Source: Shanghan Lun (Treatise on Exogenous Febrile Diseases).

Ingredients:
No. 1 Huanglian (Rhizoma Coptidis) 6 g;
No. 2 Banxia (Rhizoma Pinelliae) 12 g;
No. 3 Quangualou ( Fructus Trichosanthis ) 20 g (decocted first).

Administration:
Decoct the above drugs in water for oral use.

Actions:
Clearing away heat and resolving phlegm, relieving chest stuffiness and dispersing stagnation.

Clinical Application:
This recipe is indicated for retention of both phlegm and heat, marked by chest and epigastric fullness with pain when pressed, or expectoration with thick yellowish sputum, greasy yellowish fur, smooth and rapid pulse. It is applicable to acute or chronic gastritis, pleurisy, pleural adhesion, acute bronchitis, intercostal neuralgia and others, which are chiefly marked by chest and epigastric fullness and pain as well as greasy yellowish fur, and are ascribed to retention of both phlegm and heat. If concomitant with costal and hypochondriac pain, add Yujin (Radix Curcumae) and Chaihu (Radix Bupleuri) to disperse the obstructed liver-qi and alleviate pain.

If concomitant with vomiting, add Zhuru (Caulis Bambusae in Taeniam) and Shengjiang (Rhizoma Zingiberis Recens) to regulate the stomach and relieve vomiting. In case of difficult expectoration of thick sputum, add Danxing (Arisaema cum Bile) and Chuanbeimu (Bulbus Fritillariae Cirrhosae ) to strengthen the effect of removing phlegm.

Elucidation:
The syndrome is caused by accumulation of phlegm and heat in the chest and epigastrium as the result of consumption of body fluid by heat. It should be treated by clearing away heat and removing phlegm to relieve fullness. No. 3 has the function of clearing away heat, removing phlegm, regulating the flow of qi to relieve chest fullness as well as relieving constipation and descending lung-heat, and is used as monarch drug. No. 1 is cold in nature and capable of clearing away heat, while No. 2 is pungent and warm in nature and capable of removing phlegm and relieving fullness as well as descending qi and regulating the stomach.

Both are minister drugs and their combination can promote the function of No. 3 in clearing away heat, removing phlegm and relieving fullness. The three altogether achieve the purpose of clearing away heat and descending qi simultaneously because of their warm, bitter and pungent nature. This is a primary recipe for treating chest and epigastric fullness and pain due to accumulation of both phlegm and heat.