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Plum Pit Qi
"An Explanation of the Pattern Discrimination Treatment of 49 Cases of Plum Pit Qi" by Yuan Chang-hua, Si Chuan Zhong Yi (Sichuan Chinese Medicine), #11, 1993, p. 33-34
This clinical au*** describes the treatment of 49 cases of plum pit qi (mei he qi). Of these 49 cases, 13 were men and 36 women. Their ages ranged from a high of 76 to a low of 18 years old. The course of their disease had lasted from as long as three years to as short as two weeks. Treatment was given on the basis of a pattern discrimination diagnosis with four patterns being identified.
1. Liver depression qi stagnation ( u*â?T ddo.ng) pattern ( ma^~u)
The signs and symptoms of this pattern included the sensation ( cam giac )of something stuck ( bi. Mac ke.t)in the throat which could neither be coughed up and out nor descended ( co nguon goc tu )by swallowing ( nuo^â?Tt), chest and rib-side distention and pain, emotional lability, deep sighing, violent anger, thin, white tongue fur, and bowstring pulse. The treatment methods were to course the liver and resolve depression, rectify the qi and scatter nodulation. The formula used was Si Ni San Jia Jian (Four Counterflows Powder with Ad***ions and Subtractions).
The formula consisted of: Radix Bupleuri (Chai Hu), Fructus Immaturus Citri Aurantii (Zhi Shi), Radix Albus Paeoniae Lactiflorae (Bai Shao), Tuber Curcumae (Yu Jin), Caulis Perillae Frutescentis (Su Gen), Rhizoma Cyperi Rotundi (Xiang Fu), Radix Platycodi Grandiflori (Jie Geng), etc. If liver depression transformed into fire, Cortex Radicis Moutan (Dan Pi), Fructus Gardeniae Jasminoidis (Zhi Zi), Spica Prunellae Vulgaris (Xia Gu Cao), Fructus Meliae Toosendan (Chuan Lian Zi), etc. were added.
2. Phlegm depression in the chest & diaphragm pattern
The signs and symptoms ( trieu chung ) of this pattern included a feeling of phlegm stuck in the throat which would neither go down with swallowing or be discharged upward by cough, distention and oppression of the chest and diaphragm, a pasty, slimy feeling in the mouth, possible nausea and vomiting, thick, slimy tongue fur, and a bowstring, slippery pulse. The treatment methods were to transform phlegm, rectify the qi, and scatter nodulation. The formula used was Ban Xia Hou Po Tang Jia Jian (Pinellia & Magnolia Decoction with Ad***ions & Subtractions).
The formula consisted of: Rhizoma Pinelliae Ternatae (Ban Xia), Cortex Magnoliae Officinalis (Chuan Po), Sclerotium Poriae Cocos (Fu Ling), Radix Platycodi Grandiflori (Jie Geng), Caulis Perillae Frutescentis (Su Gen), Semen Sinapis Albae (Bai Jie Zi), Tuber Curcumae (Yu Jin), Radix Clematidis Chinensis (Wei Ling Xian), Fructus Immaturus Citri Aurantii (Zhi Shi), etc. If there was also a bitter taste in the mouth and coughing of yellow, sticky phlegm, dizziness, slimy, yellow tongue fur, and a slippery, rapid pulse, then Wen Dan Tang Jia Jian (Warm the Gallbladder Decoction with Ad***ions & Subtractions) was the formula used, consisting of: Rhizoma Pinelliae Ternatae (Ban Xia), Pericarpium Citri Reticulatae (Chen Pi), Sclerotium Poriae Cocos (Fu Ling), Fructus Immaturus Citri Aurantii (Zhi Shi), Caulis Bambusae In Taeniis (Zhu Ru), Fructus Trichosanthis Kirlowii (Gua Lou), Bulbus Fritillariae Thunbergii (Zhe Bei), Tuber Curcumae (Yu Jin), Spica Prunellae Vulgaris (Xia Gu Cao), Radix Scutellariae Baicalensis (Huang Qin), Rhizoma Belamcandae (She Gan), etc.
3. Yin vacuity-liver depression pattern
The signs and symptoms of this pattern consisted of the sensation of something obstructing and stopping the throat which could neither be coughed out nor swallowed down, a dry mouth and throat, heat in the center of the hands and feet (or heat in the hands, feet, and heart depending on how you read the Chinese), lingering pain in the rib-side, a red tongue with scanty fur, and a bowstring, fine, and rapid pulse. The treatment methods used were to enrich yin and downbear fire, soften the liver and scatter nodulation. The formula used was Yi Guan Jian (Linking Decoction with Ad***ions & Subtractions).
