Jingzhi Kesou Tanchuan Wan: A Famous Cough-Relieving Chinese Patent Medicine

Jingzhi Kesou Tanchuan Wan (Beijing-Prepared Cough, Phlegm, and Wheeze Pill) is a well-known cough-relieving Chinese patent medicine; its formula is a typical large TCM compound. Its composition includes: Peucedanum (qianhu), Cynanchum stauntonii (baiqian), bitter apricot seed (kuxingren, peeled, fried), mulberry leaf (sangye), Ephedra (mahuang), Pinellia mass (banxiaqu, bran-fried), Platycodon (jiegeng), Sichuan fritillary (chuanbeimu), perilla seed (zisuzi, fried), Citrus changshan (huajuhong, salt-fried), Aster (ziwan), coltsfoot flower (kuandonghua, honey-fried), Inula (xuanfuhua), pumice (haifushi, calcined), birthwort (madouling, honey-fried), Poria (fuling), honey-fried Licorice (zhigancao), Polygala (yuanzhi, fried until scorched), gypsum (shigao), Asarum (xixin), Schisandra (wuweizi, vinegar-processed), Cinnamon twig (guizhi, fried), Zhejiang fritillary (zhebeimu), Paeonia Alba (baishao, wine-fried), Descurainia seed (tinglizi), Belamcanda (shegan), Stemona (baibu, honey-fried), Allium macrostemon (xiebai), Scutellaria (huangqin), Codonopsis (dangshen), jujube (dazao), calcined clam shell powder (duan ge ke fen), indigo (qingdai), poppy shell (yingsuqiao), fresh ginger (shengjiang), and loquat leaf (pipaye), among others.

This formula is hard to explain by ordinary prescribing principles: virtually every TCM herb with cough-relieving and anti-asthma action appears in it. Descurainia and birthwort also promote diuresis and reduce edema, helping control pleural effusion. The main actions of the formula are to disperse wind and clear heat, diffuse the lung and stop cough, resolve phlegm and calm wheezing. It treats external wind pathogen, phlegm-heat obstructing the lung, cough with profuse sputum, panting and wheezing, inability to lie down, itchy throat, fullness in the chest and diaphragm, and phlegm-wheeze of old age. The dose is 30 pills twice daily; children take a reduced dose.

Note that birthwort (madouling) in this formula is a nephrotoxic TCM herb; in recent years it has repeatedly been reported to damage the kidneys, so this product is contraindicated in patients with renal insufficiency. It should not be taken in excess or for prolonged periods to avoid chronic cumulative poisoning; patients who wish to take it long-term should have periodic renal-function checks. Birthwort could actually be omitted from this formula with little effect on efficacy; it was included in older formulations because its toxic side effects were not then clearly understood.

This formula can treat conditions such as senile emphysema and intractable asthma, relieving persistent cough. Because it contains poppy shell, it has the characteristics of morphine-type drugs and can relieve pain. Patients with lung cancer or pulmonary metastases who develop intractable cough and wheeze in late stage may use this formula as adjunctive treatment to reduce suffering and modestly prolong survival.