua Lou Ren (Trichosanthes Seed) has antitussive, sedative, and analgesic effects.
【Functions】
Clears heat and resolves phlegm, opens accumulation and broadens the chest.
【Indications】
(1) Cold damage with improper downward purging of the exterior, causing pathogenic heat to sink inward, leading to a minor chest-binding syndrome (xiao jie xiong) with phlegm-heat accumulation below the heart. Characterized by fullness and oppression in the chest and epigastrium, pain upon pressure, a yellow and greasy tongue coating, and a floating and slippery pulse. (2) Cough with heat phlegm, thick and yellow sputum, and discomfort in the chest and diaphragm. (3) Chest impediment (chest bi) formed by the intertwining of phlegm and heat, or cough due to phlegm-heat in the diaphragm, accompanied by a red face, constant heat in the chest and abdomen, a surging (hong) pulse, and a yellow, greasy tongue coating. (4) This formula is indicated for cases presenting with a feeling of fullness and obstruction below the heart, hardness and pain upon pressure, chest distress, rapid breathing, or chest pain and difficulty expectorating phlegm when coughing. In cases with heat, the pulse often becomes floating and slippery. 《Yi Fang (Medical Formulas)》: Cold damage with improper downward purging, causing a minor chest-binding syndrome directly below the heart, with pain upon pressure and a floating, slippery pulse, as well as phlegm-heat blocking the chest (Shang Han Lun, Tai Yang). 《Shan Bu (Supplement and Revision)》: Epigastric fullness with pain upon pressure and a floating, slippery pulse.
【Suitable For】
Various febrile diseases, especially pneumonia, acute bronchitis, pleurisy, stomach ailments, epigastric pain, hepatitis, exudative pleurisy, intercostal neuralgia.
【Cautions】
(1) Epigastric fullness (pi bing) may also be seen in cases of Stomach and Intestine heat accumulation due to Yang Ming Fu excess, or in cases of Middle Qi deficiency combined with damp-heat. Although there may be a yellow tongue coating, these are not indicative of the actual symptoms of phlegm-heat substantial evil in the chest and epigastrium for which this formula is intended, and therefore should not be used. (2) Furthermore, those with spleen and stomach deficiency-cold and loose stools should not use this formula. The properties of this formula tend to be cooling and moistening, and taking it may result in looser stools.
【Mnemonic】
(1) Emaciated, sunken chest, ribs lined up like stairs, frightening! (Lian Lou Xia – Coptis, Trichosanthes, Pinellia). (2) Huang Lian (Coptis) goes down the stairs (Lian Xia Lou – Coptis, Pinellia, Trichosanthes) #
【Modifications】
(1) For severe chest fullness and pain, add Zhi Shi (Immature Bitter Orange) and Yu Jin (Turmeric Rhizome) to move Qi, resolve stagnation, disperse accumulation, and alleviate fullness. (2) For thick, sticky phlegm, add Dan Xing (Arisaema cum Bile) and Bei Mu (Fritillaria Bulb) to clear heat, moisten dryness, and transform phlegm. (3) For phlegm-heat obstructing the lungs, causing chest tightness and shortness of breath, add Xing Ren (Apricot Kernel) and Ting Li Zi (Descurainia Seed or Lepidium Seed) to clear and drain lung heat, and promote the dispersing and descending of lung Qi. (4) For pain radiating to the hypochondria, add Chai Hu (Bupleurum Root) and Huang Qin (Scutellaria Root) to clear heat and soothe the liver. (5) If accompanied by vomiting, add Zhu Ru (Bamboo Shavings) and Sheng Jiang (Fresh Ginger) to harmonize the Stomach and stop vomiting.
【Pharmacology】
Has antibacterial, anti-inflammatory, expectorant, antitussive, stomach-invigorating, choleretic, and stress-ulcer-inhibiting effects.