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Zhi Sou San He Xiao Chai Hu Tang Jia Jian
This is a research formula from the People’s Republic of China created by Yuan Xin-shun of the Xin
Xiang Municipal Cement Factory Workers Hospital in Henan. It is a combination of Zhi Sou San (Stop
Coughing Powder) and Xiao Chai Hu Tang (Minor Bupleurum Decoction) with additions and subtractions.
Our version is a 9:1 extract.
RX:
Radix Bupleuri (Chai Hu)
Radix Asteris Tatarici (Zi Wan)
Radix Et Rhizoma Cynanchi Baiqian (Bai Qian)
Radix Stemonae (Bai Bu)
Radix Codonopsitis Pilosulae (Dang Shen)
Radix Platycodi Grandiflori (Jie Geng)
Cortex Radicis Mori Albi (Sang Bai Pi)
Sclerotium Poriae Cocos (Fu Ling)
Fructus Zizyphi Jujubae (Da Zao)
Rhizoma Pinelliae Ternatae (Ban Xia)
Pericarpium Citri Reticulatae (Chen Pi)
Radix Scutellariae Baicalensis (Huang Qin)
Fructus Perillae Frutescentis (Zi Su Ye)
uncooked Rhizoma Zingiberis Officinalis (Sheng Jiang)
Radix Glycyrrhizae Uralensis (Gan Cao)
INDICATIONS:
This formula is for the treatment of chronic cough and chronic panting and wheezing manifesting as
phlegm heat with either an underlying liver-spleen disharmony or a shao yang aspect pattern.
THE SIGNS AND SYMPTOMS OF PHLEGM HEAT INCLUDE:
Coughing and panting
Thick, yellow phlegm
A slippery, rapid pulse
THE SIGNS AND SYMPTOMS OF LIVER DEPRESSION QI STAGNATION INCLUDE:
Irritability
Chest oppression
Rib-side distention
A bowstring pulse
THE SIGNS AND SYMPTOMS OF SPLEEN VACUITY INCLUDE:
Fatigue
Poor appetite
A tendency to loose stools
A fat tongue with teeth-marks on its edges
THE SIGNS AND SYMPTOMS OF A SHAO YANG ASPECT DISEASE INCLUDE:
Alternating fever and chills
Poor appetite
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A bitter taste in the mouth
Dry throat
White and yellow tongue fur
A bowstring pulse
COMBINATIONS:
If phlegm dampness is more pronounced, this formula can be combined with Er Chen Wan (Two Aged
[Ingredients] Pills). If spleen vacuity is more marked, it may be combined with Liu Jun Zi Wan (Six
Gentlemen Pills). If there is concomitant qi vacuity with a defensive qi insecurity and spontaneous perspiration,
this formula may be combined with Yu Ping Feng San Wan (Jade Windscreen Powder Pills). If
enduring heat has damaged yin fluids, this formula may be combined with Sha Shen Mai Men Dong Tang
Wan (Glehnia & Ophiopogon Decoction Pills) or Bai He Gu Jin Wan (Lily Secure Metal Pills) as appropriate.
If enduring phlegm congestion and nondepuration of the lung qi have resulted in concomitant
blood stasis, this formula can be combined with Xue Fu Zhu Yu Tang Wan (Blood Mansion Dispel Stasis
Decoction Pills).
FORMULA EXPLANATION:
If, due to either external contraction or internal damage, the lungs lose their depuration and downbearing,
the lung qi will not clear and the qi mechanism will become inhibited. If the lung qi becomes
inhibited, phlegm fluids will typically be engendered, in which case there will be coughing with profuse
phlegm. If phlegm fluids cause depression that transforms heat or becomes mixed with depressive heat
floating upward from the liver and stomach, phlegm dampness will become phlegm heat. The tendency
to engender phlegm is all the greater if there is an underlying spleen qi vacuity. In this case, the
spleen qi is too vacuous and weak to move and transform water fluids. These collect and transform into
dampness. If dampness lingers and endures, it will congeal into phlegm. Thus it is said, “The spleen is
the root of phlegm engenderment; the lungs are the place where phlegm is stored.” Further, because the
liver and lungs have a reciprocal relationship in terms of the flow of qi, if the lungs lose their depuration
and downbearing, liver depression will be aggravated. Conversely, if there is liver depression, it
makes it even harder for the lungs to recuperate. Therefore, this formula not only clears heat and transforms
phlegm, stops cough and levels panting, but also harmonizes the liver and spleen.
Within this formula, Zi Wan, Bai Qian, Bai Bu, Ban Xia, Sheng Jiang, and Chen Pi rectify the qi, transform
phlegm, and stop cough. Zi Wan, Ban Xia, and Bai Qian are an important combination for coughing and
wheezing associated with profuse, difficult to expectorate phlegm. Jie Geng loosens the chest, diffuses the
lungs, and transforms phlegm. It also acts to guide the other medicinals to the lungs and chest. Gan Cao
and Jie Geng together are able to clear and disinhibit the throat. Zi Su Ye and Sang Bai Pi clear the lungs,
stop coughing, and level panting. Fu Ling aids Ban Xia, Chen Pi, and Sheng Jiang eliminate dampness and
transform phlegm. Huang Qin clears the lungs, while Dang Shen and Da Zao fortify the spleen and support
the righteous. Chai Hu rectifies the qi and disinhibits the qi mechanism of all three burners.
In a study published on page 89 in issue #2, 2003 of the An Hui Zhong Yi Lin Chuang Za Zhi (Anhui
Journal of Clinical Chinese Medicine), this formula achieved a 76.5% cure rate and a 94.9% total effectiveness
rate in a group of 98 patients with chronic cough and asthma.
DOSAGE:
My patient does have signs and symptoms of:
Phlegm heat Yes No
Spleen vacuity Yes No
Liver depression Yes No
Shao yang aspect disease (not necessary) Yes No
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