Tiaofei Decoction: Resolving Phlegm, Moistening the Lung, Stopping Cough and Calming Wheezing

"Tiaofei Tang" comes from the *Prescriptions for Universal Relief* (Puji Fang). Its composition is: 30g of apricot kernel (Xingren, scalded, peeled, tip and double kernels removed, stir-fried, 1 liang), 60g of ephedra (Mahuang, root nodes removed, scalded in water to skim the foam, dried, 2 liang), 30g of honey-fried licorice (Zhi Gancao, 1 liang), 0.3g of perilla seed (Zisuzi, stir-fried, 1 fen), and 30g of fritillary bulb (Beimu, stir-fried, heart removed, 1 liang). Grind all the above into a fine powder; take 9g (3 qian) each time with one bowl of water (about 150 ml), add 1 dried persimmon (chopped), and decoct to six-tenths of a bowl (about 90 ml). Strain and take warm. Three times a day: on an empty stomach in the early morning, at midday, and before bed.

This formula has the effects of resolving phlegm and moistening the lung, stopping cough and calming wheezing. It is mainly indicated for lung qi panting and wheezing, weakness of the limbs, and tastelessness of food. Modern use includes cough and wheezing caused by respiratory diseases such as chronic bronchitis, emphysema, asthma, and lung cancer. This formula may be reformulated into pills: grind the above herbs into a fine powder, add 120g of persimmon frost (Shishuang), and use refined honey as a binder to make 6 mm diameter pills; take 20–30 pills three times a day. It may also be made into 6g large honey pills, one pill three times a day.

In Tiaofei Tang, apricot kernel, ephedra, fritillary bulb, licorice, and perilla seed are the most commonly used Chinese herbs for stopping cough and calming wheezing: apricot kernel and perilla seed downbear qi, resolve phlegm, and stop cough; ephedra ventilates the lung, calms wheezing, and stops cough; fritillary bulb moistens the lung, resolves phlegm, and stops cough; licorice relieves spasm, calms wheezing, and stops cough. Used together, they form a highly effective cough-and-wheezing formula. Persimmon also moistens the lung, resolves phlegm, and downbears qi; using dried persimmon or persimmon frost as an herb helps apricot kernel and perilla seed downbear qi, resolve phlegm, stop cough, and calm wheezing.

For chronic cough and wheezing with bodily weakness, add 15–30g of American ginseng (Xiyangshen) and 1–2 geckos (Gejie). For profuse phlegm, add 15g of prepared pinellia (Fabanxia), 15g of processed arisaema (Dannanxing), 15g of bamboo shavings (Zhuru), 30g of Poria (Fuling), and 15g of tangerine red (Juhong). For dry mouth, red tongue, and rapid pulse, add 30g of scutellaria (Huangqin), 30g of Ophiopogon (Maidong), 30g of Asparagus (Tiandong), 30g of schisandra (Wuweizi), 15g of Glehnia root (Beishashen), and 15g of Adenophora (Nanshashen). For pleural effusion, add 30–60g of descurainia/tingli seed (Tinglizi) and 30g of mulberry bark (Sangbaipi).

The ephedra in this formula raises blood pressure and stimulates the heart as side effects; patients may experience rapid heartbeat, palpitations, and elevated blood pressure after taking it. Patients with prior heart disease and hypertension should use it cautiously. In addition, alcohol is strictly prohibited after taking this formula.