ER CHEN WAN (BP010) Citrus & Pinellia Comb Complex

Indication

This formula was recorded in the ‘Formulary of the Tai Ping Welfare Dispensary Bureau’ (tai ping hui min he ji ju fang) (1151 CE), a compilation of popular and effective formulas that were used in the public dispensaries of the Song dynastic period. It has a broad range of applications in disorders due to the accumulation of Damp, which in turn gives rise to Phlegm.

The origin of the pathogenic complex of Phlegm and Damp is the Spleen, which, when deficient, fails to properly transform and transport the fluids. This leads to the build-up of pathological fluids, which initially manifest as Damp. Due to the effects of time, stagnation or Heat, the Damp congeals (i.e. becomes more viscous) to form Phlegm. The Phlegm-Damp complex obstructs the normal Qi movements in the middle Jiao, further compounding the initial disorder and creating a vicious cycle whereby fluid transportation is further impeded, generating more Damp, which in turn gives rise to more Phlegm.

These pathogens follow the pathway of the Spleen Qi to the Lung and obstruct the Lung Qi, manifesting a productive cough with watery, frothy or clear sputum. Thus we have a scenario in which there is Spleen Qi deficiency with Qi obstruction in the middle Jiao, which are the primary factors (ben) and accumulation of Phlegm-Damp in the middle Jiao and also in the upper Jiao (i.e. the Lung), which are the secondary factors (biao).

It should be noted that this formula addresses the secondary factors only, i.e. it regulates the Qi, harmonises the middle Jiao, resolves Phlegm and dries Damp.

The synergistic actions of the herbs are as follows:

Pinellia tuber (ban xia): resolves Phlegm, dries Damp and sends the Stomach Qi downward.

Citrus peel (chen pi): activates the Spleen and promotes Qi movement in the middle Jiao, dries Damp and resolves Phlegm, sends the Stomach Qi downward.

Poria cocos (fu ling): drains Damp and tonifies the Spleen Qi.

Glycyrrhiza root (gan cao): tonifies the Spleen Qi.

Signs & Symptoms:

Gastritis, chronic

Chronic obstructive pulmonary disease (COPD)

Meniere’s disease

Morning sickness

Nausea or vomiting

Digestion, poor

Mucus or sputum, excessive

Dizziness

Cough with thin, clear or frothy sputum

Combinations –

COPD with Spleen Qi deficiency:

JIAN PI WAN

SHEN LING BAI ZHU SAN

Meniere’s disease:

XUE FU ZHU YU TANG

WEN DAN TANG

TCM Syndromes: Phlegm-Damp retention, Qi stagnation in the middle Jiao, Spleen Qi deficiency with retention of Damp, Cold-Damp disturbance of the Spleen, Phlegm-Damp obstruction of the Lung.

TCM Actions: Dries Damp, resolves Phlegm, regulates the Qi and harmonises the middle Jiao.