TCM Kindergarten: Jie Geng and Zhi Ke. An amazing pair to open the chest

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How do we know for sure what patterns a formula treats? By understanding its construction. All formulas contain a specific architecture for herbal relationships based on actions and flavors. Learning to see these pairs ( and sometimes triplets) helps us to easily gain insight into what’s happening inside an herbal formula.

Yesterday I did a brief overview of two herbs that, when combined, open the chest. Opening the chest is a key strategy when treating coughs, asthma and even depression.

Listen to my discussion here. I apologize for the crackly audio. It was the first time I’ve done this and next time I’ll use a better quality headset.

jié gĕng 桔梗 Radix Platycodonis platycodon root
zhĭ qiào 枳壳 Fructus Aurantii bitter orange

 

•Jie Geng

•Bitter, Acrid, Neutral

•Lung

•Zhi Ke

•Bitter, Acrid, Slightly Cold

•Spleen, Stomach, Large Intestine

I discussed 4 formulas. Each of these formulas contains this pair, yet the actions of each are different:

  1. Xing Su San
  2. Ren shen bai du san
  3. Wu ji San
  4. Xue Fu Zhu Yu Tang

 

Xing Su San- Apricot and Perilla decoction

Xing Ren Sm Pruni armeniacae 9 g

Zi Su Ye Fm Perillae frutescentis 6 g

Jie Geng Rx Platycodi grandiflori 4.5 g

Chen Pi Pericarpium Citri reticulatae 3 g

Ban Xia Rh Pinelliae ternatae 6 g

Fu Ling Sclerotium Poriae cocos 6 g

Zhi Ke Fr Citri aurantii 6 g

Qian Hu Rx Peucedani 6 g

Sheng Jiang Rh Zingiberis officinalis recens 3 slices

Gan Cao Rx Glycyrrhizae uralensis 3 g

Da Zao Fr Ziziphi jujubae 3 dates

 

This is a formula that we use to treat cough due to cool dryness. Classically, we would call this an autumn cough, although it can occur in any season. The chief features of this presentation includes mild headache, chills without sweating, dry stuffy nose, a dry throat. The formula combines bitter, downbearing herbs along with fragrant dispersing herbs.

The formula also folds in Er Chen Tang, Two Aged Decoction: last week I posted a short discussion of this on Instagram. Therefore, based on the inclusion of this formula, we also know that this formula is treating Phlegm-Damp as well. By transforming phlegm, regulating the qi dynamic of the chest and gently dispersing, the cough will be resolved.

 

Ren Shen Bai Du San, Ginseng Toxin-Vanquishing Powder

Ren Shen Rx Ginseng 9 g

Fu Ling Sclerotium Poriae cocos 9 g

Zhi Gan Cao Rx Glycyrrhizae uralensis praeparata 3 g

Qiang Huo Rx et Rh Notopterygii 3 g

Du Huo Rx Angelicae pubescentis 6 g

Chuan Xiong Rx Ligustici wallichii 6 g

Sheng Jiang Rh Zingiberis officinalis recens 3 slices

Chai Hu Rx Bupleuri 6 g

Bo He Herba Menthae 3 g

Qian Hu Rx Peucedani 9 g

Zhi Ke Fr Citri aurantii 6 g

Jie Geng Rx Platycodi grandiflori 4 g

 

This formula is used to treat invasion of Wind Cold Dampness with a background of qi deficiency? The symptoms resemble the flu: with chill and high fever, body aches and fullness and distention of the chest with cough. The key here is that the formula includes ginseng to support the right qi to help dispel the pathogen. In real life clinical practice, it’s important to remember that there’s always some layer of deficiency when someone gets sick. If they were robust, then they wouldn’t have gotten sick. Unlike, say, Gui Zhi Tang or Yu Ping feng San, the pathogen here is strong and the body needs support to recover. Gui Zhi Ren Shen Tang and Xiao Chai hu Tang are 2 other formulas that, in different ways also address complex presentations of pathogens and deficiency.

The formula includes pairs for the top and bottom: Qiang Huo and Du Huo: so, we know for sure there’s body aches. It again uses Qian Hu, which, when combined with jie geng and zhi ke, opens the qi dynamic of the chest to stop cough. Ren Shen, fu Ling and Zhi Gan cao are most of Si Jun Zi tang, so we know for sure that we are tonifying the qi. Spicy warm Chuan Xiong enhances the pain relieving aspect of the formula and then is also specific for headache

Ren shen bai du san is part of a larger group of bai du san formulas all of which have similar, yet slightly different construction. Jing Fang Bai Du San, Yin Qiao Bai Du San

WU JI SAN Five Accumulations Powder  is a large and complex formula. It categorized with formulas that release the exterior and warm the interior. I recently discussed this formula at length in my “Ma Huang in Gynecology” lecture for the Shen Nong Society.

