Zao Jia has expectorant functions by increasing mucus secretion from the respiratory membranes.
By Hyunchang Cho, L.Ac., Ph.D ([email protected])
Zao Jia: Symptom Indicator Score+, Frequency of Use+
Main Symptoms: ①Rhinitis with nasal obstruction as its main symptom, or sometimes with a small amount of clear, watery nasal discharge. Gui Zhi Qu Shao Yao Jia Zao Jia Tang is mostly used, and sometimes (rarely) Zao Jia Wan.
TIP: You can consider Zao Jia after ruling out Ma Huang, Xi Xin, Ting Li, and Jie Geng.
- Pharmacological Hypothesis of Zao Jia
Zao Jia appears to treat respiratory discharge (nasal discharge and phlegm), a mixture of clear, watery discharge and thick, yellowish discharge, and secondary symptoms such as nasal congestion and, rarely, coughing.
In classic Materia Medica, Zao Jia is listed as an herb that can dissolve phlegm and penetrate stuffy noses. According to <Pharmaceutical Interpretation of Oriental Medicine>, Zao Jia has expectorant functions by increasing mucus secretion from the respiratory membranes. In clinical practice, Jao Zia works well for rhinitis with nasal congestion as its main symptom, along with nasal discharge that is a mixture of clear, watery and thick, yellowish discharge.
In clinical practice, it is hard to determine whether Zao Jia’s respiratory discharge is clear and watery or yellow and thick. Many times, it would be a mixture of both types. For this reason, it won’t be easy to decide whether we are looking at the clear, watery discharge of Ma Huang, Xi Xin or Ting Li or the thick, yellowish discharge of Jie Geng.
- Clinical Signs of Zao Jia
In Shang Han Lun and Jin Kui Yao Lue, Zao Zia is used in just two formulas: Gui Zhi Qu Shao Yao Jia Zao Zia Tang and Zao Zia Wan. Zao Zia Wan is rarely used. Therefore, we study Zao Zia to understand Gui Zhi Qu Shao Yao Jia Zao Zia Tang.
According to my protocol for respiratory disorders, first, you should look for the presence of nasal discharge. You should determine whether they are clear and watery or yellowish and thick if they are present. Phlegm and nasal discharge of Zao Zia are somewhat in between, a mixture of both types. So, to use Zao Jia, first, you must rule out Ma Huang, Xi Xin, Ting Li, and Jie Geng.
In Zao Zia Pattern:
① Stuffed nose or nasal obstruction is the most common rhinitis symptom.
② Nasal obstruction is always present. It may worsen during the change of seasons but mostly throughout the year. The nose is always stuffed, not just in the mornings and evenings. ☞This is similar to Jie Geng’s symptoms (w/thick and yellowish respiratory discharge).
③ Nasal discharge is mild or absent. So, it is not likely to be the patient’s chief complaint.
④ Nasal discharge is not yellowish nor thick. You can see small droplets of clear, watery discharge in the nasal cavity using a nasal endoscope.
As such, you can consider Zao Zia when respiratory discharge is a mixture of clear and watery and yellowish and thick discharges. Gui Zhi Qu Shao Yao Jia Zao Zia Tang is mostly used. Zao Zia Wan is sometimes (rarely) used for Excess Heat Patterns. Your choice for Gui Zhi Qu Shao Yao Jia Zao Zia Tang would be Pai Nong Tang.