Xuanfuhua (Inula Flower): Dissolving Phlegm and Promoting Diuresis, Downbearing Counterflow and Stopping Vomiting, Stopping Cough and Calming Wheezing
The Chinese herb Xuanfuhua is the capitulum of Inula japonica Thunb. or Inula britanica L. (family Asteraceae), also called Jinfu Hua, Jinqian Hua, Jinfei Hua or Xiaohuanghuazi. Traditional TCM holds that Xuanfuhua is bitter, acrid and salty in flavor and slightly warm in nature, entering the Lung, Stomach and Large Intestine meridians. It dissolves phlegm and promotes diuresis, downbears counterflow and stops vomiting. It mainly treats cough and wheezing with sticky phlegm, vomiting and belching, and chest oppression with hypochondriac pain.
Modern pharmacological studies have confirmed that Xuanfuhua has marked antitussive, expectorant and anti-asthmatic effects, as well as anti-inflammatory, antibacterial, insecticidal and anti-hepatic-injury effects; it can inhibit the elevation of serum ALT and AST. The active constituent of Xuanfuhua, tenuilin (helenalin-related), also has an anti-cancer effect.
However, the effects of Xuanfuhua produced in different regions are not identical; for example, Hubei Xuanfuhua has no antitussive effect, and Shuichaoyang Xuanfuhua has no expectorant effect. Zhang Xichun once said that Xuanfuhua produced at Wuditai was the purest.
Because Shanghan Lun contains Xuanfu Daizhe Shi Tang, in which Xuanfuhua and Daizheshi (Hematite) are the principal herbs, with the actions of downbearing counterflow and stopping vomiting, moving qi and harmonizing the stomach, the best-remembered effect of Xuanfuhua is downbearing counterflow and stopping vomiting. Tangtou Gejue says: "Xuanfu Daizhe uses Renshen, with Banxia, ginger, Gancao and Dazao; heavy to settle counterflow, salty to soften nodules, firm glomus and belching it can forbid." Xuanfu Daizhe Shi Tang is the representative formula for treating stomach-qi disharmony with belching and vomiting, and belongs to the qi-regulating formulas of TCM. The ancients believed that the main action of Xuanfuhua in this formula was "salty to soften glomus", meaning that, being salty, it has the action of softening hardness, dissipating nodules and dispersing glomus.
Ni Zhumo wrote: "Xuanfuhua is a herb that dissolves phlegm and expels fluid, and moves qi downward. It mainly binds qi in the heart and lung, deficiency-fullness below the ribs, congealed phlegm in the chest, glomus and hardness with belching, or retained fluid in the heart and spleen, retained fluid in the bladder, and old water. Generally this agent is slightly salty, so it softens hardness and disperses glomus hardness; its nature is to move qi downward and move phlegm and water—it is indeed an expelling and attacking herb." Ni Zhumo’s words can be verified clinically: Xuanfuhua indeed has expectorant and diuretic actions; after the phlegm is transformed it is excreted in the urine as water, so taking Xuanfuhua has a marked diuretic effect. Patients without the excess syndrome of exuberant phlegm-fluid should not take this herb; patients with frequent urination should also use it cautiously.
Xuanfuhua is good at stopping cough and calming wheezing, so it is also an important herb for treating cough and asthma. The Chinese patent medicine Compound Xuanfuhua Tablet (composed of Xuanfuhua, Baibu (Stemona), Huangqi (Astragalus) and Dilong (earthworm)) is a dedicated medicine for acute and chronic bronchitis and bronchial asthma. "Zhi Ru Ru Jiaoji" in Weisheng Yijian Fang (Easy Recipes for Health), which treats "spittle like glue lacquer, thick and sticky, with unfavorable throat", uses only "Xuanfuhua ground into powder, two to three qian each dose, decocted in water and sipped from time to time", showing that the ancients already recognized that single-herb Xuanfuhua can treat diseases of abundant sticky phlegm obstructing the respiratory tract. In Bencao Huiyan, the author quotes Tong Yunfeng: "If it is hot phlegm, there is much vexing heat; if damp phlegm, much tiredness and weakness; if wind phlegm, much unusual symptoms such as paralysis; if fright phlegm, much heart pain and epilepsy; if cold phlegm, much bone bi and wilting disease; if fluid phlegm, much hypochondriac and arm pain; if food-accumulation phlegm, much glomus masses and fullness. The disease presents in varied forms; using Xuanfuhua, added according to deficiency or excess, cold or heat, every hand obtains the effect."
Xuanfuhua also has a blood-pressure-lowering effect. For dizziness and distending pain of the head and eyes caused by hypertension, take equal parts of Xuanfuhua, Tianma (Gastrodia) and Ganjuhua (chrysanthemum flower), grind into powder, and take two qian each evening with boiled water; this can improve the patient’s clinical symptoms and lower blood pressure.
The clinical applications of Xuanfuhua are too numerous to list one by one. Among the cancer patients I commonly treat, Xuanfuhua is used most in gastric and esophageal cancer, because gastric and esophageal cancer often present with hiccups, belching and regurgitation, and Xuanfuhua can improve these clinical symptoms. Patients with pleural effusion and ascites also mostly belong to what TCM calls phlegm-fluid; such patients may also be given Xuanfuhua in the formula.
The hairs of Xuanfuhua irritate the throat and easily cause choking cough, so when this herb enters a decoction it must be wrapped in cloth before decocting. Because Xuanfuhua is often used in mutual promotion with Daizheshi (Hematite), which also must be wrapped in cloth, Xuanfuhua and Daizheshi are often wrapped together for decocting. Xuanfuhua has a diuretic action; patients with yin-deficiency consumptive cough or wind-heat dry cough are already in a state of fluid insufficiency, and further use of Xuanfuhua will aggravate the fluid deficiency, so such patients should not use Xuanfuhua.