Stephania Decoction

The Geumgwe formula for water pressing on the heart — drained, cooled, and supported in four herbs. Kampo tradition reads its "hard fullness below the heart" as a cardiac sign, and uses it accordingly with supervision. **木防己 and 防己 are two drugs, not one.** In the Shanghan and Jingui tradition this formula's 木防己 is Stephania tetrandra, while 防己 — the drug of Banggi-hwanggi-tang and its neighbours — is Sinomenium acutum, which is what 防己 denotes in Korea. Present-day Chinese usage has crossed the two names over, calling Stephania 방기 and Sinomenium 청풍등, and that crossing is where most of the confusion in English-language sources begins. Donguibogam records the distinction itself, and takes a harder line than either tradition: the Tangaek entry on 防己 says that the bluish-white, spongy, soft kind is called 木防己 and is 都不任用, entirely unfit for use. The same chapter notes that a Gangwon vine sold as 木通 is "called 木防己 by some", so the tangle reached three drug names already in 1613. One more turn of it is modern: the plant that Korean and Chinese botany now call 목방기 / 木防己 is Cocculus trilobus, not Stephania. This entry follows the classical reading, because what the Jingui formula asks for is the drug the Shanghan tradition called 木防己; a reader who looks the name up in a present-day plant list will land somewhere else. **Whatever the label says, what must never be supplied is Aristolochia — 광방기 (A. fangchi) or 한중방기 (A. heterophylla). Those carry aristolochic acid and cause end-stage renal failure and urothelial carcinoma; their use is prohibited in Korea. The hazard is substitution, not the medicinal itself.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.