Understanding Its Therapeutic Actions, Clinical Features,
and Differential Diagnosis
By Jubong Kang, KMD.
Actions and Diagnosis
Jinshui-Liujun-Jian treats Yin-deficiency with phlegm-retention, which is caused by overflowing water-qi due to deficiency of the lungs and kidneys. By combining Yin-nourishing herbs with herbs that promote diuresis and resolve phlegm, it improves cough, asthma, dizziness, and related symptoms.
In prescription theory, Yin-tonifying herbs may produce dampness-phlegm, while diuretic and phlegm-resolving herbs may consume yin-fluid. Therefore, Shudihuang and Danggui replenish Yin and blood, while Banxia and Fuling eliminate both pre-existing dampness-phlegm and dampness that may arise during tonification.
This prescription combines Shudihuang and Danggui from Siwu-Tang with Erchen-Tang. Erchen-Tang dries dampness and resolves phlegm, while Danggui and Shudihuang nourish Yin-blood of the lungs and kidneys. Thus, the combined use of Shudihuang and Banxia in clinical modification reflects the core meaning of Jinshui-Liujun-Jian.
Among the constituent herbs, Shudihuang and Banxia are monarch drugs.
Shudihuang is used at the largest dose, usually two to three times that of the other herbs. It nourishes Yin-fluid and replenishes blood, improving weakness of the lower back and knees, nocturnal emission, metrorrhagia, diabetes, blurred vision, deafness, dry cough, cough with thick sputum, shortness of breath, dyspnea, and consumptive diseases. Banxia dries dampness and eliminates phlegm. It relieves cough and asthma caused by phlegm, headache due to adverse rising of phlegm, chest distention, dizziness, insomnia, borborygmus, whitish and turbid urine, nocturnal emission, and leukorrhea.
Fuling and Danggui are minister drugs.
Fuling promotes diuresis and resolves dampness. It improves cough caused by phlegm-retention, edema, abdominal distention, diarrhea, nocturnal emission, stranguria with turbid urine, and fright-induced palpitation. It assists Shudihuang by preventing dampness-phlegm stagnation during Yin-blood tonification, and helps Banxia resolve phlegm and eliminate dampness.
Danggui supplements blood and assists Shudihuang in nourishing Yin and blood. It also promotes blood circulation, preventing blood stasis that may occur with the heavy nature of Shudihuang.
Shengjiang and Gancao are adjuvant drugs.
Shengjiang invigorates the stomach, improves appetite and digestion, stops vomiting, and reduces the toxicity of Banxia. Gancao benefits qi and harmonizes the actions of the other herbs through its sweet taste, serving both as an adjuvant and guiding drug.
In diagnosis, because Shudihuang treats Yin-deficiency, patients often present with abdominal weakness or subsidence below the navel, and the tongue surface may be fissured. Due to Banxia and Fuling, fluid retention or borborygmus may be found in the stomach and intestines. If there is abundant whitish tongue fur, the dose of Banxia may be increased. If the tongue is pale, the dose of Shudihuang may be increased. If the tongue is slightly dark or red due to Yin-deficiency heat, Shengdihuang may be added.
Contents in the Source Text
If the lung and kidney become deficiency-cold, water-qi may overflow and form phlegm-retention. In elderly patients, this may develop into Yin-deficiency with qi and blood deficiency. If wind-cold invasion causes cough, vomiting, asthma with profuse phlegm, or an urgent condition, this prescription has excellent effects. (“Jing Yue Quan Shu”)
Application
Chronic rhinitis, cough, dyspnea; chronic esophagitis with anemia; dizziness due to phlegm-retention or blood-deficiency, etc.
Distinction
- Suzi-Jiangqi-Tang and Jinshui-Liujun-Jian both treat deficiency-pattern cough. However, Jinshui-Liujun-Jian is used for cough due to Yin-deficiency with phlegm-retention, while Suzi-Jiangqi-Tang treats cough caused by phlegm-retention in the stomach and epigastrium obstructing qi movement. The former heavily uses Banxia and Shudihuang and is suited for patients with good digestion, whereas the latter uses Banxia, Suzi, and Danggui and is better for patients with moderate or weak digestion.
