TCM Prescriptions for Eliminating Phlegm

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Erchen Tang, Erchen Decoction
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Source: Taiping Huimin Hejiju Fang (Benevolent Prescriptions from Taiping Pharmaceutical Bureau).

Ingredients:
No. 1 Banxia (Rhizoma Pinelliae) 15 g;
No. 2 Jupi (Pericarpium Citri Reticulatae) 15 g;
No. 3 Fuling (Poria) 9 g;
No. 4 Zhigancao (Radix Glycrrhizae Praeparatae) 5 g.

Administration:
Grind the above drugs into fine powder; decoct in water 12g at one time after adding to it 7 slices of fresh ginger and 1 piece of Wumei (Fructus Mume).
  
Actions:
Drying dampness, resolving phlegm, promoting the flow of qi and regulating the middle-energizer.
 
Clinical Application:
This recipe is indicated for cough or vomiting due to phlegm-dampness, marked by cough with much whitish sputum which is easy to expectorate, fullness and choking sensation in the chest, nausea and vomiting, lassitude, or dizziness and palpitation, greasy whitish fur and smooth pulse. It is applicable to such diseases with much whitish sputum as chronic bronchitis, pulmonary emphysema, chronic gastritis, vomiting of pregnancy and neurotic vomiting, and others that are caused by phlegm-dampness.

It is a basic recipe for treating phlegm syndrome and can be modified to treat various kinds of such syndrome. In case of heat-phlegm, add Huangqin (Radix Scutellariae) and Danxing (Arisaema cum Bile) to clear away heat and remove phlegm. In case of cold phlegm, add Ganjiang (Rhizoma Zingiberis) and Xixin (Herba Asari) to warm and dispel cold phlegm. In case of wind phlegm, add Tiannanxing (Rhizoma Arisaematis) and Zhuli (Succus Phyllostachydis Henonis) to subdue wind and remove phlegm. In case of phlegm from indigestion, add Laifuzi (Semen Raphani) and Shenqu (Massa Fermentata Medicinalis) to promote digestion and remove phlegm.
 
Elucidation:
The syndrome is caused by dysfunction of the spleen in transportation and transformation and disorder of qi activity, leading to accumulation of dampness, which is then transformed into phlegm. This should be treated by drying dampness, resolving phlegm and regulating the circulation of qi and the middle-energizer. Pungent, warm and dry in nature, No. 1 acts as monarch drug, which is effective in stopping cough by drying dampness and eliminating phlegm, and capable of suppressing the adversely ascendant qi and regulating the stomach so as to relieve vomiting. Used as minister drug, No. 2 can promote the effect of No. 1 as well as promote the flow of qi to eliminate phlegm.

No. 3 acts as adjuvant drug, and can reinforce the spleen and promote diuresis to root out "the source of producing phlegm", and achieve the effect of treating both the superficial symptoms and the root cause of the disease when in combination with the monarch and minister drugs. No. 4 serves as guiding drug, which bears the function of regulating the spleen and mediating drug properties. Fresh ginger is meant to assist No. 1 and No. 2 in their action of promoting the flow of qi, removing phlegm, regulating the stomach and relieving vomiting as well as to reduce the toxic effect of No.1. Wumei (fructus Mume) is supposed to preserve the lung-qi so that phlegm is removed without body resistance impaired.

This compatibility focuses on eliminating dampness and removing phlegm but has also the effect of reinforcing the spleen and regulating the flow of qi, which is a reflection of the basic principle in treating phlegm syndrome. That is why this recipe is universal for various kinds of such syndrome. It is advisable to use the old ones the selection of No. 1 and No. 2 so as to reduce the dry and dispersive action of both.

Cautions:
Warm and dry as this recipe is, it is contraindicated for dryness syndrome of the lung due to yin deficiency or hemoptysis.



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