TCM Prescriptions for Eliminating Phlegm

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Decoction of Pinellia, Bighead Atractylodes and Gastrodia
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Source: Yixue Xinwu (A Summary on Medicine from Clinical Practice).

Ingredients:
No. 1 Banxia (Rhizoma Pinelliae) 9 g;
No. 2 Tianma (Rhizoma Gastrodiae) 6 g;
No. 3 Fuling (Poria) 9 g;
No. 4 Jupi (Exocarpium Citri Grandis) 6 g;
No.5  Baizh (Rhizoma Atractylodis Macrocephalae) 9 g;
No. 6 Gancao (Radix Glycyrrhizae) 3 g.
 
Administration:
Decoct the above drugs in water for oral application after adding to it 2 slices of fresh ginger and 3 pieces of Chinese dates.
 
Actions:
Drying dampness, resolving phlegm, calming the liver and subduing wind.
  
Clinical Application:
This recipe is indicated for the syndrome of upward attack of wind-phlegm, marked by vertigo, headache, nausea, vomiting, chest fullness, greasy whitish fur, taut and smooth pulse. It is applicable to aural vertigo, neurotic vertigo, and others, which are chiefly manifested as vertigo, nausea and greasy whitish fur and ascribed to upward disturbance by wind-phlegm.

In case of excessive dampness-phlegm with glossy whitish fur, add Zexie (Rhizoma Alismatis) and Guizhi (Ramulus Cinnamomi) to induce diuresis and remove phlegm. In case of dizziness and distending pain of the head due to hyperactivity of the liver-yang, add Gouteng (Ramulus Uncariae cum Uncis) and Daizheshi (Ochra Haematitum) to suppress the hyperactive yang and subdue the endogenous wind. If concomitant with weakness due to deficient qi, add Dangshen (Radix Codonopsis Pilosulae) and Huangqi (Radix Astragali seu Hedysari) to supplement qi and build up strength.

Elucidation:
The syndrome is caused by dysfunction of the spleen in transportation and transformation, thus phlegm is formed from accumulated dampness and accompanied by internal stirring of liver wind and disturbance of wind-phlegm on the head. It should be treated by eliminating dampness and phlegm and subduing the liver-wind. No. 1 is capable of removing dampness and phlegm and descending qi to relieve vomiting, while No. 2 has the function of subduing the liver-wind and relieving pain and vertigo. Both are used as monarch drugs and effective in treating vertigo and headache due to wind-phlegm.

No. 5 and No. 3 possess the action of reinforcing the spleen and eliminating dampness so as to prevent regeneration of phlegm and function as minister drugs, which can enhance the effect of removing phlegm and treat both the superficial symptoms and the root cause of the disease when combined with No. 1. Used as adjuvant drug, No. 4 can strengthen the effect of the monarch and minister drugs on the one hand, and promote the easy flow of qi and the elimination of phlegm and dampness on the other because it has the function of eliminating dampness and phlegm and regulating the flow of qi and the middle-energizer. No. 6 plays the role of guiding drug, which supplements qi and regulates the middle-energizer as well as mediates the drug properties. The fresh ginger and Chinese dates are meant to regulate the spleen and stomach, further enhancing the effect of this recipe in regulating the middle-energizer and removing phlegm.
 
Cautions:
This recipe is contraindicated for vertigo and headache as the result of hyperactivity of the liver-yang due to yin deficiency of the liver and kidney.



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