Nature: acrid, bitter, warm

Enters: Spleen, Lung, Stomach

Actions: Regulates Qi; adjusts the middle Jiao (acrid lifts the spleen Qi, bitter descends the stomach Qi); dries dampness; resolves phlegm; helps the spleen to transport; relieves the diaphragm; directs Qi downward.

Indications:
• Spleen/stomach Qi stagnation: distention in the epigastrium and abdomen, belching, bloating, fullness, nausea, vomiting. Also used for various other forms of nausea and vomiting.
• Accumulation of dampness in the middle Jiao: distention in the chest, epigastrium, and abdomen, stifling sensation in the chest, poor appetite, fatigue, loose stool, thick and sticky tongue coat. An important Qi-level herb of both the spleen and Lung channels, it is especially appropriate for disorders involving both channels.
• Phlegm-damp in the Lungs: cough with copious sputum, difficulty breathing, stifling sensation in the chest.
• Added to tonics to help keep their rich quality from stagnating the Qi.
• Some effectiveness as a transdermal carrier of other substances.
• Mastitis: Chen pi was used with Gan cao in one study to yield good results in 70% of the cases, usually within 2-3 days. The longer the duration of the mastitis, the less effective the treatment.
• Chen pi is aged (cured) to eliminate secondary effects and reinforce its primary actions. Generally, the older the Chen pi, the higher the quality and the more effective.
• Use with caution when there is heat.
• Can be carried to guard against taking on patients’ sicknesses.
• Compared to Qing pi, Chen pi has a more harmonious nature and tends to enter the Qi level of the spleen and Lungs. Its actions are primarily vertical and it is therefore used for both coughing and vomiting. Qing pi, on the other hand, has scattering and unblocking properties that are relatively harsh; it is accordingly prescribed for breaking up Qi stagnation. Its actions are more horizontal and it is therefore used primarily for pain.
DY: Moderately fortifies the spleen; harmonizes the stomach, stops vomiting; rectifies the Qi on the right side of the body; downbears stomach Qi counterflow.
• Three essential therapeutic methods are used to treat phlegm-dampness:
– 1. Transforming and drying existing phlegm or evacuating it through expectoration.
– 2. Moving Qi – if Qi moves with fluidity, phlegm is expelled through expectoration and stagnant dampness, which is the origin of the production of phlegm, is moved and does not accumulate – thus dampness does not congeal into phlegm.
– 3. Supplementing the spleen – to promote the transformation and transportation of water and food, and prevent the accumulation of dampness and the engenderment of phlegm.
– Chen pi possesses all three essential functions for the elimination of phlegm-dampness – it transforms phlegm, moves Qi, and fortifies the spleen.
• Zhang Zi-he of the (12^th century) Southern Song dynasty, said: “Chen pi is upbearing and floating, goes to the Lungs and spleen, influences the upper (body) and frees the flow.”
• Chen pi is often added to formulas which supplement the Qi, blood, or Yin in order to ease the assimilation of rich herbs and to avoid Qi stagnation. It can be systematically added to these types of formulas whenever spleen deficiency is suspected.
• With Ban xia for mutual reinforcement, to fortify the spleen, rectify the Qi, dry dampness, transform phlegm, and stop vomiting. For such indications as:
– 1. Cough due to an accumulation of phlegm-dampness. (Use lime-processed Ban xia.)
– 2. Chest oppression, nausea, and vomiting due to stomach disharmony and phlegm-damp stagnation. (Use ginger-processed Ban xia and stir-fried Chen pi.)
• With He zi to effectively constrain the Lung Qi, rectify the Qi, and increase the voice. For hoarse voice, loss of voice, and chronic cough (deficiency type) with loss of voice and phlegm in the throat. (He zi is contraindicated in cases of phlegm-heat or full patterns.)
• With Qing pi to soothe the liver, regulate the stomach, harmonize the liver and spleen, harmonize the liver and stomach, rectify the Qi, and stop pain. For epigastric and abdominal distention and pain, chest and lateral costal region distention and pain due to disharmony of the liver and spleen, liver and stomach, or a liver depression Qi stagnation. For these indications, uncooked or stir-fried Chen pi and vinegar mix-fried Qing pi should be used. In cases of liver-spleen disharmony, add Bai shao, Chai hu, and Bai zhu. This pair is also sometimes used to treat food accumulation in the stomach, diarrhea with abdominal distention due to liver-spleen disharmony, and premenstrual syndrome due to liver-spleen disharmony.
• With Sang bai pi to clear the Lungs and transform phlegm, rectify the Qi, stop coughing and calm asthma. For cough and asthma due to Lung heat with abundant yellow phlegm.
• With Zhu ru to clear and warm simultaneously, eliminating mixed cold and heat in the stomach. They harmonize the stomach, downbear Qi counterflow, and stop vomiting. The combination can be used in the formula Ju Pi Zhu Ru Tang for indications such as:
– 1. Nausea, vomiting, and epigastric and abdominal distention due to spleen-stomach deficiency mixed with cold and heat. (In actuality, the spleen is deficient and cold or at least benefits from the use of warm ingredients, and the stomach is hot and requires clearing with cold medicinals.)
– 2. Nausea and vomiting during pregnancy.
• Ju pi vs. Chen pi: Ju pi is the recent skin, while Chen pi is the aged skin. Ju pi is very drying and acrid, more draining and irritating to the stomach. Chen pi is moderate and more efficient. Chen pi is preferred for use in clinical practice.
Hsu: Stomachic; expectorant; anti-emetic; regulates the intestines; hemostatic – strengthens capillaries; antibacterial; increases blood pressure; stimulates the heart; inhibits GI and uterine activity; slightly inhibits urinary excretion.
HF: An important herb in anti-Gu therapy to move Qi (xing Qi) and break accumulation (po ji).

Dose: 3-9g

 
Ju Hong: Just the red part of the peel
• Acrid, bitter, warm. Enters the Lung and stomach channels.
• Similar to Chen pi, but more drying and aromatic than Chen pi and less effective at harmonizing the middle and regulating the stomach and spleen.
• Resolves phlegm, dispels wind-cold.
• Primarily used for vomiting, belching, phlegm-damp coughs.
DY: Scatters cold, rectifies the Qi; resolves the exterior; dries dampness, transforms phlegm; disperses food stagnation and distention.
• With Zi wan to effectively dry dampness and transform phlegm without drying the Lungs, rectify the Qi, and stop cough. For indications such as:
– 1. Cough with profuse phlegm and chest oppression due to accumulation of phlegm and Qi stagnating in the Lungs.
– 2. Cough with itchy throat, low grade fever, fear of cold, and profuse phlegm due to wind evils attacking the Lungs.

 
Ju He: The seed
• Liu: Shaped like a testicle: guides to and treats testicular problems.
DY: Moves the Qi; scatters nodulation; stops pain; directed toward the Jueyin channel and the Qi division, directed toward the lower burner, into the kidney channel and treats shan. See Li zhi he in this category for notes on shan.
• With Li zhi he, these two herbs are directed toward the liver channel and especially to the region of the pelvis. They effectively scatter cold and nodulation, and stop pain. For specific indications of this combination, see Li zhi he in this category.

 
Qing Ju Ye: Bluegreen citrus leaf
• Frees liver Qi.