Gua Lou Xie Bai Bai Jiu Tang (瓜蒌薤白白酒汤) — Chest Bi Wine Decoction
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Overview
Gua Lou Xie Bai Bai Jiu Tang — the “Trichosanthes, Chinese Garlic and Wine Decoction” — is from Zhang Zhongjing’s Jin Gui Yao Lue. It is the principal classical formula for Chest Bi (xiong bi) — obstruction of Yang Qi in the chest by Phlegm-Damp, presenting as chest oppression, chest pain (often with radiation to the back), cough[10] with thick phlegm and shortness of breath. The Western correlate is angina pectoris, particularly with prominent Phlegm signs. The classical recipe uses rice wine (Bai Jiu) to amplify the Yang-circulating action; modern usage often omits the wine or uses warm water.
I prescribe Gua Lou Xie Bai Bai Jiu Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.
TCM pattern
Gua Lou Xie Bai Bai Jiu Tang is prescribed for Chest Bi from Phlegm-Damp obstructing Yang:
- Chest oppression, tightness or pain
- Pain may radiate to the upper back
- Shortness of breath
- Cough with thick white phlegm
- Sense of cold or heaviness in the chest
- Symptoms worse with damp weather, eating rich food, lying down
- Tongue — pale or pale-purple, white-greasy coat
- Pulse — deep, wiry, slippery
Key herbs
- Gua Lou (Fr. Trichosanthis, 9–30g) — chief; clears Phlegm-Heat from chest; opens the chest; widens the diaphragm
- Xie Bai (Bb. Allii Macrostemonis, Chinese garlic, 9–15g) — opens Yang in the chest; resolves chest stagnation
- Bai Jiu (white wine, traditional adjunct) — carries the herbs to circulate Yang in the chest (omit in alcohol-intolerant patients)
Formula actions
- Circulates Yang in the chest
- Resolves Phlegm and opens the chest
- Relieves chest oppression and pain
- Stops cough with thick phlegm
Conditions treated
- Stable angina pectoris with Phlegm pattern (alongside conventional cardiology care)
- Coronary heart disease with chest oppression (adjunctive)
- Chronic bronchitis with chest tightness and Phlegm
- Asthma[13] with chest tightness and Phlegm pattern
- Costochondritis with chest tightness and Phlegm signs
- Functional chest pain with Phlegm pattern
Cautions
New, severe or worsening chest pain is a medical emergency — call 999. This formula is for stable, investigated chest pain only, as adjunct to conventional care.
Not appropriate for Yin-deficient chest pain (use Yang-nourishing approach) or pure Blood-stasis chest pain without Phlegm (use Dan Shen Yin or Xue Fu Zhu Yu Tang).
Always consult a qualified Chinese herbalist registered with the RCHM.
Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.
References
[10] Lee B, Kwon CY, Suh HW, Kim YJ, Kim KI, Lee BJ, Lee JH. Herbal medicine for the treatment of chronic cough: a systematic review and meta-analysis. Front Pharmacol. 2023 Oct 17;14:1230604. https://doi.org/10.3389/fphar.2023.1230604. PMID: 37920213.
[13] Shergis JL, Wu L, Zhang AL, Guo X, Lu C, Xue CC. Herbal medicine for adults with asthma: A systematic review. J Asthma. 2016 Aug;53(6):650-9. https://doi.org/10.3109/02770903.2015.1101132. PMID: 27172294.
