4.1 Xiao Ban Xia Tang

Zhi Ban Xia 6-12,  Sheng Jiang 5-10

This formula is specifically designed to stop vomiting where there are signs of phlegm and dampness.

The tongue wil have a white or slippery white/wet coating, there will be a lack of thirst or an abundance of clear saliva, or coughing with profuse, thin watery sputum with watery sounds in the epigastrium.

The formula presentation is:

1. Nausea and vomiting
2. No thirst or aversion to drinking, or abundant saliva in the mouth, or coughing with profuse, thin sputum, or watery sounds in the epigastrium, and chest and diaphragm fullness and distension.
3. Relatively thick, white, and slippery or white and greasy tongue coating.

4.2 Wen Dan Tang 温胆汤

Ban Xia 6-12,  Fu Ling 6-12,  Chen Pi 6-10,  Gan Cao 3,  Zhi Shi 6-12,  Zhu Ru 6,  Da Zao 6-12, Sheng Jiang 3-6

Although this formula is translated as “warm the gallbladder decoction” it is not a warming formula. Huang Huang believes that
at the time of designing the formula, the language reflects a cold gallbladder person as not having courage. Thus, this formula acts to calm those who are easily startled by situations, have dream-disturbed sleep, shortness of breath, palpitations and fatigue, or spontaneous sweating.

It is often used in the clinic to treat: neuroses, mental illness, autonomic dystonia, biliary disease, gastrointestinal illness, cardiovascular disease, or cerebrovascular disease.

WDT presentation:

1. Nausea, vomiting, bitter taste and/or sticky feeling in the mouth
2. Emotional lability (laughing or crying at the wrong moment), being easily startled, panicky, insomnia or dream-disturbed sleep
3. Greasy or slippery tongue coating

WDT patients frequently have panic attacks after an event that caused shock, stifling in the chest, sleep disorders and
restlessness.

Mental Illness: This formula has been shown in numerous studies to be effective in mental disorders such as schizophrenia, often modified by adding Shi Chang Pu, Yuan Zhi, and Tian Zhu Huang.

Insomnia: WDT has been very effective in ‘yin deficiency phlegm-dampness’ type insomnia by modifying the formula to produce Shi Wei Wen Dan Tang (WDT + Ren Shen, Shu Di Huang, Suan Zao Ren, Yuan Zhi, Wu Wei Zi).

Neurosis: Used effectively for menopausal related neurosis with WDT sings, with the addition of Chai Hu and Huang Qin.

Dizziness: Effective for Menieres dizziness with WDT S/S. Add Ge Gen, Gou Teng, and Ci Shi.

Coronary Artery Disease: Treats coronary artery disease with preventricular contractions and cardiogenic shock. Add Sheng Mai San.

Peptic ulcers, gastritis, and cholecystitis: Add Huang Lian or combine with Xiao Xian Xiong Tang.

4.3 Da Ban Xia Tang 大半夏汤

Ban Xia 6-12,  Ren Shen 6-9,  Feng Mi 9-15

Jing Gui Yao Lue states: ‘For regurgitation and vomiting, DBXT masters it’.

Regurgitation here refers to ‘Wei Fan’ which is a type of vomiting where the patient vomits at dusk what he ate at dawn. The course of this illness has already been rather long or has become chronic. The patient presentation is dispirited and listless, with a thin physique, a withered sallow complexion, poor appetite, occasional abdominal pain, dry stools that are difficult to pass, regurgitation and vomiting of saliva.

1. Regurgitation, vomiting in the evening of food eaten in the morning, vomitus that mostly contains saliva.
2. Epigastric focal distention with firmness, dry stools, and a withered appearance.
3. Pale red tongue, with a greasy coating that may be either thick or thin.

The difference between this formula and Xiao Ban Xia Tang is that the signs of phlegm-thin mucus, such as a lack of thirst, vomiting of clear, watery fluids, water sounds in the epigastrium, dizziness, and palpitations, are more obvious in the XBXT decoction. DBXT signs show more fluid deficiency, withered appearance and dry stools.

Examples are : esophageal spasms, esophageal cancer, functional gastrointestinal disorders, and pyloric obstruction, especially in the elderly and those debilitated by chronic diseases.

4.4 Ban Xia Hou Po Tang 半夏厚朴汤

Ban Xia 6-15g, Hou Po 6-9g, Fu Ling 9-15g, Zi Su Ye 6-9g, Sheng Jiang 6-12g

This formula generally treats chest fullness, epigastric firmness, and a sticky throat that relates to “the qi of joy, anger, sadness, thinking, worry, fear, and fright knotting together”.