The formula consisted of: Fructus Meliae Toosendan (Chuan Lian Zi), Radix Glehniae Littoralis (Sha Shen), Tuber Ophiopogonis Japonici (Mai Dong), uncooked Radix Rehmanniae (Sheng Di), Fructus Lycii Chinensis (Gou Qi), Radix Angelicae Sinensis (Dang Gui), Radix Scrophulariae Ningpoensis (Xuan Shen), Tuber Curcumae (Yu Jin), Radix Platycodi Grandiflori (Jie Geng), Radix Albus Paeoniae Lactiflorae (Bai Shao), etc.



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4. Blood stasis obstructing the network vessels pattern
The signs and symptoms of this pattern included the feeling of something blocking the throat which could neither be coughed up nor swallowed down, eating resulting in constipation, water drinking normal, lancinating chest and rib-side region pain which, if serious, radiated to the upper back, a long disease course, a dark tongue or a tongue with static spots or macules, and a bowstring, fine, choppy pulse. The treatment methods were to transform stasis and free the flow of the network vessels, move the qi and disinhibit the throat. The formula used was Xue Fu Zhu Yu Tang Jia Jian (Blood Mansion Disple Stasis Decoction with Ad***ions & Subtractions).
The formula consisted of: Semen Pruni Persicae (Tao Ren), Flos Carthami Tinctorii (Hong Hua), Radix Angelicae Sinensis (Dang Gui), Radix Ligustici Wallichii (Chuan Xiong), Radix Rubrus Paeoniae Lactiflorae (Chi Shao), Radix Bupleuri (Chai Hu), Fructus Immaturus Citri Aurantii (Zhi Shi), Radix Platycodi Grandiflori (Jie Geng), Radix Cyathulae (Chuan Niu Xi), Tuber Curcumae (Yu Jin), Spica Prunellae Vulgaris (Xia Gu Cao), Radix Salviae Miltiorrhizae (Dan Shen), etc.
The criteria for judging success in this study were as follows: Complete cure was defined as the disappearance of this con***ion clinically with no recurrence on follow-up one year later. Improvement consisted of disappearance of this con***ion clinically with recurrence within one year. And no result was defined as no obvious improvement in this con***ion clinically after two weeks of taking the above medicinals. Based on these criteria, 39 cases were completely cured, seven cases were improved, and three cases experienced no improvement. This resulted in a total amelioration rate of 93.8%.
Case history: A 42 year old woman complained of phlegm in her throat accompanied by feeling out of sorts for 3 months. She could neither cough this phlegm up nor swallow it down. In ad***ion, she had chest oppression, inability to relax, dizziness, a bitter, sticky mouth, thirst but no desire to drink, insomnia and profuse dreams, a red tongue with yellow, slimy fur, and a bowstring, slippery pulse. The (disease) diagnosis was plum pit qi. This was categorized as phlegm depression of the chest and diaphragm pattern with phlegm and qi combining, obstructing, and transforming into heat. Treatment, therefore, was to transform phlegm and clear heat, disinhibit the qi and scatter nodulation.
The formula used was modified Wen Dan Tang, consisting of: Rhizoma Pinelliae Ternatae (Ban Xia) and Sclerotium Poriae Cocos (Fu Ling), 5g each, Pericarpium Citri Reticulatae (Chen Pi), Fructus Immaturus Citri Aurantii (Zhi Shi), Radix Scutellariae Baicalensis (Huang Qin), Caulis Bambusae In Taeniis (Zhu Ru), and Tuber Curcumae (Yu Jin), 10g each, Fructus Trichosanthis Kirlowii (Gua Lou) and Spica Prunellae Vulgaris (Xia Gu Cao), 30g each, Bulbus Fritillariae Thunbergii (Zhe Bei), 12 g, and Radix Platycodi Grandiflori (Jie Geng), 6g. These were decocted in water and taken, one ji per day.
After taking three ji, the patient came again for examination. The chest oppression had been diminished and her sleep was improved. The other symptoms were the same as before. Therefore, 15 grams of Rhizoma Belamcandae (She Gan) were added to the above medicinals in order to strengthen their ability to clear heat and disinhibit the throat, transform phlegm and scatter nodulation. After taking another three ji, the patient was extremely happy. The throat con***ion was quite obviously reduced and her tongue fur had turned from yellow and glossy to thin and slimy. Therefore, there was no further change made in her formula. Three more ji and she was completely cured. On follow-up one year later, there had been no recurrence.
