Banxia Houpo Tang — A Closer Look at a Classic Formula

Banxia Houpo Tang (Pinellia and Magnolia Bark Decoction) originates from the Essential Prescriptions from the Golden Cabinet (Jingui Yaolüe), in the chapter on women’s miscellaneous disorders. The original text reads:

“When a woman feels as though there is a slice of roasted meat stuck in her throat, Banxia Houpo Tang governs.”

Composition: Banxia (Pinellia) 1 sheng, Houpo (Magnolia Bark) 3 liang, Fuling (Poria) 4 liang, Shengjiang (Fresh Ginger) 5 liang, Suye (Perilla Leaf) 2 liang. Boil in 7 sheng of water to obtain 4 sheng, and divide into four warm doses — three during the day and one at night.

You Zaijing explained: “This is congealed phlegm and bound qi obstructing the gate of the throat. The Thousand Golden Prescriptions describes it as something adhering in the throat, like a piece of roasted meat that can neither be swallowed nor spat out. Banxia, Houpo, and Shengjiang — pungent to disperse accumulations, bitter to direct rebellious qi downward. Fuling assists Banxia in draining phlegm-qi. Zisu is aromatic and enters the Lung to diffuse the qi.”

Cao Yingfu’s understanding is even more significant: “Damp-phlegm stagnation causes the qi mechanism in the throat to become impeded, as though something is stuck — unable to be spat out, unable to be swallowed. In the absence of adequate words, Master Zhong described it as ‘like a slice of roasted meat,’ which is what people commonly call plum-pit qi (meihe qi). The formula uses Jiang and Xia to eliminate phlegm, Houpo to broaden the chest and diaphragm, Suye to open the Lung, and Fuling to drain dampness — the goal being to ensure that the upper diaphragm is spacious and that damp-turbidity descends, so that the throat’s intake and output become unobstructed.”

Why is Cao Yingfu’s insight more important? Because plum-pit qi is exceedingly common in clinical practice, and Banxia Houpo Tang is frequently prescribed — yet many colleagues report inconsistent results. The reason lies right here.

Looking at the formula as a whole, Shengjiang (Fresh Ginger) ranks first — yet it is often overlooked. The principal therapeutic effect of Banxia Houpo Tang for plum-pit qi derives from the pungent, scattering power of Fresh Ginger. If the dosage is insufficient, or if dried ginger is substituted, the efficacy is often unreliable.

In earlier years, I sometimes omitted Fresh Ginger entirely — and it still worked sometimes. This is not surprising, because Banxia alone benefits the throat, and using it by itself can sometimes produce decent results.

It is worth noting that the Thousand Golden Prescriptions states that this formula treats “chest fullness, hardness below the heart, something adhering in the throat like roasted meat — unable to be spat out, unable to be swallowed.” The additional symptoms of “chest fullness” and “hardness below the heart” supplement the Jingui text. In clinical practice, many patients who complain of a sense of stifled breath in the chest with no detectable abnormalities on examination are well-suited to this formula.

Overall, this formula is indicated for excess patterns. It should not be used when the condition leans toward deficiency. Throat discomfort in deficient patients is mostly related to the Lung, Kidney, or Liver. Even when there is phlegm-fluid accumulation, the treatment method must be carefully weighed — otherwise, one risks stirring up the “dragon-thunder fire” (hyperactive minister fire).

半夏厚朴汤出自《金匮要略·妇人杂病脉证并治》，原文记载为：

妇人咽中如有炙脔，半夏厚朴汤主之。

半夏一升　厚朴三两　茯苓四两　生姜五两　苏叶二两

以水七升，煮取四升，分温四服，日三夜一服。

尤在泾认为：”此凝痰结气，阻塞咽嗌之门。《千金》所谓咽中帖帖如有炙肉，吞不下，吐不出者是也。半夏、厚朴、生姜，辛以散结，苦以降逆。茯苓佐半夏利痰气。紫苏芳香，入肺以宣其气也”。

曹颖甫的认识则更为重要：”湿痰阻滞，咽中气机不利，如有物梗塞，吐之不出，咽之不下，仲师于无可形容之中，名之曰如有炙脔，即俗所称梅核气也。方用姜，夏以去痰，厚朴以宽胸膈，苏叶以开肺，茯苓以泄湿，务令上膈气宽，湿浊下降，则咽中出纳无阻矣”。

为什么说曹颖甫的认识更重要呢，因为临床上梅核气是很常见的，非常常见，半夏厚朴汤也是很常用，但很多同道都反应这个方子的效果是时好时坏，原因就在这里。

纵观全方，生姜是第一位的，而往往是被忽略的，半夏厚朴汤治疗梅核气的主要功效来源是生姜的辛散之力，如果用量不够，或者用干姜代替，疗效往往不能保证。

我在前几年的时候甚至不放生姜，有时也是有用的，这也不奇怪，因为仅仅半夏这个药就对咽喉是有好处的，单用半夏有时候效果也不错。

值得注意的是，《千金方》说本方主治”胸满，心下坚，咽中怗怗，如有炙肉，吐之不出，吞之不下”，提出了”胸满，心下坚”的症状，是对金匮进行了补充，临床上遇到很多所谓胸中倒腾不上气，又检查不出什么问题的病人，都适合用这个方子。

这张方总体来说适用于实证，如果偏虚则不宜使用，虚人的咽中不适大多与肺肝肾有关，就算有痰水郁结，治疗方法也应适当权衡，否则易动龙雷之火。