HERB FORMULAS

SAN ZHONG KUI JIAN TANG #1 - 散腫潰堅湯一号 - DECOCTION TO DISPERSE SWELLING AND ULCERATE WHAT IS HARD #1

English: Decoction to Disperse Swelling and Ulcerate What is Hard #1
Also Known As: Disperse the Swelling and Break the Hardness Decoction
Forsythia and Laminaria Combination

HERBS AND ACTIONS

Pharmaceutical Latin
Pin Yin
Dosage
Actions
Thallus Eckloniae (washed in cold water) Xi Kun Bu

15g Resolves Phlegm, softens Phlegm nodules and clears Heat.
With Hai Zao, for goiter and scrofula.
Cx. Phellodendri (dry-fried with liquor) Chao Huang Bai 15g Drains Damp-Heat, drains Kidney Fire, drains Fire and relieves toxicity.
With Jin Zhi Mu, for Yin Deficiency fever with steaming bones and night sweats and Lower Jiao Damp-Heat.
With Huang Lian and Lian Qiao, for skin abscesses and lesions.
Rz. Anemarrhenae (soaked in liquor) Jin Zhi Mu 15g Clears Heat from the Lung and Stomach, drains Fire, nourishes Yin, moistens Dryness, generates fluids and resolves Phlegm.
With Huang Bai, clears Heat and Drains Fire.
Rx. Platycodi Jie Geng 15g Expels Phlegm, expels pus, benefits the throat and directs the effects of other herbs to the upper body.
With Zhi Gan Cao, for hoarseness, pain and swelling of the throat due to Wind-Heat and Lung abscess with expectoration of pus and pain in the chest and flanks.
Rz. Sparganii (soaked in liquor) Jin San Leng 9g Dispels Blood Stasis, regulates Qi and dissolves accumulations.
With Jin E Zhu, for Qi and Blood Stagnation with clumping and accumulation leading to distending pain in the chest, epigastrium and abdomen.
Rz. Curcumae (soaked in liquor) Jin E Zhu 9g Invigorates Blood circulation, dispels Blood Stasis, regulates Qi and dissolves accumulations.
Fr. Forsythiae Lian Qiao 9g Clears Heat (especially in the Upper Jiao), relieves toxicity, reduces abscesses and dissipates clumps.
Rz. Coptidis Huang Lian 9g Clears Heat, drains Dampness, drains Fire and relieves toxicity.
Rx. Glycyrrhizae Preparata Zhi Gan Cao 15g Moistens the Lungs, resolves Phlegm, clears Heat relieves Fire toxicity and moderates and harmonizes the harsh properties of the other herbs.
With Jie Geng, for pain and swelling of the throat.
With Chao Bai Shao, Dang Gui Wei and Chai Hu, for hypochondriac pain due to Liver Qi Stagnation.
Rx. Scutellariae (dry-fried with liquor) Chao Huang Qin 9g Clears Lung Heat, drains Fire and detoxifies.
 With Chai Hu, for Heat in the Shao Yang with alternating chills and fever and nausea.
Rx. Paeoniae Alba (dry-fried with liquor) Chao Bai Shao 6g Nourishes Blood, astringes Yin and calms Liver Yang.
With Zhi Gan Cao, for epigastric, hypochondriac or flank pain.
With Chai Hu, for flank pain due to Liver Qi Stagnation.
Rx. Puerariae Ge Gen 9g Relieves Heat, generates fluids and counteracts toxins.
Rx. Bupleuri Chai Hu 1.5g Spreads Liver Qi, relieves Stagnation, raises Yang Qi and resolves Phlegm and congestion.
With Bai Shao, for vertigo, dizziness, thoracic and costal pain, and menstrual irregularity due to Liver Qi Stagnation.
With Chao Huang Qin, restores normal function of the Liver and Gallbladder.
Extremitas Rx. Angelicae Sinensis Dang Gui Wei 1.5g Tonifies invigorates and harmonizes the Blood, reduces swelling and expels pus.
 With Chao Bai Shao, regulates and harmonizes Qi and Blood.
Rx. Gentiana Long Dan Cao 9g Drains Damp-Heat from the Liver and /Gallbladder channels, drains and pacifies excess Liver Fire and relieves toxicity.
With Chai Hu and Huang Qin, for Liver Fire or Liver and Gallbladder Damp-Heat.
Rx. Cimicifugae Sheng Ma 1.5g Clears Heat, relieves toxicity raises Yang and lifts Sunken Qi (guides other herbs upwards).
 With Dang Gui Wei, raises the clear Qi, allowing turbidity to descend and moistening the Intestines.
Rx. Trichosanthis Tian Hua Fen 15g Drains Heat, transforms Phlegm, relieves toxicity, expels pus and reduces swelling.
Hb. Sargassii Hai Zao 15g Clears Heat, resolves Phlegm and softens Phlegm nodules.
With Gan Cao, for goiter and scrofula.
(Rz. Zingiberis) (Sheng Jiang) (3-6g) (Reduces the toxicity of other herbs. Not listed in all versions.)