According to the author, plum pit qi is a disease which is mostly due to the liver and spleen. However, this disease is not limited solely to the liver and spleen but may involve the liver, stomach, spleen, kidneys, and other viscera and bowels. Ban Xia Hou Po Tang is the most commonly used formula for the treatment of plum pit qi. Nonetheless, because this disease may differ (in different patients), so must the formula. If treatment is not given on the basis of a pattern discrimination diagnosis, the results are not good.
Be that as it may, the author goes on to say that there are two especially important medicinals in the treatment of plum pit qi. These are Tuber Curcumae (Yu Jin) and Spica Prunellae Vulgaris (Xia Gu Cao). The Ben Cao Hui Yan (Collected Sayings on the Materia Medica) says of Tuber Curcumae:
Its nature should not be belittled. It is able to scatter depression and stagnation. It normalizes counterflow qi. Above, it reaches the high mountain peaks, while also moving the lower burner. (Affecting) the heart, lungs, liver, and kidneys, it is effective for even the tiniest qi, blood, phlegm, and fire depressions which are checked and not moving.
Spica Prunellae Vulgaris is bitter, acrid, and cold and enters the liver and gallbladder channels. In particular, it is able to move liver qi, open liver depression, and scatter nodulation. The Chong Qing Chang Sui Bi (Chongqing Common Informal Essays) states: "Spica Prunellae Vulgaris is slightly acrid and sweet and thus scatters nodulations while at the same time harmonizing yang and nourishing yin." (Based on the above quotation,) one can understand that Spica Prunellae Vulgaris not only scatters nodulation but is also able to level the steelyard (of the hand-held scale) when regulating yin and yang. Although plum pit qi may be divided into the types described above, it is always accompanied by qi nodulation in the throat. Therefore, these two medicinals may be added when writing a formula and should be not lacking in the treatment of this disease.
"The Treatment of 40 Cases of Plum Pit Qi with Shun Qi Xiao Shi Hua Tan Tang (Normalize the Qi, Disperse Food, & Transform Phlegm Decoction)" by Jin Ming-mo, Ji Lin Zhong Yi Yao (Jilin Chinese Medicine & Medicinals), #4, 1993, p.19
This clinical au*** reports on the treatment of 40 cases of plum pit qi using Shun Qi Xiao Shi Hua Tan Tang with ad***ions and subtractions. Among these 40 cases, 12 were men and 28 were women. Ten cases ranged in age from 18-30 years old, 21 cases were 31-40 years old, five cases were 41-50 years old, and the rest were over 50. The course of disease had lasted from as long as three years to as short as seven days. Further, 23 cases were from emotional causes, seven were from unregulated diet, and the rest were due to upper respiratory tract infection.
The formula consisted of: Pericarpium Citri Reticulatae (Chen Pi), 10g, Pericarpium Citri Reticulatae Viride (Qing Pi), 10g, bile-treated Rhizoma Arisaematis (Dan Nan Xing), 10g, Rhizoma Pinelliae Ternatae (Ban Xia), 10g, Fructus Perillae Frutescentis (Su Zi), Semen Raphani Sativi (Lai Fu Zi), 10g, Radix Bupleuri (Chai Hu), 10g, Rhizoma Cimicifugae (Sheng Ma), 10g, Radix Platycodi Grandiflori (Jie Geng), 10g, and Rhizoma Cyperi Rotundi (Xiang Fu), 10g. One ji was taken per day, decocted in water and divided into two doses.
Spinosae (Chao Zao Ren), 20g, and Cortex Cinnamomi Cassiae (Gui Yuan Rou), 10g, were added. If food and drink were not well regulated, Massa Medica Fermentata (Shen Qu), 40g, Endothelium Corneum Gigeriae Galli (Ji Nei Jin), 10g, and stir-fried Fructus Germinatus Hordei Vulgaris (Chao Mai Ya), 10g, were added. If there was upper respiratory tract infection, Flos Lonicerae Japonicae (Jin Yin Hua), 20g, Radix Isatidis Seu Baphicacanthis (Ban Lang Gen), 50g, and Herba Taraxaci Mongolici Cum Radice (Pu Gong Ying), 50g, were added.
Complete cure consisted of obvious disappearance of the signs and symptoms with no recurrence within a half year. Based on this criteria, 28 cases or 70% experienced complete cure. Some improvement was defined as obvious diminishment of the signs and symptoms. Eight cases or 20% fell into this category. Only four cases or 10% failed to experience any improvement.
