Ling Gan Wu Wei Jiang Xin Tang (苓甘五味姜辛汤) — Cold-Phlegm Decoction
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Overview
Ling Gan Wu Wei Jiang Xin Tang — the “Poria, Licorice, Schisandra, Ginger and Asarum Decoction” — is from Zhang Zhongjing’s Jin Gui Yao Lue. It is a five-herb formula treating Cold-Phlegm-Rheum lodged in the Lung, particularly chronic recurrent productive cough[10] with copious clear watery phlegm in a patient with cold-deficient pattern. Gan Jiang and Xi Xin powerfully warm and disperse Cold-Phlegm from the Lung; Wu Wei Zi astringes the Lung against the dispersing action; Fu Ling drains Damp at the root; Gan Cao harmonises.
I prescribe Ling Gan Wu Wei Jiang Xin Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.
TCM pattern
Ling Gan Wu Wei Jiang Xin Tang is prescribed for Cold-Phlegm-Rheum in the Lung:
- Chronic productive cough with copious clear watery white phlegm
- Worse with cold and in winter
- Possibly wheezing or chest tightness
- Cold extremities
- Pale complexion
- Tongue — pale, swollen, white moist coat
- Pulse — slippery, possibly slow
Key herbs
- Fu Ling (Poria, 12g) — drains Damp; addresses the root of Phlegm production
- Gan Jiang (Rz. Zingiberis, 9g) — warms the Lung; transforms Cold-Phlegm
- Xi Xin (Hb. Asari, 3-9g) — warms the Lung; disperses Cold-Phlegm; opens the orifices
- Wu Wei Zi (Fr. Schisandrae, 3-12g) — astringes Lung Qi; balances the warming dispersing herbs
- Zhi Gan Cao — harmonises and tonifies
Formula actions
- Warms the Lung
- Transforms Cold-Phlegm-Rheum
- Stops chronic cough with thin watery phlegm
Conditions treated
- Chronic bronchitis with Cold-Phlegm pattern
- COPD with copious clear sputum
- Bronchiectasis with cold-pattern thin phlegm
- Cold-pattern asthma[13] with clear watery phlegm
- Chronic cough after viral illness with persistent clear phlegm
- Allergic cough triggered by cold air
- Chronic post-nasal drip with cold pattern
Cautions
Contains Xi Xin — use only at classical low dose; absolutely contraindicated in renal impairment due to aristolochic acid risk; use only pharmaceutical-grade root (asari radix not asari herba).
Not appropriate for Lung Heat (yellow phlegm, fever, thirst), Yin-deficient dry cough, or Phlegm-Heat patterns — the warming herbs aggravate Heat and damage Yin.
Chronic cough with weight loss, haemoptysis or progressive dyspnoea requires medical investigation to exclude TB, malignancy or other serious pathology.
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.
