Pinellia Heart-Draining Decoction

Pinellia Heart-Draining Decoction

Pinelliae Rhizoma (Ban Xia) 0.5 sheng (12g), Scutellariae Radix (Huang Qin) 3 liang (9g), Zingiberis Rhizoma (Gan Jiang) 3 liang (9g), Ginseng Radix et Rhizoma (Ren Shen) 3 liang (9g), Coptidis Rhizoma (Huang Lian) 1 liang (3g), Jujubae Fructus (Da Zao) 12 pieces (4 pieces), Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao) 3 liang (9g)

Decoct these seven medicinals with one dou of water, boil them until six sheng of water remains, remove the dregs, and boil them until three sheng of water is left. Take one sheng of the warm decoction three times a day. (Modern use: prepare as a decoction.)

Disperses pi and dissipates masses through the combination of cold and warm medicinals.

Pi is caused by the binding of cold and heat, marked by stuffiness below the heart, fullness without pain, vomiting, borborygmus, diarrhea, and a slightly yellow, greasy coating.

The pattern of pi treated by Ban Xia Xie Xin Tang is originally caused by inappropriate purgative treatment in a Xiao Chai Hu Tang pattern. The purge damages the yang in the middle jiao and the shaoyang pathogenic heat invades inward. The result is pi below the heart because of the binding of cold and heat. Pi describes an obstruction, which causes the interaction between the upper jiao and lower jiao to fail. Pi below the heart actually refers to pi in the stomach cavity. The spleen and stomach are located in the middle jiao, which is the hub of the ascending and descending movement of qi. Since center qi weakness leads to binding of cold and heat, pi may result. The spleen is a yin zang that governs ascent, while the stomach is a yang fu that governs descent. Damaged center qi may cause disordered ascending and descending, which may lead to vomiting, borborygmus and diarrhea. The pathogenesis of this pattern is quiet complicated because the middle jiao disharmony and the disordered ascending and descending are due to the binding of cold and heat, as well as a deficiency-excess complex. The treatment is to harmonize the cold and warm aspects, boost qi, harmonize the stomach, dissipate masses, and disperse pi.

About acrid medicinals that open and bitter medicinals that promote descent

1. Essential pattern differentiation Ban Xia Xie Xin Tang is a commonly used formula used to treat the disharmony of the intestines-stomach due to center qi weakness, binding cold and heat, and disordered ascending and descending of the qi movement. It is also a common formula to utilize the method of harmonizing the cold and warm aspects through the combination of cold and warm medicinals. It uses acrid medicinals to open and bitter medicinals to promote descent. This clinical pattern is marked by pi and fullness below the heart, vomiting and diarrhea, and a slightly yellow coating, and an rapid and forceful pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of binding cold and heat and center qi deficiency: acute and chronic gastroenteritis, chronic colitis, chronic hepatitis, and early cirrhosis. 3. Cautions and contraindications This formula is not applicable for pi and fullness below the heart due to qi stagnation or food accumulation.

1. Sheng Jiang Xie Xin Tang (Fresh Ginger Heart-Draining Decoction, 生薑瀉心湯)

Ginseng ( Panax ginseng ) is listed in the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) Appendix II. Its trade is allowed but subject to licensing controls.