Case history: Female, 46 years old. Nine months previously the patient had experienced emotional upset. At that time, she felt something in her throat which she could neither swallow down nor spit up. When eating, her throat was normal and there was no obvious aching or pain. She also experienced abdominal distention and oppression extending to both rib-side regions. She had tried numerous formulas but without result. Examination revealed that her lips were slightly dry, her urine was yellow, and her stools were dry. Her tongue fur was slightly yellow and her pulse was bowstring and slippery. Her pattern was thus categorized as liver depression and qi counterflow, loss of harmony of the spleen and stomach, and phlegm qi counterflowing upward. It was, therefore, appropriate that her treatment mainly consisted of coursing the liver and resolving depression, rectifying the qi and transforming phlegm. The medicinals employed consisted of Shun Qi Xiao Shi Hua Tan Tang plus Cortex Tubiformis Cinnamomi Cassiae (Gui Yuan Rou), 10g, and Fructus Gardeniae Jasminoidis (Zhi Zi), 10g. After three ji, her symptoms had disappeared. After another five ji, her disease was completely cured. On follow-up after one year, there had been no recurrence.
"The Treatment of 54 Cases of Plum Pit Qi with Bai Mei Li Yan Tang (Peony & Mume Disinhibiting the Throat Decoction)" by Zhang Jian-hua, Shang Hai Zhong Yi Yao Za Zhi (The Shanghai Journal of Chinese Medicine & Medicinals), #1, 1992, p. 20-21
This clinical au*** discusses the effects of Bai Mei Li Yan Tang on what is known in the West as neurotic esophageal stenosis or globus hystericus. This formula consists of: uncooked Radix Albus Paeoniae Lactiflorae (Bai Shao), 9g, Flos Pruni Mume (Lu E Mei), 4.5g, Radix Adenophorae Strictae (Nan Sha Shen), 4.5g, Bulbus Lilii (Bai He), 9g, Radix Platycodi Grandiflori (Bai Jie Gen), 4.5g, Rhizoma Belamcandae (She Gan), 4.5g, and uncooked Radix Glycyrrhizae (Gan Cao), 3g.
A number of modifications are given for this formula. Unfortunately, several of them are very unusual ingredients or unusual names for common ingredients the translator has not been able to identify. These are given in Pinyin only. For dizziness and vertigo due to liver hyperactivity, Ramulus Uncariae Cum Uncis (Diao Teng Gou), Fructus Tribuli Terrestris (Bai Ji Li), etc.were added. For liver qi depression and binding with chest oppression and qi inversion, Tuber Curcumae (Yu Jin), Flos Citri Sacrodactylis (Fo Shou Hua), Ye Qiang Wei Hua, mix-fried Fructus Citri Aurantii (Zhi Ke), etc. were added. For heart palpitations and insomnia, Sclerotium Pararadicis Poriae Cocos (Fu Shen), Fructus Schisandrae Chinensis (Wu Wei Zi), processed Radix Polygalae Tenuifoliae (Zhi Yuan Zhi), Flos Albizziae Julibrissinis (He Huan Hua), etc. were added. For pasty phlegm in the head of the throat which is not able to be easily spit out, Fructus Arctii Lappae (Niu Bang Zi), Bulbus Fritillariae Thunbergii (Zhe Bei Mu), Di Ku Luo, etc. were added. For yin vacuity dry throat with scanty fluids, Radix Trichosanthis Kirlowii (Tian Hua Fen), Radix Scrophulariae Ningpoensis (Bei Yuan Shen), etc. were added. And for spleen vacuity with damp accumulation and torpid intake, Radix Glycyrrhizae was deleted and scorched Rhizoma Atractylodis Macrocephalae (Bai Zhu), Radix Dioscoreae Oppositae (Shan Yao), Massa Medica Fermentata (Shen Qu), etc. were added.
One packet of the above ingredients was decocted each day. The resulting liquid was divided in two and these two doses were taken per day. Two weeks of such treatment constituted one complete course of therapy. Twenty-one or 38.9% of the cases experienced obvious improvement after two whole courses of therapy. Another 28 cases or 51.8% experienced some improvement. Five cases experienced no improvement or 9.3%. The total amelioration rate in this study was, therefore, 90.7%.
