A Staple for the Damp-Heat Summer: Huoxiang Zhengqi Wan

We have entered the hot season. In TCM theory, summer heat brings heavy dampness, so damp-heat diseases are common. The weather is changeable, and this summer has been abnormal: southern friends joked that this year's Start of Summer felt like Start of Winter, and it even snowed one year in Chongqing on Start of Summer. Sudden weather changes easily cause colds or gastrointestinal upset.

For this season's colds, the patent medicine of choice is Huoxiang Zhengqi Wan (or Huoxiang Zhengqi water/softgel), because summer colds are often gastrointestinal colds: along with cold symptoms patients often have nausea, vomiting, and poor appetite, and in severe cases eczema.

Huoxiang Zhengqi Wan (or water or softgel) clears summerheat and resolves dampness, harmonizes the stomach and stops vomiting, and aromatically transforms turbidity. It works well for gastrointestinal colds and summer GI upset from overeating cold/raw food—with vomiting, diarrhea, and poor appetite.

Its main ingredients are Huoxiang (Patchouli), Fuling (Poria), Dafupi (Areca Peel), Zisuye (Perilla Leaf), Baizhi (Angelica Dahurica), Jupi (Tangerine Peel), Jiegeng (Platycodon), Baizhu (Atractylodes), Houpo (Magnolia Bark), Banxia (Pinellia), and Gancao (Licorice). Their main effects are to release the exterior and reduce fever, regulate qi and harmonize the middle, resolve phlegm and stop vomiting, awaken the spleen and stomach, and drain dampness. So Huoxiang Zhengqi Wan resolves both exterior and interior: it reduces fever, harmonizes the stomach and stops vomiting, and dries dampness to stop diarrhea.

Huoxiang Zhengqi Wan is led by Huoxiang, whose main effects are aromatically transforming dampness, harmonizing the middle and stopping vomiting, releasing the exterior and dispelling summerheat; it also awakens and fortifies the spleen. Used alone, Huoxiang also relieves epigastric fullness, nausea, vomiting, and heavy limbs.

Huoxiang Zhengqi Wan is a common over-the-counter medicine, available in several formulations. Because Huoxiang Zhengqi water contains much alcohol, it must not be combined with drugs that react with alcohol, such as Western cephalosporins or TCM formulas containing Mahuang (Ephedra); doing so can cause accidents.

TCM cold remedies vary with the seasons. The general principle is "no cold/cool herbs in autumn-winter, no acrid-warm herbs in spring-summer," though there are exceptions.

In TCM, because the climate differs through the year, external-contraction diseases cannot all be treated with the same formula.

Autumn and winter are cold; colds are mostly wind-cold, so Mahuang- and Guizhi-series acrid-warm formulas are used often. Spring is when the Shaoyang channel is active; patients easily get bitter mouth, so spring colds often use Chaihu-series formulas.

Summer is heavy with summerheat-dampness, so summer colds show damp-heat features; treatment must pair dampness-draining herbs. Hence Huoxiang Zhengqi Wan, Xiangru Yin, Qingshu Yiqi Tang, and Liuyi San are used often—Huoxiang Zhengqi Wan most often of all.

When prescribing decoctions for other diseases in a given season, physicians should add a few seasonal herbs. For example, this season, adding some Huoxiang and Peilan to a patient's prescription works better. This clinical flexibility is what a TCM doctor should master.