1. Feeling of something being caught in the throat or chest stuffiness with a feeling of congestion as a result of some type of emotional factor.
2. Coughing and wheezing with profuse phlegm and chest stuffiness, or abdominal distention, vomiting and nausea, and poor appetite.
3. A tongue coating that is usually thick and greasy, or white and greasy, with the mouth having a sticky, greasy sensation.

This formula is often used in cases of neurosis and hysteria with a phlegm pathology.

Used for:

Sensation in the throat with accompanying depression and phlegm in 11 patients: 70% effective.

Vertebral sensitivity + epigastric focal distension: 70% effective in 7 patients

4.5 Ban Xia Bai Zhu Tian Ma Tang 半夏白术天麻汤

Ban Xia 6g, Bai Zhu 9g, Tian Ma 6g, Chen Pi 6, Fu Ling 6g, Gan Cao 3g, Da Zao 12g

Most effective for phlegm invasion headache with dizziness. Ban Xia treats phlegm inversion headaches, Tian Ma treats blurry
vision with dizziness or internal stirring of deficiency wind.

1. Headache, dizziness, with a feeling of pressure in the head
2. Abdominal distention, borborygmus, loose stools or stool that starts off formed and later becomes loose.
3. Soft and loose musculature, subjective feeling of water retention, or frequently has edema, or easily sweats.
4. Red or pale red tongue body, the tongue itself is relatively large, and with a greasy or slightly yellow, greasy coating.

4.6 Ban Xia Xie Xin Tang  半夏泻心汤

Ban Xia 6-15g, Huang Lian 3-6g, Huang Qin 6-9g, Gan Jiang  3-6g, Gan Cao 3-6g, Ren Shen 6-9g, Da Zao 12g

This formula typically treats digestive complaints with focal distension and stifling without pain under the epigastrium, specifically under the xyphoid. As the formula does not contain Chai Hu or Da Huang, as the pattern does not involve liver constraint and does not require purgation, rather it requires harmonisation of hot and cold complex between the spleen yang deficiency and stomach yang ming heat.

1. Upper abdominal fullness, stuffiness and discomfort, a slight degree of distention and pain, but little resistance when palpated; can be accompanied by digestive tract symptoms of nausea, vomiting, diarrhea or constipation, and borborygmus. Generally, it will be a ‘blocked’ feeling just under the xyphoid.
2. Irritability and restlessness, a feeling of internal heat in the body, excessive dreaming, or insomnia.
3. Thin and greasy, or yellow and greasy tongue coating. Often red strawberry tip.
4. Pulse can have a floating and tight sensation in the right guan position, often both guan’s will be tight. The difference between XCHT and BXXXT formula is only SJ swapped with GJ and HL swapped with CH – but XCHT will have more pronounced floating tight pulse on left guan. The Cun pulses will often be full as the qi and heat is trapped in the upper jiao, Guans often show tightness where the pivot is stuck in the shaoyang/yangming.

This is a beautifully balanced formula and a perfect example of how hot and cold, tonifying and purging medicinals work so well together in complicated presentations. A common mistake is to remove many of the herbs as they seem conflicting.

Huang Lian and Huang Qin are cooling and draining, they help cool the small intestine and Yang Ming heat (large intestine and stomach) while Ren Shen and Gan Jiang warm the spleen yang deficiency, and together they stop bleeding in colitis, calm intestinal inflammation and help gastric juices secrete.

This formula can be used for just about any discomfort in the abdomen where the pattern of focal distension fits with tight guan pulse and greasy tongue coating. I personally love using this formula for IBS, Ulcerative Colitis (UC) and Crohn’s disease with fantastic results. Quite often the huang lian is enough at 6g to stop bleeding seen in UC, however it can be raised to 9g and Bai Tou Weng added to increase the effect.

4.62 Gan Cao Xie Xin Tang

Zhi Gan Cao 9-15g,  Ban Xia 6-15g, Huang Lian 3-6g, Huang Qin 6-9g, Gan Jiang  3-6g, Ren Shen 6-9g, Da Zao 12-30g

When there is ulceration of the membranes of the intestines (ulcerative colitis etc) or Vagina (lichen schlerosis etc). Very useful for patients with a herpes attack or undergoing chemotherapy.