Click the blue text below the title to follow Yuyi Health Guidance
As the saying goes, “most diseases are caused by phlegm,” and “dampness is the source of all diseases.” Therefore, eliminating phlegm and dampness is particularly important. In daily life, there are indeed many people troubled by phlegm and dampness, and once afflicted, even minor ailments can become persistent and difficult to cure, dampening people’s spirits. While it may not be completely debilitating, it can certainly be quite unpleasant!So, is there a good TCM prescription to address this troublesome phlegm and dampness? Certainly, there are many effective TCM formulas for resolving phlegm and dampness, but the most famous one comes from the Song Dynasty’s Taiping Huimin Heji Ju Fang, a remarkable formula that is not only simple but also effective. This classic formula for drying dampness and resolving phlegm is Er Chen Tang.The composition of Er Chen Tang is quite simple; it can be considered as four medicinal herbs, but it can also be viewed as six. According to the original text, Er Chen Tang consists of “Ban Xia (Pinellia ternata, washed seven times), Ju Hong (tangerine peel) each 250g, Bai Fu Ling (Poria cocos) 150g, and Gan Cao (licorice, roasted) 75g”, among four main herbs. The specific preparation method is to crush these herbs into a fine powder, and each time, take 15g of the powder, add one cup of water, along with seven slices of ginger and one dried plum, and decoct until reduced to about 60ml, then strain and take warm.
In the Song Dynasty, it was common to prepare decoctions in large quantities, so while the total dosage may seem large, the actual single dose is not. The modern general dosage is: Ban Xia and Chen Pi (the original formula uses Ju Hong, but later practitioners often use Chen Pi) each 15g, Bai Fu Ling 9g, and Gan Cao 4.5g, along with seven slices of ginger and one dried plum, decocted in water. Ban Xia should be decocted for one hour first, then combined with the other herbs and decocted for another 20-30 minutes, straining out the dregs, with each dose being 100-150ml, taken three times a day.Upon seeing the composition of Er Chen Tang, one might notice similarities with Liu Jun Zi Tang. In fact, Liu Jun Zi Tang is a combination of Si Jun Zi Tang and Er Chen Tang. So, what is the secret behind the compatibility of Er Chen Tang? First, let’s look at its monarch, minister, assistant, and envoy herbs. Er Chen Tang uses Ban Xia as the monarch herb, primarily functioning to dry dampness, resolve phlegm, and harmonize the stomach while descending rebellious qi; Ju Hong (or Chen Pi) serves as the minister herb, mainly acting to regulate qi, relieve stagnation, and dry dampness; Bai Fu Ling, ginger, and dried plum serve as assistant herbs, primarily enhancing spleen function, draining dampness, stopping vomiting, consolidating lung qi, and protecting stomach yin; Gan Cao acts as the envoy herb, primarily harmonizing the formula and moderating the effects of the other herbs.Within these few herbs, there are even more profound insights. The first is the combination of Ban Xia and Chen Pi (Ju Hong), which are used in equal amounts, complementing each other to enhance the overall ability to dry dampness and resolve phlegm, reflecting the principle that “to treat phlegm, one must first regulate qi; when qi flows smoothly, phlegm dissipates.” Moreover, Ban Xia and Chen Pi are among the “Six Chen Herbs,” which improve in efficacy the longer they are stored, hence the name “Er Chen” (Two Chens). The second is the pairing of Bai Fu Ling and Chen Pi (Ju Hong), which is specifically tailored to address “phlegm due to qi stagnation” and the “source of phlegm production.” This combination is a proactive measure to predict and prevent the progression of disease. This aligns with the high-level practice described in the Huang Di Nei Jing as “treating disease before it occurs,” and the Jin Gui Yao Lue stating, “when observing liver disease, one should know it has affected the spleen.”
The third point is the use of ginger. As the saying goes, “if it’s not for Ban Xia and Hou Po, why would you need ginger?” Thus, ginger in Er Chen Tang primarily assists Gan Cao in moderating the toxicity of Ban Xia. Furthermore, it works synergistically with Ban Xia to resolve phlegm, descend rebellious qi, and harmonize the stomach to stop vomiting. The fourth is the dried plum, which is the finishing touch of the formula. Why is dried plum added? Because it can consolidate lung qi and protect stomach yin, while also working with Ban Xia and Chen Pi to mitigate the adverse effects of excessive drying.The complete version of Er Chen Tang consists of six medicinal herbs; removing ginger and dried plum results in an incomplete Er Chen Tang. The six herbs in Er Chen Tang address both symptoms and root causes, treating existing diseases while also preventing future ones. It can “dry dampness, regulate qi, and eliminate existing phlegm,” which treats current ailments, while it “strengthens the spleen, drains dampness, and prevents the source of phlegm,” which prevents future diseases. It is truly a remarkable formula that can effectively address many complex and difficult conditions in clinical practice.Er Chen Tang primarily focuses on drying dampness and resolving phlegm. Can it also effectively eliminate various types of phlegm? Er Chen Tang says, “Absolutely.” To effectively eliminate various types of phlegm, adjustments must be made. As the saying goes, “if you want to love me, you must double the effort; if you want to treat a condition, you must add flavors.” For example, to eliminate damp phlegm, one should add herbs like Cang Zhu (Atractylodes) and Hou Po (Magnolia bark); to eliminate heat phlegm, one should add Dan Nan Xing (Arisaema) and Quan Gua Lou (Trichosanthes fruit); to eliminate cold phlegm, one should add Gan Jiang (dried ginger) and Xi Xin (Asarum); to eliminate wind phlegm, one should add Tian Ma (Gastrodia) and Jiang Can (Silkworm); to eliminate food phlegm, one should add Lai Fu Zi (Radish seed) and Bai Jie Zi (White mustard seed); to eliminate stagnant phlegm, one should add Xiang Fu Zi (Cyperus) and Yu Jin (Curcuma); to eliminate phlegm nodules, one should add Hai Zao (Sargassum), Kun Bu (Kelp), Zhe Bei Mu (Fritillaria), and Mu Li (Oyster). It can be said that “no matter what type of phlegm you have, Er Chen can help.”
