【Chinese Name】 |
半夏瀉心湯
|
【Phonetic】 |
Ban Xia Xie Xin Tang
|
【English Name】 |
Pinellia Heart-Draining Decoction |
【Classification】 |
Harmonizing formulas |
【Source】 |
《Treatise on Cold Damage》Shang Han Lun《傷寒論》 |
【Combination】 |
Pinelliae Rhizoma (Ban Xia) 0.5 sheng (12g), Scutellariae Radix (Huang Qin) 3 liang (9g), Zingiberis Rhizoma (Gan Jiang) 3 liang (9g), Ginseng Radix et Rhizoma (Ren Shen) 3 liang (9g), Coptidis Rhizoma (Huang Lian) 1 liang (3g), Jujubae Fructus (Da Zao) 12 pieces (4 pieces), Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao) 3 liang (9g) |
【Method】 |
Decoct these seven medicinals with one dou of water, boil them until six sheng of water remains, remove the dregs, and boil them until three sheng of water is left. Take one sheng of the warm decoction three times a day. (Modern use: prepare as a decoction.) |
【Action】 |
Disperses pi and dissipates masses through the combination of cold and warm medicinals. |
【Indication】 |
Pi is caused by the binding of cold and heat, marked by stuffiness below the heart, fullness without pain, vomiting, borborygmus, diarrhea, and a slightly yellow, greasy coating. |
【Pathogenesis】 |
The pattern of pi treated by Ban Xia Xie Xin Tang is originally caused by inappropriate purgative treatment in a Xiao Chai Hu Tang pattern. The purge damages the yang in the middle jiao and the shaoyang pathogenic heat invades inward. The result is pi below the heart because of the binding of cold and heat. Pi describes an obstruction, which causes the interaction between the upper jiao and lower jiao to fail. Pi below the heart actually refers to pi in the stomach cavity. The spleen and stomach are located in the middle jiao, which is the hub of the ascending and descending movement of qi. Since center qi weakness leads to binding of cold and heat, pi may result. The spleen is a yin zang that governs ascent, while the stomach is a yang fu that governs descent. Damaged center qi may cause disordered ascending and descending, which may lead to vomiting, borborygmus and diarrhea. The pathogenesis of this pattern is quiet complicated because the middle jiao disharmony and the disordered ascending and descending are due to the binding of cold and heat, as well as a deficiency-excess complex. The treatment is to harmonize the cold and warm aspects, boost qi, harmonize the stomach, dissipate masses, and disperse pi. |
【Clarification】 |
About acrid medicinals that open and bitter medicinals that promote descent This is a particular type of combination that uses acrid warm medicinals in combination with bitter cold medicinals. This combined method is used to harmonize the cold and warm aspects, diffuse and unblock qi movement, direct qi downward and arrest vomiting, and disperse pi and eliminate fullness. It is applicable for binding of cold and heat or damp-heat accumulation, characterized by pi and fullness, diarrhea, and vomiting. In this formula, acrid warm (hot) ban xia and gan jiang are used together with bitter cold huang qin and huang lian in order to manifest the therapeutic effect of acrid medicinals that open and bitter medicinals that promote descent. |
【Application】 |
1. Essential pattern differentiation Ban Xia Xie Xin Tang is a commonly used formula used to treat the disharmony of the intestines-stomach due to center qi weakness, binding cold and heat, and disordered ascending and descending of the qi movement. It is also a common formula to utilize the method of harmonizing the cold and warm aspects through the combination of cold and warm medicinals. It uses acrid medicinals to open and bitter medicinals to promote descent. This clinical pattern is marked by pi and fullness below the heart, vomiting and diarrhea, and a slightly yellow coating, and an rapid and forceful pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of binding cold and heat and center qi deficiency: acute and chronic gastroenteritis, chronic colitis, chronic hepatitis, and early cirrhosis. 3. Cautions and contraindications This formula is not applicable for pi and fullness below the heart due to qi stagnation or food accumulation. |
【Additonal formulae】 |
1. Sheng Jiang Xie Xin Tang (Fresh Ginger Heart-Draining Decoction, 生薑瀉心湯) [Source]《Treatise on Cold Damage》Shang Han Lun《傷寒論》 [Ingredients] Sheng jiang 4 liang (12g), zhi gan cao 3 liang (9g), ren shen 3 liang (9g), gan jiang 1 liang (3g), huang qin 3 liang (9g), ban xia 0.5 sheng (9g), huang lian 1 liang (3g), da zao 12 pieces (4 pieces) [Preparation and Administration] Decoct these eight medicinals with 1 dou of water, boil them until 6 sheng of water remains, remove the dregs, and boil them again. Take 1 sheng of the warm decoction three times a day. [Actions] Harmonizes the stomach and disperses pi. [Applicable Patterns] Pi syndrome due to binding cold and heat. Symptoms include: pi and hardness below the heart, belching that smells like food, diarrhea with thunderous rumbling in the abdomen. 2. Gan Cao Xie Xin Tang (Licorice Heart-Draining Decoction, 甘草瀉心湯) [Source]《Treatise on Cold Damage》Shang Han Lun《傷寒論》 [Ingredients] Zhi gan cao 4 liang (12g), ren shen 3 liang (9g), gan jiang 3 liang (9g), huang qin 3 liang (9g), ban xia 0.5 sheng (9g), huang lian 1 liang (3g), da zao 12 pieces (4 pieces) [Preparation and Administration] Decoct these seven medicinals with 1 dou of water, boil them until 6 sheng of water remains, remove the dregs, and boil them again. Take 1 sheng of the warm decoction three times a day. [Actions] Harmonizes the stomach, supplements the center, directs counterflow downward, and disperses pi. [Applicable Patterns] Pi syndrome due to stomach qi deficiency. Symptoms include: diarrhea dozens of times with undigested food in the stool, diarrhea with thunderous rumbling in the abdomen, pi, hardness, and fullness below the heart, belching, vexation and easy to get upset. 3. Huang Lian Tang (Coptis Decoction, 黃連湯) [Source]《Treatise on Cold Damage》Shang Han Lun《傷寒論》 [Ingredients] Huang lian 3 liang (9g), zhi gan cao 3 liang (9g), gan jiang 3 liang (9g), gui zhi 3 liang (9g), ren shen 2 liang (6g), ban xia 0.5 sheng (9g), da zao 12 pieces (4 pieces) [Preparation and Administration] Decoct these seven medicinals with 1 dou of water, boil them until 6 sheng of water remains, remove the dregs, and boil them again. Take 1 sheng of the warm decoction three times a day. [Actions] Harmonizes the cold and heat, harmonizes stomach and directs counterflow downward. [Applicable Patterns] Upper heat and lower cold. Symptoms include: Pi and oppression in the chest and stomach cavity, vexing heat, qi counterflow and nausea, abdominal pain, borborygmus, diarrhea, white and glossy tongue coating and wiry pulse. |
【Remark】 |
Ginseng (Panax ginseng) is listed in the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) Appendix II. Its trade is allowed but subject to licensing controls. |
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