Formulas · Transform Phlegm 化痰 · Manbyeong Hoechun (萬病回春)

Trichosanthes and Bitter Orange Decoction

Gwarujisil-tang

한글 과루지실탕 · Pinyin Gua Lou Zhi Shi Tang

瓜蔞枳實湯

Composition 構成

Gwaruin Gua Lou Ren
瓜蔞仁 과루인 · Trichosanthes Seed

4 g
Chief 君
Jisil Zhi Shi
枳實 지실 · Immature Bitter Orange

4 g
Deputy 臣
Gilgyeong Jie Geng
桔梗 길경 · Platycodon

4 g
Deputy 臣
Jeokbokryeong Chi Fu Ling
赤茯苓 적복령 · Poria (red)

4 g
Assistant 佐
Paemo Bei Mu
貝母 패모 · Fritillaria

4 g
Assistant 佐 stir-fried (炒)
Jinpi Chen Pi
陳皮 진피 · Aged Tangerine Peel

4 g
Assistant 佐
Hwanggeum Huang Qin
黃芩 황금 · Scutellaria

4 g
Assistant 佐 broad lamina (片芩)
Chija Zhi Zi
梔子 치자 · Gardenia

4 g
Assistant 佐
Danggui Dang Gui
當歸 당귀 · Korean Angelica

2.4 g
Assistant 佐
Sain Sha Ren
砂仁 사인 · Amomum

2 g
Assistant 佐縮砂
Mokhyang Mu Xiang
木香 목향 · Costus Root

2 g
Assistant 佐
Jungnyeok Zhu Li
竹瀝 죽력 · Bamboo Sap

10 g
Envoy 使 5 spoons, added at service
Gamcho Gan Cao
甘草 감초 · Licorice

1.2 g
Envoy 使
Saenggang Sheng Jiang
生薑 생강 · Fresh Ginger

1 g
Envoy 使 half a spoon of juice, added at service

Total 50.6 g per packet (첩) · representative dosage — verify against source texts.

Received this formula from your practitioner? Amounts shown here are classical reference values — granule and prepared products differ. Always follow your prescribed dosage and directions.

Actions 效能

Frees bound phlegm in the chest and diaphragm
Opens the orifices of the heart and restores speech

Indications 主治

Pattern-based

Bound phlegm that cannot be coughed up
Pain in the chest and diaphragm, unable to turn from side to side
Chest fullness with hasty breathing
Phlegm confounding the heart orifices with loss of speech

Biomedical correlates

Pleuritic chest pain with productive cough
Acute phlegm-heat with altered mental status

Source text 原文

Donguibogam 東醫寶鑑

治痰結, 咯吐不出, 胸膈作痛, 不能轉側, 或痰結, 胸滿氣急, 或痰迷心竅, 不能言. 瓜蔞仁ㆍ枳實ㆍ䓀莄ㆍ赤茯苓ㆍ貝母(炒)ㆍ陳皮ㆍ片芩ㆍ梔子各一錢, 當歸六分, 縮砂ㆍ木香各五分, 甘草三分. 右剉, 作一貼, 水煎, 入竹瀝五匙, 薑汁半匙, 和服. 《回春》

Translation

Treats bound phlegm that cannot be coughed up, with pain in the chest and diaphragm so that one cannot turn from side to side; or bound phlegm with chest fullness and hasty breathing; or phlegm confounding the orifices of the heart with loss of speech. Trichosanthes seed, bitter orange, platycodon, red poria, fritillaria (stir-fried), tangerine peel, scutellaria (broad lamina) and gardenia 1 don each; angelica 6 pun; amomum and costus 5 pun each; licorice 3 pun. Cut up, make one packet, decoct in water, stir in 5 spoons of bamboo sap and half a spoon of ginger juice, and take. — Manbyeong Hoechun 回春 (Donguibogam · Damum)

Clinical commentary 臨床

The indication moves through three stages of the same problem, and they are worth reading as a sequence rather than a list: phlegm that will not come up, then phlegm that fills the chest and shortens the breath, then phlegm that reaches the heart and takes speech away. Amomum and costus are the surprising members here — two warm aromatic qi movers in a cold formula — and they are doing what the parent problem requires, since bound phlegm is bound by stagnant qi and cooling alone will bind it further. Angelica at 6 pun addresses the same logic from the blood side. **Chest pain that prevents turning, breathlessness, or sudden loss of speech must be assessed urgently.** These are the presentations of cardiac and cerebrovascular emergencies, and this passage describes a pattern rather than authorizing outpatient management. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.