【Source】

《Treatise on Cold Damage》 (Shang Han Lun)

 【Ingredients】

Coptis Chinensis Rhizome (Huang Lian), (Baked)Licorice Root (Gan Cao), Dried Ginger (Gan Jiang), Cinnamon Twig (Gui Zhi), Ginseng Root (Ren Shen), Pinellia Ternate Rhizome (Ban Xia), Jujube (Da Zao)
(7)

 【Categorization】

<Tonify Spleen and Middle Jiao>: Licorice Root (Gan Cao), Jujube (Da Zao)

<Clear Heat and Dry Dampness>: Coptis Chinensis Rhizome (Huang Lian)

<Tonify Qi>: Ginseng Root (Ren Shen)

<Pungent-Warm, Release the Exterior>: Cinnamon Twig (Gui Zhi)

<Warm the Interior>: Dried Ginger (Gan Jiang)

<Transform Phlegm>: Three assistant herbs: Licorice, Dried Ginger, Jujube (Gan Jiang Zao), Pinellia Ternate Rhizome (Ban Xia)

【Formula Principles】

《Yi Fang (Medical Formulas)》: A medicine for Foot Yangming.

(1)Coptis Chinensis Rhizome: Bitter and cold to purge heat and descend Yang.

(2) Ginger, Cinnamon: Pungent and warm to dispel cold and ascend Yin.

(3) Pinellia Ternate Rhizome: Harmonizes the stomach and stops vomiting.

(4)Licorice Root, Jujube: Regulate the middle jiao and stop pain.

(5) When cold and heat contend in the Upper and Middle Jiao, this formula harmonizes them.《Shan Bu (Supplement and Revision)》: Cheng Ying-mao stated: When there is heat in the chest, with vexation, agitation, and depression, it indicates that there is evil qi in the stomach, because cold evil is trapped below.

This pattern presents with both cold and heat. Compared to the cold and heat of Da Qing Long Tang, it is one layer deeper, so its manifestations are not at the exterior-interior junction, but only at the upper-lower junction. Abdominal pain signifies Yin evil in the stomach, where cold predominates below.

Desire to vomit signifies Yang evil in the chest, where heat predominates above. This is a treatment for upper and lower disharmony, where cold and heat are simultaneously applied, with pungent-cold replaced by bitter-cold, and pungent-hot supplemented by bitter-hot. Additionally, Ginseng Root and Pinellia Ternate Rhizome are used to tonify and regulate the middle qi, ascending Yang and descending Yin. This principle extends to the various Xie Xin Tang formulas. Heat in the chest and cold in the stomach lead to clear Yang not ascending, turbid Yin not descending, and disharmony between the exterior and interior.

Therefore, Coptis Chinensis Rhizome is used to purge heat from the chest, while Dried Ginger and Cinnamon Twig disperse cold from the stomach, cooperating to balance cold and heat. Furthermore, Pinellia Ternate Rhizome harmonizes the stomach and directs rebellious qi downward, while Ginseng Root, Jujube, and Licorice Root benefit qi and harmonize the middle jiao, restoring the normal ascent and descent of the middle jiao. This resolves cold and heat, harmonizes the exterior and interior, and stops both pain and vomiting.

This formula can also be used for stomach pain and vomiting due to a pre-existing cold deficiency of the stomach exacerbated by exposure to cold.《Han Dian (Chinese Materia Medica Classics)》: This is a prescription derived from Ban Xia Xie Xin Tang by removing Scutellaria Root (Huang Qin) and adding Cinnamon Twig. Coptis Chinensis Rhizome and Ginseng Root have anti-inflammatory and stomach-strengthening effects.

Pinellia Ternate Rhizome, with the cooperation of Dried Ginger, can stop nausea and vomiting. Cinnamon Twig and Dried Ginger, with the cooperation of Licorice Root and Jujube, can stop abdominal pain and restore gastrointestinal function.

 【Functions】

Harmonizes cold and heat, harmonizes the stomach and descends rebellious qi.

 【Indications】

(1) Heat in the chest, cold in the stomach, abnormal ascent and descent, disharmony between exterior and interior, leading to vexing heat in the chest, epigastric focal distention, discomfort, qi rushing upward, desire to vomit, abdominal pain, or borborygmus with diarrhea, white-slippery tongue coating with a yellow overlay, and a wiry pulse.

(2) This formula is used for patterns similar to Ban Xia Xie Xin Tang but with accompanying abdominal pain. Target symptoms include epigastric focal distention, a sensation of heaviness, poor appetite, nausea, vomiting, abdominal pain, bad breath, and often a yellow tongue coating. Bowel movements may be irregular, presenting with either diarrhea or constipation.《Yi Fang (Medical Formulas)》: Unresolved cold damage with heat in the chest and desire to vomit, and cold in the stomach with abdominal pain (from the Shaoyang chapter of Shang Han Lun).《Shan Bu (Supplement and Revision)》: Cold damage with heat in the chest, evil qi in the stomach, abdominal pain with desire to vomit.

 【Applications (Western Medical Conditions)】

Acute and chronic gastritis, gastroenteritis, peptic ulcers, chronic diarrhea, vomiting, abdominal distention, postoperative intestinal adhesions, etc.

 【Contraindications】

Contraindicated for those with stomach pain and vomiting due to Yin deficiency.

 【Mnemonics】

(1) 鬼臉嚇人 (Gui Lian Xia Ren) + 三佐 (San Zuo): “Ghost face scares people” (sounds like Gui-zhi, Huang-lian, Ban-xia, Ren-shen) + Three Assistants (Gan-cao, Gan-jiang, Da-zao). (2) 連江貴人下早朝 (Lian Jiang Gui Ren Xia Zao Chao): “Lianjiang nobility goes down for early morning assembly” (sounds like Huang-lian, Gan-jiang, Gui-zhi, Ren-shen, Ban-xia, Da-zao, Gan-cao).

 【Modifications】

(1) For severe qi stagnation with poor appetite, add Amomum Cardamom (Bai Kou Ren) 6g, Bitter Orange Peel (Zhi Ke) 10g, Medicated Leaven (Shen Qu) 10g; for qi deficiency, add Codonoopsis Root (Dang Shen) 15g, White Atractylodes Rhizome (Bai Zhu) 10g. (2) For predominant Liver-Stomach heat, add Sichuan Chinaberry Fruit (Chuan Lian Zi) 10g, Scutellaria Root (Huang Qin) 10g. (3) For acid regurgitation and gnawing sensation, add Evodia Fruit (Wu Zhu Yu) 10g, Calcined Arca Shell (Wa Leng Zi) 15g. (4) For severe exterior cold with cold limbs, increase the dosage of Cinnamon Twig (Gui Zhi) and Dried Ginger (Gan Jiang).

 【Pharmacology】

Possesses antibacterial, antipyretic, analgesic, anti-inflammatory, antiemetic, and other effects.