Transform Accumulation in the Channels is indicated when Phlegm accumulation and internal Heat are present, manifesting as fixed, hardened Phlegm. It is the result of a mixed pattern of Phlegm, Heat and Blood stagnation. Although this pattern can develop over a period of time, a sudden manifestation of this pattern is also possible, typically following an exterior Wind invasion. As Spleen Qi insufficiency lingers, Dampness is generated, leading to Phlegm that begins to accumulate and eventually hardens in the channels. As the Spleen weakens, the Liver will begin to stagnate, becoming rigid and unable to bend. Since the Liver is responsible for the smooth flow of Qi throughout the body, a stagnation of the Liver further contributes to obstruction in the channels. Heat is generated from the constraint of Phlegm that is accumulating in the channels, and from stagnant Liver Qi that is unable to flow smoothly. As a consequence of the Liver Qi stagnation, the Blood will also stagnate. These hardened, fixed Phlegm accumulations are typically located in the region of the head or neck, due to Heat tending to rise upward in the body. They can, however, manifest anywhere in the channels. Transform Accumulation in the Channels softens accumulations, transforms Phlegm, moves Liver Qi, clears Heat, and invigorates Blood. This formula uses mainly purging and moving herbs to unblock stagnation and accumulation, and to address the excess nature of this pattern. A few tonifying herbs are included to support the actions of the purging and moving herbs, and to protect Yin and Blood from their harsh draining properties. The chief herb, Prunella fruit spike, clears stagnation and Heat from the Liver, redirecting the Liver Yang downward and transforming accumulation. Zhejiang fritillary bulb clears Fire, transforms Phlegm and disperses clumps. Together these herbs‘ ability to disperse and transform Phlegm is much stronger than it is for either herb alone. Scrophularia root clears Heat, nourishes the Yin, cools the Blood, redirects Phlegm Fire downward, softens hardness and dissipates accumulations. Platycodon root releases the Exterior, opens up and disseminates Lung Qi, and dispels Phlegm. Sargassum herb transforms Phlegm, clears Damp Heat and supports healthy urination. Chinese rhubarb rhizome purges Heat and Fire, cools the Blood, disperses Blood stasis, purges accumulations and supports healthy urination. It also invigorates the Blood, and in combination with Dong quai root it dispels stagnation. The latter also tonifies Liver and Heart Blood and supports the overall goal of the formula by addressing Blood deficiency accompanied with Wind Damp obstruction and accumulations. Prepared Rehmannia root protects the Yin and Blood from the strong purging and Heat clearing effects of the formula. It tonifies the Blood, enriches Yin, especially of the Liver and Kidney, and generates Essence. Chinese licorice root and rhizome harmonizes the functions of the other herbs in the formula. Trichosanthes root clears Heat, reduces accumulation and invigorates the Blood. Isatis leaf strongly cools blazing Heat in both the Qi and Blood levels. Forsythia fruit cools and vents Heat and disperses clumps. Japanese ampelopsis root clears Heat and disperses clumped Qi. Dry fried Bitter orange mature fruit regulates the Qi in the chest and abdomen. Chinese mint herb releases Wind Heat. This formula can be combined with other formulas, depending on the location of the Phlegm. Combine with Minor Bupleurum, Free and Easy Wanderer or Bupleurum Soothing Liver Formula for Qi and Phlegm stagnation between or lodged in the Middle and Upper Burner. Combine with Quell Fire for Phlegm, Heat or Blood stagnation in the neck. If Spleen tonification is needed, combine with Four Gentlemen. With underlying Yin deficiency, combine with Rehmannia Six or Temper Fire. With underlying Blood deficiency, especially for menstrual disharmony, combine with Four Substances or for Blood deficiency and strong Blood stagnation, combine with Augmented Four Substances. For Phlegm, Heat or Blood stagnation in the prostate gland, combine with Prostate Support. ORIGINS AND DEVELOPMENTTransform Accumulation in the Channels is a modern formulation.
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