Qi Ge San - 启膈散 - Open Up The Diaphragm Powder

English:	Open up the Diaphragm Powder
Also Known As:

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Rx. Glehniae/Adenophorae	Sha Shen	9-15g	Clears Heat, Generates fluids, Nourishes Lung and Stomach Yin, Tonifies Liver and Kidney Yin and dispels Phlegm.
Rx. Salviae Miltiorrhizae	Dan Shen	9-10g	Clears Heat, Cools the Blood, Dispels Blood Stasis, Invigorates the Blood, Reduces abscesses.
Poria	Fu Ling	3-12g	Harmonizes the Middle Jiao, Leaches out Dampness, Promotes urination, Strengthens the Spleen.
Bul. Fritillariae Cirrhosae	Chuan Be Mu	4.5-12g	Clears Heat, transforms Phlegm and dissipates nodules.
Rx. Curcumae	Yu Jin	1.5-12g	Invigorates the Blood, dispels Blood Stasis, regulates Qi flow, clears Heat, cools the Blood, speeds healing of chronic sores and alleviates pain. With Dan Shen, for Heat with Blood Stasis causing chest Bi.
Per. Amomi	Sha Ren Ke	1.2-10g	Promotes the movement of Qi, aromatically transforms Dampness, strengthens the Spleen and stops vomiting.
Calyx Nelumbinis	He Ye Di	3g	Dispels Dampness, Harmonizes the Stomach, Raises Yang Qi, Strengthens the Spleen's transportive and transformative functions.
(Fol. Nelumbinis)	(He Ye)	(3g)	(Substitutes for He Ye Di.)
Testa Oryzae	Chu Tou Kang	1.5g	Opens the Stomach, descends Qi and treats occlusion.

Formula Actions

• Regulates Qi flow
• Transforms Phlegm
• Opens Qi Stagnation
• Moistens Dryness

Syndromes

• Dysphagia due to Qi Stagnation

Clinical Manifestations

Difficult to swallow food Swallowing with a choking sensation Swallowing eventually becomes impossible Dull or burning pain Distention with indistinct pain that is relieved by belching, dry retching or spitting up of Phlegm or mucus A feeling of esophageal constriction Dry mouth and throat Focal distention of the chest and diaphragm Difficult bowel movements

Severe weight loss Gradual emaciation Sometimes acute pain Maybe severe coughing Maybe aspiration of fluids Maybe fever Maybe aortic erosion T: Red C: White P: Thready and wiry

Treats

Early stage esophageal cancer Chronic esophagitis Stomach cancer with dysphagia Reflux esophagitis

Esophageal diverticuli Chronic pharyngitis Dysphagia Hiatus hernia

Contraindications And Herb/Drug Interactions

Notes

• Take 5-10g a day orally. Dissolve the powder into 400ml of boiled hot water, drink 200ml in the morning and 200ml in the evening.

