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Phragmites Combination

Phragmites Combination

Greg Zimmerman has over 20 years of experience as a professional Acupuncture and Chinese Medicine practitioner. He started to learn Chinese Medicine theory while still in High School. In college he studied biology and biochemistry as a major and quickly moved into the discipline and received his Master’s degree in Acupuncture and Chinese Medicine. Since then Greg has practiced as a clinician and has continually studied specialized advanced aspects and specific areas of discipline that are a part of this 5000-year old medical legacy.

Contact Greg Zimmerman at greg@retreatacupuncture.com

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Phragmites Combination, Wei Jing Tang (葦經湯) or Qian Jin Wei Jing Tang (千金葦經湯), is an important formula that is used to treat lung welling-abscesses (fei yong 肺癰).

Lung welling-abscesses occur when externally contracted wind evils and toxic heat foment and obstruct the lung. The constrained heat becomes congested and intensifies, which will damage the blood and body fluids, and lead to stagnant blood. When these pathogens bind they will form a welling-abscess that will eventually begin to suppurate and clog the lungs.

The classic signs of a lung welling-abscess are coughing up blood and pus. Other common signs include fever, shivering, cough, chest pain, rapid breathing, and sticky fishy-smelling purulent phlegm.

The Essential Prescriptions of the Golden Cabinet (Jin Gui Yao Lue 金匱要略, Chapter 7) states, “Qian Jin Wei Jing Tang treats cough with mild heat, vexation, fullness, and scaling on the chest due to lung abscesses.”

The therapeutic approach used in Traditional Chinese Medicine to treat this condition is to clear the lungs, transform phlegm, resolve toxins, and expel pus.

Traditional Formula Composition

15gm Phragmites Wei Jing (Lu Gen) 葦莖 (蘆根)

30gm Coix Yi Yi Ren 薏苡仁

10gm Persica Tao Ren 桃仁

12gm Benincasa Dong Gua Zi 冬瓜子

Wei Jing Tang’s therapeutic functions:

  • Clear heat from the lungs
  • Nourish fluids and cool the blood
  • Moisten the lungs and discharge pus
  • Transform phlegm and expel dampness
  • Resolve blood stasis and clear agglomeration

Wei Jing (Lu Gen) 葦莖 (蘆根) is sweet and cold, soft and hollow, light and floating and it enters the lung and stomach. These are qualities that allow it to enter the heart and lungs in the upper jiao and clear heat from the lungs. Wei Jing is said to “specialize in facilitating the passage through the orifices and is therefore good at treating lung welling-abscesses.”

Yi Yi Ren 薏苡仁 is sweet, bland, and slightly cold and it enters the lung, spleen, stomach, and kidney. It clears heat from the lungs and disperses pus from the upper parts of the body, strengthens the spleen, eliminates dampness, and helps restore function to the intestines, thereby providing an outlet for dampness and heat through the urine.

Tao Ren 桃仁 is bitter, sweet, and neutral and it enters the heart, large intestine, liver, and lung. It invigorates the blood and eliminates blood stasis, moistens the intestines, promotes bowel movement, and eliminates dry stools which clears agglomeration and thereby break up the welling-abscess.

Dong Gua Zi 冬瓜子 is sweet, cold, and slippery and it enters the lung, stomach, large intestine, and small intestine. It clears and transforms phlegm-heat, resolves dampness, and discharges pus. It clears heat that has accumulated in the lungs and intestines and damp-heat with phlegm obstruction in the lung and intestines.

Dong Gua Zi and Tao Ren promote bowel movement which is an outlet for the phlegm through the stool.

Traditional Indications and Formula Pattern:

  • Cough with foul-smelling sputum that may be streaked with blood
  • Slight fever
  • Vexation
  • Mild chest fullness and pain
  • Dry, scaly skin that is thickening
  • Red tongue with a greasy yellow coating
  • Slippery rapid pulse

Examples of Modern Applications:

Asthmatic bronchitis, Bronchial dilation, Bronchiectasis, Bronchitis, Lung abscesses, Pertussis, Pneumonia.

Because of these indications, it has become one of the important Chinese medicinal formulas used in the treatment of COVID-19, especially in cases where a cough sounds turbid suggesting the respiratory system is congested with phlegm.

In any case when Chinese herbs are applied to a disease or pattern of illness, whether traditionally or bio-medically referenced, formulas and herbs should only be used when the Chinese medical pattern of illness deems it appropriate. This is essential for safe and efficacious herbal therapy.

Common Formula Modifications:

  • Pronounced heat in the lungs, add:
    • Lonicera, Jin Yin Hua 金銀花
    • Houttuyniayu, Xing Cao魚腥草
  • Marked pus in the sputum, add:
    • Platycodon, Jie Geng 桔梗
    • Fritillaria, Chuan Bei Mu 川貝母
    • Licorice, Gan Cao 甘草
  • Excessive sputum, add:
    • Lepidium, Ting Li Zi 葶藶子
  • Lingering heat and persistent cough, add:
    • Luffa, Si Gua Lou 絲瓜絡
    • Trichosanthis Peel, Gua Lou Pi 栝蔞皮
    • Loquat Leaf, Pi Pa Ye 枇杷葉
  • Measles with coughing, fever, thirst, and red rashes, add:
    • Scute, Huang Qin 黃芩
    • Morus Bark, Sang Bai Pi 桑白皮
    • Fritillaria, Chuan Bei Mu 川貝母
  • Pronounced lung heat with the formation of pus or yellow sputum in disorders such as pneumonia or acute bronchitis, add:
    • Platycodon, Jie Geng 桔梗
    • Bupleurum, Chai Hu 柴胡
    • Houttuynia, Yu Xing Cao 魚腥草
    • Lonicera, Jin Yin Hua 金銀花
    • Subtract: Coix, Yi Yi Ren 薏苡仁
  • Abundant heat, increase:
    • Phragmites, Wei Jing (Lu Gen) 葦莖 (蘆根)
  • Abundant pus, increase:
    • Coix, Yi Yi Ren 薏苡仁
  • Stubborn and congealed pus in the lungs blocking the orifices, add Platycodon, Jie Geng 桔梗

Knowing how to use and compose this formula is very helpful in many clinical situations. If the finished granule extract formula is not available, it is easy to mix the single herbal granule extracts in a proportional ratio to produce the formula. It is also easy and convenient to make modifications by adding additional herb granule extracts or formula granule extracts according to the needs of the individual case.

References

Scheid, V., Bensky, D., Ellis, A., Barolet, R.,

2009. Chinese Herbal Medicine: Formulas and Strategies 2nd Edition. Eastland Press, 878-879 pp.

Lun, FS., Robidoux, S., 2018. Six Syndrome Guide to Classical Formulas: Shang Han Za Bing Lun. Chinese Medicine Traveller. 459-461 pp.

Zhang, J., Wiseman, N., Wilms, S, 2013. Jin Gui Yao Lue: Essential Prescriptions of the Golden Cabinet: Translation and Commentaries. Paradigm Publications. 153, 175-176 pp.

Wiseman, N., Feng, Y., 1998. A Practical Dictionary of Chinese Medicine. Paradigm Publications. 670 pg.

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