Ma Huang Herba Ephedrae 4 g

Bai Zhi Rx Angelicae dahuricae 3 g

Cong Bai Herba Allii fistulosi 4 g

Sheng Jiang Rh Zingiberis officinalis recens 3 slices

Cang Zhu Rh Atractylodis lanceae 12 g

Hou Po Cortex Magnoliae officinalis 3 g

Chen Pi Pericarpium Citri reticulatae 4 g

Gan Cao Rx Glycyrrhizae uralensis 3 g

Ban Xia Rh Pinelliae ternatae 3 g

Fu Ling Sclerotium Poriae cocos 3 g

Jie Geng Rx Platycodi grandiflori 6 g

Zhi Ke Fr Citri aurantii 4 g

Gan Jiang Rh Zingiberis officinalis 2 g

Rou Gui Cortex Cinnamomi cassiae 2 g

Dang Gui Rx Angelicae sinensis 3 g

Bai Shao Rx Paeoniae albae 3 g

Chuan Xiong Rx Ligustici wallichii 3 g

 

It treats the 5 accumulations: Cold, damp, phlegm, qi and blood.

When we unpack it, we’ll find a number of important formulas and principles within it. The key herbal relationships are

  • Dispel Exterior Cold
    • Bai Zhi (Radix Angelicae Dahuricae) 90 g
    • Ma Huang (Herba Ephedrae) 180 g
  • Warm Interior Cold
    • Rou Gui (Cortex Cinnamomi) 90 g
    • Gan Jiang (baked Rhizoma Zingiberis) 120 g,
  • Dry Damp, Eliminate Stagnation
    • Cang Zhu (Rhizoma Atractylodis) 720 g
    • Hou Po (Cortex Magnoliae Officinalis) 120 g
  • Strengthen the Spleen, Transform Phlegm
    • Chen Pi (Pericarpium Citri Reticulatae) 180 g
    • Ban Xia (Rhizoma Pinelliae) 90 g
    • Fu Ling (Poria) 90 g
  • Regulate up and down
    • Zhi Qiao (Fructus Aurantii) 180 g
    • Jie Geng (Radix Platycodi) 360 g
  • Nourish Blood
    • Dang Gui (Radix Angelicae Sinensis) 90 g
    • Shao Yao (Radix Paeoniae) 90 g
    • Chuan Xiong (Rhizoma Chuanxiong) 90 g
  • Harmonizes
    • Zhi Gan Cao (Radix Glycyrrhizae Praep) 90 g

There’s a number of formulas hiding within it:

  • Ping Wei San
    • Cang Zhu
    • Hou Po
  • Er Chen Tang
    • Chen Pi
    • Ban Xia
    • Fu Ling
  • Si Wu Tang
    • Dang Gui
    • Shao Yao
    • Chuan Xiong
  • Wen Dan Tang
    • Chen Pi
    • Ban Xia
    • Fu Ling
    • Zhi Qiao
  • Dang Gui Shao Yao Tang
    • Dang Gui
    • Shao Yao
    • Chuan Xiong
    • Fu Ling

It’s an enormously helpful and flexible formula if the patient’s key presentation includes some of the following:

◦More flabby and watery than fftss

◦More obvious phlegm-damp

◦More jiggly

◦Nausea

◦Loose stool

◦Lower body edema or bearing down

sensation

◦White greasy tongue coating

◦Pulse, deep and wiry or floating and slow

Here, the jie geng and zhi ke regulate the qi dynamic to open the chest and allow phlegm to transform.

Xue Fu Zhu Yu Tang Blood Mansion Eliminating Stasis Decoction.

The final formula is Wang Qing Ren’s iconic blood moving formula to regulate the blood and eliminate blood stasis, regulate the liver qi and unblock stagnation.

Dang Gui Rx Angelicae sinensis 9 g

Sheng Di Huang Rx Rehmanniae glutinosae 9 g

Chi Shao Rx Paeoniae rubrae 6 g

Chuan Xiong Rx Ligustici wallichii 5 g

Tao Ren Sm Persicae 12 g

Hong Hua Flos Carthami tinctorii 9 g

Chai Hu Rx Bupleuri 3 g

Zhi Ke Fr Citri aurantii 6 g

Niu Xi Rx Cyathulae 9 g

Jie Geng Rx Platycodi grandiflori 5 g

Gan Cao Rx Glycyrrhizae uralensis 3 g

The formula is structured around a combination of Si Ni San- Four frigid Extremities Powder and Tao Tong Si Wu Tang- Peach Kernel and Carthamus Four Agents Decoction.

In this case, the up/down movement of jie geng and zhi ke is complimented by the up/down movement of chai hu and niu xi. Here, Jie geng and Zhi Ke Expand the chest. Niu xi guides blood down and chai hu soothes the liver nad raises the clear yang. In Si Ni San,  Chai hu and Zhi Ke are the key up/down herbal pair.

Professionals can order these formulas from China Herb Company in low alcohol herb concentrates. Take the formulas as they are written, or modify them to meet your patients precise needs using our HerbScript Pro. Set up an account today and use the the code ILOVEHERBS to receive 20% off your first order