2. Huanglian Tang from "Shanghan Lun"

2. Huanglian Tang from "Shanghan Lun"

[Composition] Coptis chinensis 3 grams (three liang), Pinellia ternata 10 grams (half sheng), prepared licorice 3 grams (three liang), dried ginger 3 grams (three liang), cinnamon twig 3 grams (three liang), codonopsis pilosula 3 grams (two liang), jujubes four pieces (twelve pieces).

[Administration] Decoct in water and take orally.

[Indications] Heat in the chest and cold in the stomach.

[Symptoms] Abdominal pain, urge to vomit, vexation and heat in the chest, intestinal rumbling and diarrhea, yellow tongue coating, and taut, tight pulse.

[Functions] Clear the upper part and warm the lower part.

[Formula Analysis] Vexation and heat in the chest, urge to vomit, and yellow tongue coating indicate heat in the chest; abdominal pain, intestinal rumbling and diarrhea, and taut, tight pulse suggest cold in the stomach. This pattern arises because heat in the chest and cold in the stomach disrupt the ascending and descending functions. Coptis is bitter and cold, clearing heat in the chest; dried ginger is pungent and warm, dispelling cold in the stomach. Together, these two herbs primarily achieve the function of clearing the upper part and warming the lower part. Pinellia harmonizes the stomach and suppresses reverse flow, while cinnamon twig warms yang and lifts the clear qi. These two herbs work in tandem to restore the proper ascending and descending functions, thereby stabilizing the stomach and intestines. Codonopsis and jujubes tonify the middle burner and replenish qi, complementing the main action of expelling pathogenic factors. Licorice harmonizes all the herbs and serves as a guiding agent.

[Clinical Modifications] For severe abdominal pain, add salvia miltiorrhiza, costus root, and amomum villosum; for severe vomiting, add fresh ginger and raw hematite; for pain in both flanks, add Corydalis yanhusuo and melia azedarach seeds.

[References]

① In Shanghan Lun, if there is heat in the chest, pathogenic qi in the stomach, abdominal pain, and an urge to vomit, Huanglian Tang is the primary treatment. (From "Shanghan Lun")

② In this case, the upper, middle, and lower jiaos are all affected, but the root cause lies in the stomach. The pathogenic qi is cold and damp, and the stomach is the organ responsible for regulating the ascending and descending movements. When the stomach is invaded by pathogenic factors and loses its harmony, the mechanism of ascending and descending is disrupted, leading to coldness in both the upper and lower parts. (From "Shanghan Guanzhu Ji")

③ Using this formula combined with zhishi, houpou, wuju yu, and laibuzi cured a case of pyloric obstruction. (From "Xin Zhongyi," Supplement 1, 1980)

[Commentary] This formula can be used for chronic gastritis, gastric and duodenal ulcers, acute gastroenteritis, and gastrointestinal neurosis.