Er Chen Tang was originally used to treat “phlegm-damp” diseases, clinically manifesting as nausea, vomiting, dizziness, palpitations, discomfort in the stomach, and disharmony of the spleen and stomach, among others. However, when using Er Chen Tang in modern practice, there is a key diagnostic point: the main symptom is “cough with copious white phlegm that is easy to expectorate, accompanied by a heavy sensation in the limbs, chest fullness, and nausea or vomiting,” with or without “dizziness and palpitations.” Of course, the effects of Er Chen Tang extend far beyond these symptoms. Later practitioners have expanded its use to treat cough, asthma, insomnia, stroke, phlegm vertigo, dizziness, scrofula, stagnation, stomach pain, menstrual irregularities, and leukorrhea, among many other conditions. In modern clinical practice, Er Chen Tang has been effectively used to treat gastritis, gastric and duodenal ulcers, neurogenic vomiting, pregnancy-related vomiting, colds, bronchitis, pulmonary emphysema, inner ear vertigo, cerebrovascular accidents, thyroid enlargement, epilepsy, hernias, and other disorders caused by spleen dampness leading to phlegm and obstructed qi, achieving satisfactory results.With the successful application of Er Chen Tang in modern clinical settings, pharmacological studies have also been conducted. These studies suggest that Er Chen Tang has pharmacological effects such as lowering blood lipids, anti-tumor effects, lowering blood sugar, regulating fatty liver, and suppressing cough while resolving phlegm. Er Chen Tang and its modified formulas are increasingly being used across various modern medical specialties, including respiratory, digestive, neurological, gynecological, and otolaryngological diseases, covering a wide range of conditions such as asthma, bronchitis, vomiting, amenorrhea, as well as dizziness, acne, and oral mucous cysts; chronic bronchitis, chronic obstructive pulmonary disease, asthma, pneumonia, non-small cell lung cancer, non-infectious diarrhea in children, non-alcoholic fatty liver, secretory otitis media, post-nasal drip syndrome, tinnitus, vertigo, migraine, and insomnia.Thus, it is evident that Er Chen Tang is a “nemesis” for phlegm and dampness. Whether it is phlegm due to spleen dampness, obstructed qi, or other accumulations of damp phlegm, Er Chen Tang can be used with modifications for treatment. People know that “phlegm and dampness cause a hundred diseases,” but it can also be said that “once phlegm and dampness are eliminated, a hundred diseases disappear.” The role of Er Chen Tang in this process is truly remarkable. However, due to the drying nature of Er Chen Tang, caution should be exercised in cases of dry phlegm, or one should add herbs that can reduce dryness and resolve phlegm. Additionally, it is not suitable for individuals with symptoms of hemoptysis, thirst, yin deficiency, or blood deficiency.References[1] He Lun, Dun Bao Sheng. Differentiation and Application of Er Chen Tang and Its Variants. Shaanxi Journal of Traditional Chinese Medicine, 1985, 6(8): 376-377.[2] Liao Hua Jun. Modern Pharmacological Research on Er Chen Tang. Journal of Traditional Chinese Medicine, 2012, 40(5): 142-144.[3] Chen Ni Ji Shi, Zhang Heng Liang, Li De Sen, et al. Overview of Literature and Clinical Research on Er Chen Tang. Fujian Journal of Traditional Chinese Medicine, 2011, 42(2): 63-64.[4] Yao Jin Tong, Ma Ying Ying. Progress in Clinical Application Research of Er Chen Tang. World Latest Medicine Information Digest, 2018, 18(68): 58-60.[5] Liu Ci Bin, He Wei Qiang. Clinical Application and Research Progress of Er Chen Tang. Today’s Pharmacy, 2020, 30(7): 501-504.
Previous Highlights
1. Dissolving Stasis and Obstruction: One Herb to Clear All Stasis and Obstruction
2. Immunity is the Best Medicine: One Herb to Awaken It
3. What to Do About Loose Teeth and Receding Gums? With This Chinese Patent Medicine, Your Teeth Will Be Different
If you find this article helpful, remember to like and share.
