Xiao Xingren Jian for Resolving Phlegm, Stopping Cough and Calming Wheezing

Xiao Xingren Jian comes from the Jifeng Puji Fang. It consists of Xingren (Apricot kernel) 2 liang (60 g), and Ziwan (Aster), Kuandonghua (Coltsfoot flower) and Fulin (Poria), each 5 qian (15 g). Preparation: grind the apricot kernels into a paste; grind Ziwan, Kuandonghua and Fulin into a fine powder; combine the apricot kernel paste with refined honey to make pills the size of a parasol seed. Take 5-7 pills each time with rice water after meals, twice daily. Its main action is to diffuse the lung and resolve phlegm, stop cough and calm wheezing; it is indicated for cough with upward flow, emaciation, phlegm in the throat, vexation below the heart, and inability to sleep.

There are sweet and bitter apricot kernels. Both expel phlegm and stop cough, and moisten the intestines to free the stool; both have some toxicity, though sweet almond is less toxic than bitter. Sweet almond tends to moisten the lung and suits patients with chronic lung-deficiency cough or fluid damage and constipation. Bitter almond descends and purges lung qi, tending to drain the lung and calm wheezing; it is somewhat toxic and suits excess-type cough and wheezing due to lung qi repletion.

Bitter almond should not be taken in large doses or long-term, because the amygdalin and amygdalinase in bitter almond produce hydrocyanic acid on contact with water, causing poisoning; bitter almond blocks respiration and paralyzes the cardiovascular center. Eating too much sweet almond also causes discomfort, though milder than bitter. So when preparing this formula, choose the almond according to the patient's condition. If the patient has no lung-qi repletion and needs long-term medication, sweet rather than bitter almond is best. But bitter almond has some anti-cancer action and is more suitable for cancer patients. With long-term use, control the dose; the Jifeng Puji Fang records 5-7 pills each time, a very small and safe amount.

Ziwan moistens the lung and downbears qi, dissipates phlegm and stops cough. TCM holds that Ziwan warms the lung, downbears qi, dissipates phlegm and stops cough, and treats wind-cold cough and wheezing and consumptive cough with pus and blood. Modern pharmacology shows Ziwan has antibacterial, antiviral and tumor-inhibiting actions. Kuandonghua moistens the lung and downbears qi, resolves phlegm and stops cough; it is indicated for cough with upward flow and wheezing, and throat impediment. Ziwan and Kuandonghua often appear as a pair; combined, their cough-stopping and wheezing-calming action is stronger. Fulin fortifies the spleen and promotes diuresis, seeps dampness and resolves phlegm; it is a key TCM herb for expelling water-rheum and phlegm-dampness. Here Fulin acts as assistant, opening an outlet for water-rheum and phlegm-dampness so that cough is stopped without retaining the pathogen.

Thus this formula, though simple, has a marked cough-stopping, wheezing-calming and phlegm-resolving effect. Adding Tinglizi and Sangbaipi (Morus bark) to this formula can relieve cough, wheezing and breathlessness from pleural effusion due to lung cancer. Adding Huangqin, Yuxingcao, Lugen (Phragmites rhizome) and Jinqiaomai (Fagopyrum cymosum) treats lung heat repletion with sticky cough-phlegm.