[Source]

Treatise on Cold Damage

 [Composition]

Jujube, Genkwa Flower, Euphorbia Kansui, Kansui Root
(4)

 [Classification]

<Tonifying Spleen and Middle Jiao>: Jujube

<Drastically Purging and Draining Water>: Kansui Root, Euphorbia Kansui, Genkwa Flower

[Prescription Explanation]

“Medical Formulas”: This is a Taiyang herb. (1) Genkwa Flower, Kansui Root: Acrid and bitter, used to drain water and phlegm. (2) Euphorbia Kansui: Bitter and cold, can reach the site where water and phlegm accumulate, used for powerful purging. (3) These three herbs are too strong, so Jujube is used for its sweetness to moderate the effect, tonifying Earth to overcome Water, allowing the pathogenic factors to be expelled through urination and defecation. “Shan Bu”: Ke Qin said: Euphorbia Kansui, Genkwa Flower, Kansui Root, all three are acrid, bitter, cold, and extremely toxic. When used together, their properties are mutually complementary and assisting, thus they can attack the nest of water pathogens, unblock the channels, and purge them vigorously, resolving the illness in one go.

 [Functions]

To powerfully purge and drain water and phlegm.

 [Indications]

Xuanyin or Zhiyin caused by stagnation of water and phlegm, with phlegm accumulating in the chest and hypochondria, hardness and fullness in the hypochondria, panting and gasping, cough with pain, tearing pain in the chest and back unrelieved by breathing, and a deep and wiry pulse. Edema and abdominal distension due to excess patterns, with generalized edema, especially in the lower body, abdominal distension, fullness, panting, and difficult urination. “Medical Formulas”: (1) Treats Taiyang wind-attack with diarrhea and vomiting, when the exterior is resolved and it is suitable to purge; the patient sweats, with intermittent attacks, headache, epigastric fullness and distension, tearing pain in the hypochondria, dry heaving, short breath, sweating without aversion to cold; this indicates that the exterior is resolved but the interior is not harmonious, with pathogenic heat accumulating internally and latent phlegm (Treatise on Cold Damage, Taiyang Chapter). (2) Treats Xuanyin. Zhiyin with water in the diaphragm and below (Golden Cabinet, Phlegm-Dampness). “Shan Bu”: Treats Taiyang wind-attack with resolved exterior, sweating without aversion to cold, with water in the interior, difficult urination, vomiting, short breath, and fullness and hardness from the epigastrium to the hypochondria. This is an urgent formula for treating water retention.

 [Western Indications]

Various types of exudative pleurisy, ascites due to liver disease, edema due to heart and kidney disease, etc.

 [Contraindications]

(1) This formula is a powerful agent for purging water and phlegm. Its use should be guided by the resulting loose stools. (2) For those with deficiency and excess, it should be alternated with Qi-tonifying formulas, either purging first then tonifying, or tonifying first then purging. Do not take with Licorice. (3) Contraindicated for pregnant women.

 [Mnemonic]

Sleep early, wake late (Jujube, Kansui, Genkwa, Zaojiao).

 [Modifications]

“Medical Formulas”: (1) San Hua Shen You Wan: Remove Jujube, add Rhubarb, Black Ugly Bean, and Calomel. Treats strong individuals with wind-phlegm stagnation and heat, paralysis of limbs, migratory pain, damp-heat swelling and fullness, stagnation of Qi and blood causing obstruction, accumulated phlegm, and regurgitation vomiting (Miscellaneous Diseases, Phlegm-Dampness) (Hejian Formula). (2) Xiao Wei Dan: Add Phellodendron Bark and Rhubarb. Treats heat-phlegm and damp-phlegm in the chest, diaphragm, intestines, and stomach (heat-phlegm-dampness in the Three Jiao) (Miscellaneous Diseases, Phlegm-Dampness). “Formulas in Chinese Medicine – Tang Dynasty”: (1) Remove Genkwa Flower and Jujube, add White Mustard Seed, this becomes Kong Xian Dan, also known as Miao Ying Wan or Zi Long Wan “San Yin Fang”. Equal parts of the above-mentioned drugs are powdered and made into pills the size of Chinese hackberries. Take five to ten pills with lukewarm ginger decoction after meals before bedtime. Its function is to dispel phlegm and drain water.

 [Pharmacology]

Genkwa Flower, Euphorbia Kansui, and Kansui Root have a purgative effect. Kansui Root and Genkwa Flower have a diuretic effect.