Gua Lou Xie Bai Ban Xia Tang — Trichosanthes, Chinese Garlic & Pinellia Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

Overview

Gua Lou Xie Bai Ban Xia Tang — the “Trichosanthes, Chinese Garlic and Pinellia Decoction” — is from Zhang Zhongjing’s Jin Gui Yao Lue. It is a modification of Gua Lou Xie Bai Bai Jiu Tang with Ban Xia added — used for more severe Chest Bi with prominent Phlegm, where the patient cannot lie flat (orthopnoea), has severe chest pain radiating to the back, and the Phlegm pattern is more entrenched. The addition of Ban Xia adds stronger Phlegm-resolving and descending action.

I prescribe Gua Lou Xie Bai Ban Xia Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Gua Lou Xie Bai Ban Xia Tang is prescribed for severe Chest Bi with prominent Phlegm-Damp:

• Severe chest oppression, tightness or pain
• Pain radiating to the back
• Inability to lie flat (orthopnoea)
• Cough with thick white phlegm, sometimes copious
• Marked shortness of breath
• Nausea, possible vomiting
• Tongue — pale or pale-purple, thick white-greasy coat
• Pulse — deep, wiry, slippery

Key herbs

1. Gua Lou (Fr. Trichosanthis, 12–30g) — chief; clears Phlegm; opens the chest
2. Xie Bai (Bb. Allii Macrostemonis, 9–15g) — opens Yang in the chest
3. Ban Xia (Rz. Pinelliae, 9–15g) — strongly resolves Phlegm; descends rebellious Qi; stops nausea
4. Bai Jiu (white wine, traditional adjunct) — circulates Yang (often omitted in modern practice)

Formula actions

1. Circulates Yang in the chest
2. Strongly resolves Phlegm and opens the chest
3. Descends rebellious Qi (addresses orthopnoea)
4. Relieves severe chest pain and oppression

Conditions treated

1. Severe angina pectoris with Phlegm-Damp pattern (alongside conventional cardiology care)
2. Congestive heart failure with orthopnoea and Phlegm (adjunctive)
3. Severe chronic bronchitis with chest tightness and copious phlegm
4. Acute exacerbation of COPD with Phlegm-Damp chest pattern
5. Severe asthma with chest tightness and orthopnoea
6. Pleural effusion (after drainage) with persistent Phlegm pattern

Cautions

New, severe or worsening chest pain or breathlessness is a medical emergency — call 999. This formula is an adjunct to conventional care, not a replacement.

Not appropriate for Yin-deficient cough or dry cough — the warming and drying herbs aggravate dryness.

Always consult a qualified Chinese herbalist registered with the RCHM.

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