Gua Di San瓜蒂散
Melon Pedicle Powder
Ingredients2 herbs
Indications
Phlegm-drool congesting the chest, or food stagnation lodged in the upper stomach. Classical doctrine holds that an obstruction sitting high, above the diaphragm, is closer to the mouth than to the bowel and was therefore lifted out; the pattern is one of frank excess in a patient with reserves, and the same doctrine excludes anyone depleted.
Clinical Manifestations
- Phlegm congesting the chest with a hard, stuffed sensation (classical use)
- Food stagnating in the upper stomach that neither moves down nor comes up (classical use)
- Qi surging into the throat so that breathing feels blocked (classical use)
- Historical accounts of an ingested poison still in the stomach — modern care is emergency assessment, not emesis
Health Categories
Modern Applications
Common adjustments
- No vomiting after the first dose — the classical instruction is to add only a very small further amount and to stop the moment vomiting comes — the dose is never simply repeated
- Vomiting will not stop — stop the formula at once; ginger juice is the classical measure, and in modern terms protracted vomiting needs medical assessment for dehydration and electrolyte loss
- Any deficiency, recent bleeding, or a frail constitution — the formula is withheld outright — the itself excludes patients who have lost blood or are depleted, and there is no way to soften it
Contraindications
Every constituent and every consequence here has to be stated plainly. Gua Di is toxic: its cucurbitacins irritate the gut violently and, in more than a small dose, damage the liver, the kidneys and the heart; fatal poisonings are on record. Chi Xiao Dou and Dan Dou Chi are food-grade and benign, so the entire risk of the formula sits in Gua Di. The related emetics of this class are worse, not better — Li Lu (used in the appended San Sheng San) is cardiotoxic, Chang Shan is strongly emetic and hepatotoxic, and Dan Fan is copper sulfate, which causes haemolysis and liver and kidney failure. Of these, Li Lu belongs to the classical incompatibilities: it must never be combined with Ren Shen,, Dan Shen, Xuan Shen, Ku Shen, Xi Xin or. Induced vomiting itself carries the risks, not only the drugs: stomach contents can be aspirated into the lungs (aspiration pneumonia, which can be fatal), repeated vomiting strips sodium, potassium and chloride and dehydrates, and forceful retching can tear the lower oesophagus and cause bleeding. The formula is absolutely contraindicated in pregnancy and after childbirth, in the elderly and frail, in children, in anyone with a bleeding tendency, haematemesis, oesophageal varices, peptic ulcer or recent surgery, and in anyone with heart disease, arrhythmia or hypertension. It must never be used after ingestion of a corrosive (acid, alkali, bleach) or a petroleum product, where vomiting compounds the injury, and never in a drowsy, confused or unconscious person, who cannot protect the airway. Suspected poisoning is a medical emergency: call emergency services or a poison centre. Do not induce vomiting.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Absolutely contraindicated in pregnancy and in the postpartum period. Gua Di is toxic, and the violent retching the formula is designed to produce raises intra-abdominal pressure and causes fluid and electrolyte loss — both hazardous to a pregnancy. Also contraindicated while breastfeeding.
Related Formulas
References
Source Shang Han Lun 《伤寒论》 · Eastern Han
「病如桂枝证，头不痛，项不强，寸脉微浮，胸中痞硬，气上冲喉咽不得息者，此为胸有寒也，当吐之，宜瓜蒂散。」
- Classical source (public domain), cited in the source-quote section.
2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
3. 《方剂学》（全国中医药行业高等教育规划教材）— chapter placement, 功用 and pattern analysis cross-checked.
Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.