Baisan Jie San for Gastrointestinal Cold in the Debilitated
'Baisan Jie San' is from Taiping Huimin Heji Jufang. The formula consists of: Renshen (Ginseng), Fuling (Poria), Zhi Gancao (honey-fried Glycyrrhiza), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Huoxiang (Agastachis Herba), Houpo (Magnoliae Cortex) and Fabanxia (processed Pinelliae Rhizoma), each 30 g. Preparation: process all the herbs together into a fine powder. Take 6 g each time, with a bowl (about 150 ml) of water, add 3 slices of fresh ginger, 1 jujube and a 10-cm scallion white; decoct together to about 100 ml and strain. Take warm, twice daily.
This formula boosts qi and releases the exterior, harmonizes the middle and resolves dampness. It is indicated for spleen-stomach weakness with contraction of wind-cold, damp obstruction and qi stagnation, cold and fever with spontaneous sweating, aching joints, cough with phlegm, sallow complexion, fatigue and lack of strength, shortness of breath on exertion, discomfort in the chest and diaphragm, nausea and retching, and loss of taste.
This formula is derived by adding Chenpi, Huoxiang, Houpo and Fabanxia to Sijunzi Tang. Sijunzi Tang is Chinese medicine's foremost spleen-boosting and qi-fortifying formula, a classic for spleen-stomach qi deficiency. In it, Renshen and Baizhu fortify the spleen and boost qi; Fuling and Baizhu fortify the spleen and resolve dampness; Zhi Gancao boosts qi and moderates the middle. Hence Sijunzi Tang treats spleen-stomach weakness with shortness of breath and fatigue. Modern use includes chronic gastritis and gastric/duodenal ulcers. In my experience, Sijunzi Tang also works well for anemia, raising white blood cell count and hemoglobin, and treating leukopenia from various causes; the effect is even more pronounced with the addition of raw Huangqi (Astragalus).
Chenpi moves qi and fortifies the spleen, dries dampness and resolves phlegm. Huoxiang resolves dampness and awakens the spleen, wards off foulness and harmonizes the middle, and also dispels summerheat, releases the exterior and reduces fever; it is a key herb for summer gastrointestinal cold. Houpo dries dampness, resolves phlegm, downbears qi and eliminates fullness; it is an important herb for abdominal distension. Fabanxia dries dampness, resolves phlegm, disperses focal distention, dissipates nodules and downbears counterflow to stop vomiting. Banxia and Chenpi are known as the 'two aged' (the older the better), and are the main herbs of Erchen Tang, Chinese medicine's leading phlegm-resolving and counterflow-downbearing formula. Fresh ginger, jujube and scallion white assist the above herbs in fortifying the spleen and promoting sweating to release the exterior.
Thus this formula may be seen as a modified combination of four formulas: Sijunzi Tang, Erchen Tang, Banxia Houpo Tang and Huoxiang Zhengqi San. It combines their effects: fortifying the spleen and boosting qi, eliminating distention and fullness, downbearing counterflow and stopping vomiting, moving qi and harmonizing the middle, and releasing the exterior, resolving dampness, reducing fever and relieving pain. It is commonly used by weak patients who contract summerheat-damp cold.
Today a decoction is usually used instead of the ancient powder. For decoction, adults may use: Renshen 6 g, Fuling 6 g, Zhi Gancao 6 g, Chenpi 6 g, Chao Baizhu (stir-fried Atractylodes) 6 g, Huoxiang 6 g, Houpo 6 g, Fabanxia 6 g, scallion white 10 cm, fresh ginger 3 slices, jujube 1. Decoct in water; one dose daily, morning and evening. If the fever is hard to clear but the formula is working, 2-3 doses may be taken over a day and night, one dose every 2 hours.
This formula also suits late-stage cancer patients who catch a cold after chemotherapy and develop fever, nausea, abdominal distension, dizziness and body pain. If white blood cells are low, add raw Huangqi 30 g; if platelets are too low, adults add Xiankecao (Agrimonia) 100 g, children 30-50 g.