Shufeng Zhisou Pill: The Qing Court's Imperial Formula for Treating Cough
"Shufeng Zhisou Pill" comes from the *Selected Discussions on Medical Prescriptions of the Guangxu Emperor of Cixi* (Cixi Guangxu Yifang Xuanyi), and was an imperial prescription used in the late-Qing palace to treat cough caused by wind-cold common cold. Its composition is: 15g of perilla stem (Sugeng, 5 qian), and 9g each of saposhnikovia root (Fangfeng), kudzu root (Gangege, Gegen), stir-fried aurantium fruit (Chao Zhiqiao), peucedanum root (Qianhu), platycodon root (Jiegeng), mulberry bark (Sangbaipi), apricot kernel (Xingren), processed pinellia (Zhibanxia), and Poria (Fuling); 6g each of tangerine peel (Chenpi), Sichuan fritillary bulb (Chuanbeimu), notopterygium root (Qianghuo), and scutellaria root (Huangqin); and 3g of licorice (Gancao, 1 qian).
The preparation method is to grind all the above herbs into a fine powder, add a small amount of refined honey, and form into pills the size of mung beans. Take 9g (3 qian) each time with warm boiled water, twice a day. Shufeng Zhisou Pill has the effects of dispersing wind to release the exterior, stopping cough, and resolving phlegm. It is mainly indicated for exterior contraction of wind-cold with cough and profuse sputum, or cough that is difficult to expectorate; or for prolonged cough with phlegm when the exterior pathogen has not been fully expelled.
This formula may be modified into a decoction; the above dosage serves as the daily dose for an adult. Children over 4 years old should take half the dose, and children under 4 years old one-third. However, because Sichuan fritillary bulb is expensive, the decoction is relatively costly, so making it into pills is more economical. When using the pill form, processed pinellia (Zhibanxia) may be replaced by prepared pinellia (Fabanxia), because pharmacies generally do not sell Zhibanxia.
This formula is suitable for patients who, after a wind-cold cold, present with mixed cold-heat symptoms, cough with profuse sputum, or prolonged cough with phlegm. The reason I recommend it is that Shufeng Zhisou Pill is very well suited to today's cough patients. Since the onset of winter this year, respiratory diseases have been frequent. At the early stage they are basically all wind-cold colds in TCM terms, but various pathogens are mixed together and difficult to treat; many constitutionally weak adults and children have coughs that linger for a long time without healing. If there is someone at home with lung-qi deficiency who coughs easily and has not responded to various treatments, this formula may be considered.
Although this formula has the action of dispersing wind and releasing the exterior, that action is relatively mild; its emphasis is on clearing the lung, resolving phlegm, and stopping cough. It is therefore very suitable for patients in whom the exterior pathogen has not yet resolved but is not severe—with low-grade fever or no fever, slight aversion to cold or none, and whose main symptom is cough with profuse sputum. In the later stage of a cold, although there is cold on the exterior, there is also heat in the interior; hence this formula combines wind-dispersing cold-expelling herbs with lung-heat-clearing herbs, making it ideal for mixed cold-heat patterns. Qianhu, Jiegeng, Sangbaipi, Xingren, Banxia, Chuanbei, Huangqin, and Fuling all clear the lung, resolve phlegm, and stop cough, so the emphasis of this formula is on stopping cough.
This fine cough prescription from the hands of a Qing imperial physician is exquisitely composed, using light and moderate herbs, and is well worth our study.