Modifications

As a substitute for Testa Oryzae Chu Tou Kang:		For pronounced Stomach Qi Rebellion with belching and dry retching:
Flos Inulae	Xuan Fu Hua
Fr. Setariae Germinatus	Gu Ya	+ Flos Inulae	Xuan Fu Hua
Or		+ Haematitum	Dai Zhe Shi
Fr. Evodiae	Wu Zhu Yu	+ A few drops of Succus Zingiberis Rhizomatis	Jiang Zhi
Fr. Citri Sarcodactylis	Fo Shou
For spitting up Phlegm or mucus:		For Qi Stagnation transforming into Fire:
+ Rz. Pinelliae Preparatum	Zhi Ban Xia	- Per. Amomi	Sha Ren Ke
+ Rz. Coptidis	Huang Lian
+ Per Citri Reticulatae	Chen Pi	+ Fr. Gardeniae	Zhi Zi
For constipation:		+ Rx. Sophorae Tonkinensis	Shan Dou Gen
+ Rx. et Rz. Rhei	Da Huang
+ Sm. Raphani	Lai Fu Zi	For esophageal cancer:
For esophageal cancer with Qi Stagnation leading to Fire:		+ 10g Lignum Santali Albi	Tan Xiang
+ 10g Lignum Santali Albi	Tan Xiang	+ 10g Sm. Impatientis	Ji Xing Zi
+ 15g Fr. Trichosanthis	Gua Lou
+ 10g Sm. Impatientis	Ji Xing Zi	For esophageal cancer:
+ 15g Fr. Trichosanthis	Gua Lou	+ 10g Lignum Santali Albi	Tan Xiang
- Fr. Amomi	Sha Shen
+ Rz. Coptidis	Huang Lian	+ 10g Sm. Impatientis	Ji Xing Zi
+ Sm Oroxyli	Mu Hu Die	+ 15g Fr. Trichosanthis	Gua Lou
+ Rx. Paeoniae Rubra	Chi Shao	+ Rx. Scrophulariae	Xuan Shen
For esophageal cancer with marked Phlegm Obstruction:		+ Rx. et Rz. Rhei	Da Huang
+ Sm. Raphani	Lai Fu Zi
+ 10g Lignum Santali Albi	Tan Xiang	For dysphagia:
+ 12-15g Sm. Impatientis	Ji Xing Zi
+ 10g Sm. Impatientis	Ji Xing Zi
+ 15g Fr. Trichosanthis	Gua Lou	+ 12-15g Flos Inulae	Xuan Fu Hua
+ Rz. Pinelliae Preparatum	Zhi Ban Xia	+ 18-30g Haematitum	Dai Zhe Shi
+ 9-12g Caulis Bambusae in Taeniam	Zhu Ru
+ Per. Citri Reticulatae	Chen Pi
+ Flos Inulae	Xuan Fu Hua	+ 9-12g Fr. Akebiae	Ba Yue Zha
For dysphagia with signs of Dryness:		+ 12-18g Rx. Clematidis	Wei Ling Xian
- Poria	Fu Ling	For dysphagia with fullness and discomfort in the chest:
+ 12-15g Sm. Impatientis	Ji Xing Zi
+ 12-15g Sm. Impatientis	Ji Xing Zi
+ 12-15g Flos Inulae	Xuan Fu Hua
+ 18-30g Haematitum	Dai Zhe Shi	+ 12-15g Flos Inulae	Xuan Fu Hua
+ 9-12g Caulis Bambusae in Taeniam	Zhu Ru	+ 18-30g Haematitum	Dai Zhe Shi
+ 9-12g Caulis Bambusae in Taeniam	Zhu Ru
+ 9-12g Fr. Akebiae	Ba Yue Zha
+ 12-18g Rx. Clematidis	Wei Ling Xian	+ 9-12g Fr. Akebiae	Ba Yue Zha
+ 9-12g Rx. Ophiopogonis	Mai Men Dong	+ 12-18g Rx. Clematidis	Wei Ling Xian
+ 18-24g Rx. Scrophulariae	Xuan Shen	+ 18-24 Fr. Trichosanthis	Gua Lou
+ 9-12g Rx. Trichosanthis	Tian Hua Fen	+ 9-12g Per. Citri Reticulatae	Chen Pi
+ 1 spoonful Mel	Feng Mi	For dysphagia with Phlegm nodule encroaching on the esophagus:
For dysphagia with Blood Stagnation:
+ 12-15g Sm. Impatientis	Ji Xing Zi	+ 12-15g Sm. Impatientis	Ji Xing Zi
+ 12-15g Flos Inulae	Xuan Fu Hua	+ 12-15g Flos Inulae	Xuan Fu Hua
+ 18-30g Haematitum	Dai Zhe Shi	+ 18-30g Haematitum	Dai Zhe Shi
+ 9-12g Caulis Bambusae in Taeniam	Zhu Ru	+ 9-12g Caulis Bambusae in Taeniam	Zhu Ru
+ 9-12g Fr. Akebiae	Ba Yue Zha	+ 9-12g Fr. Akebiae	Ba Yue Zha
+ 12-18g Rx. Clematidis	Wei Ling Xian	+ 12-18g Rx. Clematidis	Wei Ling Xian
+ 9-12g Sm. Persicae	Tao Ren	+ 18-24g Rx. Scrophulariae	Xuan Shen
+ 9-12g Flos Carthami	Hong Hua
+ 6-9g Rz. Chuanxiong	Chuan Xiong	+ 24-30g Concha Ostreae	Mu Li
For dysphagia with frequent belching:
+ 12-15g Sm. Impatientis	Ji Xing Zi	+ 9-12g Rz. Dioscoreae Bulbiferae	Huang Yao Zi
+ 12-15g Flos Inulae	Xuan Fu Hua	+ 9-12g Bul. Fritillariae Thunbergii	Zhe Bei Mu
+ 18-30g Haematitum	Dai Zhe Shi
+ 9-12g Caulis Bambusae in Taeniam	Zhu Ru	For acid reflux and hiatus hernia:
- Bul. Fritillariae Cirrhosae	Chuan Bei Mu
+ 9-12g Fr. Akebiae	Ba Yue Zha
+ 12-18g Rx. Clematidis	Wei Ling Xian	- Calyx Nelumbinis	He Ye Di
+ 9-12g Per. Citri Reticulatae	Chen Pi	- Testa Oryzae	Chu Tou Kang
+ 15g Fr. Trichosanthis	Gua Lou
+ 3-6g Lignum Aquilariae	Tan Xiang	+ 15g Flos Inulae	Xuan Fu Hua
+ 12g Rz. Pinelliae Preparatum	Zhi Ban Xia
+ 9g Rz. Perillae	Zi Su Geng
+ 6g Rx Glycyrrhizae Preparata	Zhi Gan Cao