"The Treatment of 64 Cases of Chronic Laryngitis with Xue Fu Zhu Yu Tang (Blood Mansion Dispelling Stasis Decoction)" by Li Xin-cun, Bei Jing Zhong Yi (Beijing Chinese Medicine), #6, 1993, p. 48
This clinical au*** reports on the treatment of 64 cases of chronic inflammation of the throat. The author begins by equating this con***ion with what is called plum pit qi in Chinese medicine. This con***ion mostly occurs in adults. Of the 64 patients treated with this formula, 23 were men and 41 were women. Thus the male to female ratio was 1:1.8. The youngest patient was 18 years old and the oldest was 54. The shortest disease course was eight days and the longest was four years. The main symptoms of these patients' con***ion were hyperemia of the throat, dry throat, sore throat, itchy throat, and the feeling as if something were stuck in the throat which spitting could not discharge and swallowing could not descend. Twenty-five cases mainly experienced a dry, sore throat, and 39 mainly experienced an itchy throat and the feeling as if something were stuck in the throat.
Xue Fu Zhu Yu Tang consisted of: Radix Angelicae Sinensis (Dang Gui), 15g, Flos Carthami Tinctorii (Hong Hua), 10g, Semen Pruni Persicae (Tao Ren), 10g, Fructus Citri Aurantii (Zhi Ke), 10g, Radix Bupleuri (Chai Hu), 10g, Radix Rubrus Paeoniae Lactiflorae (Chi Shao), 15g, Radix Ligustici Wallichii (Chuan Xiong), 10g, Radix Platycodi Grandiflori (Jie Geng), 10g, Radix Cyathulae (Chuan Niu Xi), 15g, uncooked Radix Rehmanniae (Sheng Di), 15g, and Radix Glycyrrhizae (Gan Cao), 10g. These were decocted in water and administered, one ji per day.
If there was a dry, sore throat, Radix Scrophulariae Ningpoensis (Yuan Shen), 15g, Radix Trichosanthis Kirlowii (Hua Fen), 15g, and mix-fried Folium Eriobotryae Japonicae (Pi Pa Ye), 10g, were added. If there was itchy throat, Rhizoma Belamcandae (She Gan), 10g, and Herba Menthae Haplocalycis (Bo He), 10g, were added. If there was the feeling as if something were stuck in the throat, Caulis Perillae Frutescentis (Su Gen), 10g, and Rhizoma Pinelliae Ternatae (Ban Xia), 10g, were added. Ten ji equalled one course of treatment.
Complete cure consisted of the disappearance of the clinical symptoms and no hyperemia of the throat, and marked improvement consisted of diminishment of the clinical symptoms. Based on these criteria, 52 cases or 81.2% were cured, 11 or 17.2% experienced marked improvement, and only one or 1.6% experienced no result. Thus the total amelioration rate was 98.4%. The smallest number of ji administered was eight and the largest was 20, the average being 14.
Case history: Female, 28 years old. The patient had felt like she had something stuck in her throat for three years. This could neither be spit up nor swallowed down. In ad***ion, her throat was dry and sometimes itchy. She also experienced vexation and agitation. She had been treated previously with Western medical anti-inflammatories but without success. When she came for examination, her throat was hyperemic, her tongue was dark red with static spots on its edges and thin, white fur, and her pulse was deep and bowstring. Treatment consisted of quickening the blood and transforming stasis, resolving depression and disinhibiting the throat.
For this, Xue Fu Zhu Yu Tang with ad***ions and subtractions was employed: Radix Angelicae Sinensis (Dang Gui), 15g, Flos Carthami Tinctorii (Hong Hua), 10g, Semen Pruni Persicae (Tao Ren), 10g, Fructus Citri Aurantii (Zhi Ke), 10g, Radix Bupleuri (Chai Hu), 10g, Radix Rubrus Paeoniae Lactiflorae (Chi Shao), 15g, uncooked Radix Rehmanniae (Sheng Di), 20g, Radix Platycodi Grandiflori (Jie Geng), 10g, Radix Cyathulae (Chuan Niu Xi), 15g, Radix Glycyrrhizae (Gan Cao), 6g, Caulis Perillae Frutescentis (Su Gen), 10g, Rhizoma Pinelliae Ternatae (Ban Xia), 10g, and Radix Scrophulariae Ningpoensis (Yuan Shen), 15g. These were decocted in water and administered, one ji per day.
After taking six ji, the hyperemia had disappeared and the dry throat, occasional itching, and the feeling as if something were stuck in the throat had diminished. Therefore, Scrophularia was subtracted from the above formula and Cortex Magnoliae Officinalis (Chuan Po), 10g, was added. Administration was stopped after she was given another five ji. At that point, all her symptoms had disappeared and, on follow-up a half year later, there had been no recurrence.
Functionally translated by Bob Flaws. Copyright â Blue Poppy Press, 2000. All rights reserved.

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