Huanglian Zhuru Jupi Banxia Decoction for Stomach-Heat Vomiting

Huanglian Zhuru Jupi Banxia Decoction comes from the Wenre Jingwei (Mirror of Thermal Diseases), and consists of Huanglian (Rhizoma Coptidis), Zhuru (Caulis Bambusae in Taeniam), Jupi (Pericarpium Citri Reticulatae) and Banxia (Rhizoma Pinelliae), in equal parts (each 3-6 g). It has the actions of clearing the stomach and resolving dampness, moving qi and directing counterflow downward. It is indicated for injury to the spleen and stomach in infants with vomiting and counterflow. In modern practice it is mostly used for damp-heat vomiting, presenting as epigastric and abdominal pain, indigestion, red tongue with yellow greasy coating, loose stools, dizziness and dry mouth; some patients also show halitosis, mouth sores and acne.

Huanglian in this formula clears heat and dries dampness, drains fire and resolves toxin, and has broad-spectrum antibacterial and anti-inflammatory action; berberine extracted from Coptis is a common drug for gastritis. Zhuru clears heat and resolves phlegm, eliminates vexation and stops vomiting; it clears heat from both the lung and stomach and also stops vomiting. Jupi moves qi and resolves dampness, dries dampness and resolves phlegm, and also directs counterflow downward to stop vomiting. Banxia dries dampness and resolves phlegm, directs counterflow downward to stop vomiting, dissipates clumping and disperses nodules; it is an important TCM antiemetic.

Jupi combined with Zhuru is the main component of Jupi Zhuru Decoction (consisting of Jupi, Zhuru, Shengjiang, Gancao, Renshen, Dazao); the two together make the antiemetic action more pronounced. This formula does not use the Shengjiang, Gancao, Renshen and Dazao of Jupi Zhuru Decoction because these are all warm-drying herbs unsuitable for damp-heat patterns.

Jupi combined with Banxia is the main component of Erchen Decoction (consisting of Banxia, Jupi, Fulin, Gancao), a famous TCM formula for resolving phlegm and stopping vomiting. This formula does not use the Fulin and Gancao of Erchen Decoction, also because Fulin and Gancao have the suspicion of aiding heat.

Using two strong antiemetic herb pairs, plus Huanglian that clears heat and dries dampness and drains fire and resolves toxin, treats both the branch and the root. The compositional logic of this formula is exquisite and well worth learning.