Er Ke Tang - 二壳汤 - Two Shells Decoction

English:	Two Shells Decoction
Also Known As:

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Concha Margaritaferae	Zhen Zhu Mu	20g	Calms the Liver, anchors Yang and drains Liver Fire Clears the Liver.
Concha Haliotidis	Shi Jue Ming	20g	Drains Liver Fire, pacifies the Liver and anchors and sedates Liver Yang.
Fr. Gardeniae	Zhi Zi	9g	Clears Heat, reduces Fire, eliminates irritability and resolves Dampness. With Da Huang, for constipation.
Rx. Trichosanthis	Tian Hua Fen	9g	Clears and drains Lung Heat, Drains Heat, Generates Fluids, Moistens Lung Dryness, Transforms Phlegm.
Rx. Scrophulariae	Xuan Shen	9g	Clears Heat, cools the Blood, nourishes Yin, transforms Phlegm-Heat, drains Fire and relieves toxicity.
Rx. Puerariae	Ge Gen	9g	Discharges Exterior conditions, relieves Heat, generates fluids and alleviates headache, dizziness and tinnitus. With Zhi Zi, for irritability.
Hb Apocyni Veneti	Luo Bu Ma Ye	9g	Calms Liver Yang, clears Liver Fire, extinguishes Wind, clears Heat and facilitates urination.
Arisaema cum Bile	Dan Nan Xing	6g	Calms Wind, Clears Heat, Dissolves Phlegm, Stops convulsions.
Rx. et Rz. Rhei	Da Huang	6g	Drains Heat, purges accumulations and eliminates Phlegm. With Huang Lian, for a feeling of fullness and distention due to Heat Accumulation and distention, Heart palpitations, mental distress with facial congestion and epilepsy due to Excess Heat.
Rz. Coptidis	Huang Lian	3g	Clears Heat, drains Dampness, drains Fire and resolves Fire toxicity.

Formula Actions

• Calms the Liver
• Subdues Yang
• Transforms Phlegm-Heat

Syndromes

• Liver Yang Rising with Phlegm-Fire

Clinical Manifestations

Obesity A red flushed, face Head distention Dizziness Vertigo A throbbing headache Irritability Irascibility

Chest oppression Heart vexation Profuse dreams Thirst Constipation T: Normal C: Slimy and yellow P: Slippery, wiry and rapid

Treats

Cushing's syndrome

Contraindications And Herb/Drug Interactions

Notes

Modifications

For severe obesity:		For head distention, dizziness and vertigo:
+ 12g Rx. Polygoni Multiflori	He Shou Wu	+ 12g Rz. Gastrodiae	Tian Ma
+ 12g Ram. cum Uncis Uncariae	Gou Teng
+ 12g Sm. Cassiae	Jue Ming Zi
For a throbbing headache:		+ 12g Flos Chrysanthemi	Ju Hua
+ 3g Scorpio	Quan Xie
+ 3g Scolopendra	Wu Gong	For irritability or irascibility:
For thirst:		+ 12g Rx. Gentianae	Long Dan Cao
+ More (12g) Rx. Trichosanthis	Tian Hua Fen
+ 12g Rz. Phragmitis	Lu Gen