定喘汤 breakdown
By mchern • Apr 4th, 2008 • Category: Lungs, formula- 定喘白果与麻黄
- 黄芩甘草白皮桑
- 杏仁苏子款冬夏
- 宣肺平喘效力彰
That’s my song for this formula. Note that:
- 麻黄、杏仁 combination is there to deal with the breathing difficulties.
- 黄芩 makes an appearance here. we now know it to be an anti-allergy herb in addition to being an anti-pyretic herb. How? it destroys the enzyme that triggers the mast cell cascde, the result of which is reduced histamines release.
- the third line is made up of descending herbs.
- 白果 holds the lungs together, while 桑白皮 blast the heat from the lungs. We know that 桑白皮 is made up of alot of flavanoids, some of which mimick the blood pressure lowering functions of Ach. So, for now, I think of it as just reducing the tension in the upper jiao area.
The focus of this formula is in reducing the breathing difficulties. A simple way to remember how it does so is as follows:
- reducing bronchial spasms: 麻、杏
- reducing histamine activity: 黄芩
- keeps the lungs in maintenance condition: 白果、桑白皮
- reduce further coughing and phlegm production that puts too much pressure on the whole respiratory system: 杏仁、苏子、款冬花、半夏
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I see this formula as a basic formula for a bronchial situation where the patient is present heaty symptoms. It needn’t be very hot, but the symptoms are not “cold,” and so just think of this formula as an alternative to 小青龙汤.
The really warm herbs that stand out are 麻黄 (ephedra) and 半夏 (pinella). These have to be added because there aren’t really any cold alternatives. The rest of the herbs are pretty much cold, but nothing like 石膏, which tells us the heat isn’t really that intense to use a 阳明实热 herb.
To differentiate 定喘汤 and 越婢加半夏汤：
Similarities: They both have 麻黄 and 半夏, warm herbs in a formula that treats “hot” respiratory problems.
Difference 1: the cold drugs they use differ in degree. While 定喘汤 uses a slew of mainly cold drugs, 越婢加半夏汤 just puts on plain 石膏 to blast the heat out.
Difference 2: The former formula uses the 麻、杏 combination, which we know works to ALLEVIATE THE PANTING.The latter formula uses the 麻、膏 combination (which appears in 麻杏石甘汤) which we know works to CLEAR HEAT.
Difference 3: The most recent textbook says that former is not used to treat 表证 while the latter treats it. I don’t think this is an important point.
白果 is more for 虚喘. Normally not used, unless it’s a 顽固性 problem. Or when normal herbs don’t work, can try throwing it in.
use this when it’s heaty asthma, but the heat is not severe.