Gua Lou (Snakegourd Fruit)
瓜蒌: clear heat and resolve phlegm, moisten and resolve dry-phlegm, open chest and dissipate accumulation, moisten intestine and relax bowel.

Name
Gua Lou (Fructus Trichosanthis), recorded in the Shennong Bencao Jing.
Source and quality
Plant
The dried ripe fruit of the perennial herbaceous vine Trichosanthes kirilowii Maxim. or T. rosthornii Harms, family Cucurbitaceae.
Where it is grown
Hebei, Henan and Anhui provinces.
Harvest
Collected in autumn once the fruit has ripened.
Smell and taste
Smell of burnt sugar; lightly sour and sweet.
Better grade
Intact and unbroken, with a thick pericarp, wrinkled and fibrous, heavy and full of sugar.
Processing
Used unprocessed, or with the kernel made into frost.
Nature and action
Sweet, slightly bitter and cold; enters the lung, stomach and large intestine channels. Clears heat and resolves phlegm, moistens and resolves dry-phlegm, opens the chest and dissipates accumulation, and moistens the intestines and relaxes the bowels.
When it is used
Cough and wheezing from heat-phlegm, cough from dry-phlegm
Gua Lou is sweet, cold and moistening. It is good at clearing lung heat and moistening dryness of the lung to resolve both heat-phlegm and dry-phlegm.
For productive cough and wheezing from lung heat it is used alone in Run Fei San from Xuan Ming Lun Fang to clear the lung and resolve phlegm. Where phlegm is copious, with cough, wheezing, yellow sputum that is hard to bring up, and stuffiness and fullness of the chest, it is combined with herbs that clear heat-phlegm and resolve phlegm, as with Dan Nan Xing, Huang Qin and Zhi Shi in Qing Qi Hua Tan Wan from Yi Fang Kao. For dry-heat damaging the lung, with a dry cough or scanty, sticky sputum that is difficult to raise, it is combined with herbs that clear the lung and moisten dryness, together with phlegm-resolving antitussives, such as Tian Hua Fen and Chuan Bei Mu as recorded in Yi Xue Xin Wu.
Chest impediment and thoracic accumulation
It resolves phlegm and promotes the flow of qi, which eases the chest and dissipates nodules. It is therefore mostly indicated for fullness, oppression and distending pain in the chest caused by phlegm obstructing the movement of qi.
For angina with wheezing that prevents lying down, it is combined with herbs that invigorate yang and dissipate accumulation, along with herbs that move qi and resolve phlegm, as with Xie Bai and Ban Xia in Gua Lou Xie Bai Ban Xia Tang from Jingui Yaolue. For phlegm-heat accumulation in the chest, with stuffiness, fullness and tenderness, it is combined with herbs that clear heat, resolve phlegm and dry dampness, as with Huang Lian and Ban Xia in Xiao Xian Xiong Tang from Shanghan Lun.
Lung abscess, intestinal abscess and acute mastitis
It clears heat, dissipates accumulation and resolves swelling. For abscesses and swelling from heat-toxin it is often combined with herbs that clear heat and relieve toxicity, or herbs that move the blood and resolve stasis: with Yu Xing Cao, Lu Gen and Bai Jiang Cao for coughing up pus and blood; with Bai Jiang Cao and Hong Teng for abdominal pain from intestinal abscess. In the early stage of acute mastitis, with a red, swollen, hot, painful breast, it is combined with Dang Gui, Ru Xiang and Mo Yao in Shen Xiao Gua Lou San from Fu Ren Da Quan Liang Fang.
Constipation from intestinal dryness
Gua Lou Ren is moistening, and by moistening dryness with laxation it relaxes the bowels, so it is used for constipation from intestinal dryness. It is often combined with herbs that moisten the intestines and relax the bowels, such as Huo Ma Ren, Yu Li Ren and Jue Ming Zi.
Dose
Decoction 10~20g of whole Gua Lou; Gua Lou Pi 6~12 g; Gua Lou Ren 10~15 g, smashed.
Cautions
Prohibited for loose stool from spleen deficiency, because of its sweet, cold and slick nature. Contraindicated with Wu Tou.
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