Golden Needle Practitioner Library

Source: Wen Bing Tiao Bian (Systematized Identification of Warm Diseases).  [1798 CE]

Ingredients

Sang Ye (桑叶 mulberry leaf, Mori Folium) 2.5 Qian (7.5 g)

Ju Hua (菊花 chrysanthemum, Chrysanthemi Flos) 1 Qian (3 g)

Xing Ren (杏仁 apricot kernel, Armeniacae Semen) 1 Qian (6 g)

Lian Qiao (连翘 forsythia, Forsythiae Fructus) 1.5 Qian (4.5 g)

Bo He (薄荷 mint, Menthae Herba) 8 Fen (2.5 g)

Jie Geng (桔梗 platycodon, Platycodonis Radix) 2 Qian (6 g)

Gan Cao (甘草licorice, Glycyrrhizae Radix) 8 Fen (2.5 g)

Lu Gen (芦根 phragmites, Phragmitis Rhizoma) 2 Qian (6 g)

Original Method:  [Start with] two cups of water; boil until one cup [remains].  Take twice a day.  Modern method:  Decoct and take warm.

Actions: Courses wind and clears heat; diffuses the lung and relieves cough.

Indications: Early stages of wind-warmth; mild exterior heat patterns. There may be cough, generalized heat effusion that is not severe, mild thirst, and a floating rapid pulse.

Analysis

Warm-heat disease evil enters through the nose and mouth.  The evil invades the network vessels of the lung and causes the lung to lose its clearing and depurative functions; this leads to the principle symptom of cough.  Because the contracted evil in this pattern is mild and superficial, there is generalized heat effusion that is not severe and only mild thirst.   

Sang Ye is sweet, bitter, and cool; it courses wind-heat in the upper burner and also tends to travel to the network vessels of the lung, so it can clear and diffuse lung heat and relieve cough.  Ju Hua is acrid, sweet, and cold; it courses wind-heat and clears the heat and eyes while diffusing the lung.  Both of these medicinals are mild and clearing, and travel directly to the upper burner; they work together to course wind-heat from the lung, so they are both considered to be sovereigns according to some texts.  Other texts link Ju Hua with Xing Ren and Jie Geng, and consider it to be a minister to increase the diffusion of lung qi and relieve cough.

Bo He is sometimes grouped with the assistants Lu Gen and Lian Qiao, but it is sometimes classified as a minister.  Books that classify it as a minister emphasize its ability to course wind-heat and strengthen the exterior-resolving power of the sovereign medicinal(s).  When listed as a minister, it is associated with the other ministers Jie Geng and Xing Ren. 

Xing Ren is bitter and downbearing in nature, so it promotes the lung’s depurative downbearing function.  Jie Geng opens and diffuses the lung qi with its acrid and dissipating nature.  Together the two form a pair that restores lung function by both diffusing and downbearing, and they are classified as ministers.

Lian Qiao outthrusts evil and resolves toxin, while Lu Gen clears heat and engenders liquid; these are assistants.  Gan Cao harmonizes the nature of the other medicinals and is the courier.  In conjunction with Jie Geng, it also helps to disinhibit the throat. Together, all the medicinals course wind-heat from the upper burner and diffuse and downbear the lung qi, so that both the exterior pattern is resolved and the cough is relieved.

In comparison with Yin Qiao San (Lonicera and Forsythia Powder), this formula is stronger at diffusing the lung and relieving cough, but it is weaker at resolving the exterior and clearing heat.  This formula is sometimes known as a “acrid-cool mild formula,” while Yin Qiao San is known as an “acrid-cool balanced formula.”

If qi aspect heat becomes gradually exuberant after two or three days, Shi Gao (Gypsum Fibrosum) and Zhi Mu (Anemarrhenae Rhizoma) may be added.

If there is relatively frequent coughing, lung heat is more severe and Huang Qin (Scutellariae Radix) should be added.

For cough with sticky yellow phlegm that is not easily expectorated, add Huang Qin (Scutellariae Radix), Sang Bai Pi (Mori Cortex), Bei Mu (Fritillariae Bulbus), and Gua Lou (Trichosanthis Fructus). 

If there is cough with expectoration of blood, add Bai Mao Gen (Imperatae Rhizoma), Qian Cao (Rubiae Radix), and Mu Dan Pi (Moutan Cortex). 

For severe thirst, add Tian Hua Fen (Trichosanthis Radix). 

Warning: This formula should not be decocted too long.  Because it is mild, it should not be used without modification if there is severe lung heat.  It is also inappropriate for wind-cold patterns of cough