FORMULA ACTIONS

  • Disperses Qi Stagnation
  • Dispels Heat and Dampness
  • Resolves Phlegm
  • Dissipates nodules
  • Reduces swelling
  • Drains pus

SYNDROMES

  • Liver Qi Stagnation with Damp-Heat and Phlegm

CLINICAL MANIFESTATIONS

  • Feeling of a lump in the throat
  • The lump is soft and becomes larger or smaller according to the emotional situation
  • The lump is small or medium sized, relatively soft and slippery
  • The edges are indistinct
  • The sores may be suppurative
  • The sores may remain hard after discharge of pus
  • Ulcerations
  • Oppressive feeling in the chest and hypochondrium
  • Difficulty swallowing
  • Loose stools
  • Irregular menstruation
  • Pre-menstrual tension
  • Restlessness
  • Insomnia
  • Thirst
  • Feeling of Heat
  • Irritability
  • Frequent sighing
  • Bitter taste in the mouth
  • Red eyes
  • Tremor of hands
  • Red face
  • T: Pale or dusky or Red with red tip and edges
  • C: White or Thin and greasy or Dry and yellow
  • P: Wiry

TREATS

CONTRAINDICATIONS AND HERB/DRUG INTERACTIONS

CONTRAINDICATIONS
  • Care must be taken to protect the patient's Yin and Qi, due to the large number of drying and dispersing herbs.
  • Elderly patients may require simultaneous tonic formulas.
HERB/DRUG INTERACTIONS

NOTES

MODIFICATIONS

For a hard and nodular goiter: For loose stools:
+ 9g Rx. Angelicae Sinensis Dang Gui + 9g Rx. Atractylodes Macrocephalae Bai Zhu
+ 9g Rx. Chuanxiong Chuan Xiong
or
+ 9g Sm. Persicae Tao Ren + 9g Sm. Dolichorus Bai Bian Dou
+ 9g Flos Carthami Hong Hua
or
For swellings that are on the Shao Yang channels only:
+ 9g Sm. Coicis Yi Yi Ren
- Rz. Cimicifugae Sheng Ma
For swellings that are squarely on the Yang Ming channel:
- Rx. Puerariae Ge Gen - Rx. Bupleuri Chai Hu
For helping to bring the swellings to a head:
For nodules and hardness with redness, swelling and pain and/or accompanying fever:
+ Flos Lonicerae Jin Yin Hua + Gypsum Fibrosum Shi Gao
+ Fr. Aurantii Immaturus Zhi Shi + Fr. Gardeniae Zhi Zi
For Qi Deficiency:
For Excess-type constipation:
+ Rx. Astragali Huang Qi + Rx. et Rz. Rhei Da Huang
+ Rx. Ginseng Ren Shen
For constipation due to Blood Dryness:
For enlarged thyroid:
+ Rx. et Rz. Rhei Da Huang
+ Rx. Fritillariae Thunbergii Zhe Bei Mu + Sm. Persicae Tao Ren
+ Spica Prunellae Xia Ku Cao
For hyperactive thyroid:
For nodules and hardness after the formation of pus:
+ Rx. Fritillariae Thunbergii Zhe Bei Mu
+ Rx. Astragali Huang Qi + Spica Prunellae Xia Ku Cao
+ Rx. Angelicae Dahuricae Bai Zhi + Fr. Gardeniae Zhi Zi
    + Rx. Scrophulariae Xuan Shen