Zhu Danxi's "Kaxue Fang" (Coughing Blood Formula)
Zhu Danxi, one of the Four Great Masters of the Jin-Yuan period, had a formula called "Kaxue Fang" for treating the cough-and-blood syndrome caused by liver fire invading the lung. It is composed of 6 g (2 qian) of Qingdai (Indigo Naturalis, water-floated), 9 g (3 qian) of Gualouren (Trichosanthes Seed, oil removed), 9 g (3 qian) of Haige Fen (Clam Shell Powder), 9 g (3 qian) of Zhizi (Gardenia Fruit, fried black), and 6 g (2 qian) of Hezi (Chebula Fruit).
Preparation: grind the five herbs together into a fine powder, then combine honey and ginger juice to make honey pills. Administration: let the pill dissolve in the mouth, or swallow directly, or prepare as a decoction in water. As a decoction, the adult daily dose may follow the amounts above, except that Qingdai and Haige Fen should be wrapped in a non-woven bag when decocting. Because both are powdered herbs, if not wrapped they would cook into a paste.
Kaxue Fang clears the liver and quiets the lung, cools the blood and stops bleeding. It chiefly treats cough with blood due to liver fire invading the lung, presenting as cough with thick phlegm streaked with blood that is difficult to expectorate, irritability and easy anger, pain in the chest and hypochondrium, dry throat and bitter mouth, a flushed face, constipation, a red tongue with yellow coating, and a wiry rapid pulse. This formula is now often used for hemoptysis caused by bronchiectasis; adding 10-30 g of Baiji (Bletilla Tuber) speeds the effect. Kaxue Fang may also be used for hemoptysis caused by lung cancer or pulmonary metastatic tumors.
In this formula, Qingdai clears the liver and purges fire, and cools the blood and stops bleeding. Zhizi is bitter and cold, also clearing heat and cooling blood, purging fire and eliminating vexation; after being fried black its hemostatic effect is better. Gualouren clears heat and resolves phlegm. Haige Fen clears the lung and lowers fire, softens hard masses and dissipates nodules, and resolves phlegm and stops cough. Hezi astringes the lung and clears fire, and resolves phlegm and stops cough. If Baiji is added, the hemostatic effect is even more marked; Baiji is an important herb for treating hemoptysis.
This formula can relieve hemoptysis in advanced lung cancer patients, but for better efficacy it should be used together with antitumor drugs.