Gua Di San

Gua Di San (Melon Pedicle Powder), from the Shang Han Lun (Discussion of Cold-Induced Disorders) by Zhang Zhong-Jing.

Actions: Induces vomiting of phlegm or stagnant food.

Presentation: Phlegm or food stagnation in the chest and epigastrium: chest or epigastric distention and hardness, feelings of discomfort, a feeling of qi rising to the throat causing difficulty in breathing, restlessness, and a slightly superficial pulse at the cun position.

Cautions:

• Gua Di is toxic and injures qi and Stomach; contraindicated with Spleen and Stomach deficiency
• Contraindicated without stagnant phlegm in the chest, or when stagnant food has passed to the intestines
• Only for acute excess conditions; extreme caution in children, elderly, postpartum blood deficiency, and dizziness/palpitations from qi and blood deficiency
• Discontinue once effective; no prolonged use
• Do not use to induce vomiting of corrosive substances

Toxicology: Small doses: no significant change in respiration, blood pressure or heart rate. Large doses: irregular respiration, lowered blood pressure and heart rate, eventually respiratory collapse. One fatality 8 h after 30g Gua Di + 15g Chi Xiao Dou on an empty stomach; another fatality from GI bleeding the same day (dose unknown). Overdose: discontinue; persistent vomiting relieved with 0.03-0.06g She Xiang or 0.3-0.6g Ding Xiang.

Source: Chen JK, Chen TT. Chinese Herbal Formulas and Applications: Pharmacological Effects & Clinical Research. Art of Medicine Press, 2009, p. 1311.

Gua Di simmered until yellow. Grind equal amounts of both into fine powder; take 1 spoonful (1-3g) with a warm strained decoction of 6-9g Dan Dou Chi. Increase slightly if no vomiting; gag reflex may be used. Stop once vomiting occurs.