Xuanfu Daizhe Tang, the Famous Formula for Regurgitation and Hiccup
Xuanfu Daizhe Tang comes from the Shanghan Lun (Treatise on Cold Damage), which states: 'After cold damage treated by sweating, or vomiting, or purging, if the chest epigastrium is hard and stuffed and belching does not cease, Xuanfu Daizhe Tang governs it.'
Composition: Xuanfuhua (Inula) three liang (9 g), Renshen (ginseng) two liang (6 g; I often use Dangshen 10 g instead), fresh ginger five liang (15 g), Daizheshi (Hematitum) one liang (3 g), Zhi Gancao (honey-fried licorice) three liang (15 g), Banxia (Pinellia, washed) half sheng (9 g), jujube 12 pieces (broken; now usually 4-5, crushed when decocting).
Original method: boil with one dou of water down to six sheng, strain; then simmer down to three sheng, take one sheng warm, three times daily. Modern: boil two bowls down to one, twice, divide into three, take over the day. Xuanfu Daizhe Tang belongs to the harmonizing method, whose herbs are to be decocted a second time after straining; in practice this is unnecessary, and normal decoction works fine.
It is a classic for hiccup and regurgitation. Zhang Zhongjing did not specify the pulse, and in practice all pulses may occur, depending on the patient. Regardless of pulse, if the symptoms are clear, use it—this is 'setting the pulse aside for the pattern.' Zhang Xichun's Can-Zhe Pei-Qi Tang for dysphagia was built by adding herbs to this base. I often use it as the main formula for esophageal/gastric tumors and for nausea and vomiting after chemotherapy, with minor modifications.
Its pattern is seen in reflux esophagitis, superficial and atrophic gastritis, cholecystitis, gallstones, esophageal, cardiac, and gastric cancer: oppressive belching, frequent hiccupping and vomiting, epigastric fullness, subcostal pain. Untreated, it torments patients for years. For severe cases, combine with Erchen Tang, Jupi Zhuru Tang, or Dingxiang Shidi Tang to strengthen the downward-rebel, anti-vomiting effect.
It also treats meihe qi (plum-pit qi): the feeling of a stuck object in the throat, neither swallowable nor expectorable, like a plum pit. This may come from esophageal or throat lesions or from neurosis; it can be treated by Houpo Banxia Tang or Xuanfu Daizhe Tang.