Bulaowan (Ageless Pill): Warming the Spleen to Stop Diarrhea and Prolong Life
Bulaowan (Ageless Pill) comes from volume 5 of the Wei Shi Jia Cang Fang (Wei Family’s Secret Prescriptions). This book was compiled by the Song-dynasty physician Wei Xian, who gathered medical prescriptions from three generations—his grandfather, his father, and himself—and it contains many proven, effective formulas.Bulaowan is composed of: Chuan Houpo (Cortex Magnoliae Officinalis; peeled, processed with ginger, dry-fried), 1.5 liang (45 g); Chuan Baijiang (Zingiberis Rhizoma; baked in moist paper), 1.5 liang (45 g); Roudoukou (Semen Myristicae; baked wrapped in dough), 1.5 liang (45 g); Baizhu (Atractylodis Macrocephalae Rhizoma; dry-fried), 1.5 liang (45 g); Fuzi (Aconiti Radix Lateralis; peel and rootlet removed, cut into small pieces, soaked in ginger juice overnight, dry-fried), 1 liang (30 g); Rougui (Cinnamomi Cortex; coarse bark removed), 1 liang (30 g); Dingxiang (Caryophylli Flos), 1 liang (30 g); Bibo (Piperis Longi Fructus), 7.5 qian (22.5 g).Preparation: grind all the above herbs into a fine powder, then make a paste by cooking with Shenqu (Massa Medicata Fermentata) and ginger juice, and form into pills the size of a parasol-tree seed. This formula strengthens the spleen and stomach, resolves phlegm-rheum, and improves appetite and digestion. It is indicated for chronic diarrhea or loose, unformed stools due to deficiency-cold of the viscera. The dosage is 50 pills twice daily, taken with rice water (now plain boiled water may also be used), at any time of day (that is, it need not be taken before or after meals, nor at any fixed hour).Chuan Baijiang in this formula is simply dried ginger (Ganjiang). Every herb in the formula is acrid and warm in nature, so the composition follows the strategy of using acrid-hot herbs to warm the middle jiao. It is therefore only for patients with deficiency-cold-type chronic diarrhea and must not be used in those with damp-heat syndromes. Patients suited to this formula commonly present with clear, copious urine; indigestion; passage of undigested food; acid regurgitation and heartburn; dull, lingering epigastric and abdominal pain; stools without foul odor; and a cold body with cold limbs. In TCM terms, such patients have deficiency-cold of the viscera and absence of fire in the middle jiao, so they cannot transform and digest water and grain, producing a whole series of digestion-related symptoms.This formula works immediately on chronic deficiency-cold diarrhea, but its side effects are equally immediate on damp-heat-type chronic diarrhea. After taking it, damp-heat patients will not only fail to improve but may worsen, developing mouth ulcers, stomach pain, gastric distension, and even adverse reactions such as gastric hemorrhage. Therefore, when using this formula for chronic gastrointestinal disease, one must carefully distinguish the syndrome and prescribe with caution.The original text prescribes 50 pills per dose, a dosage that is suspect for being too large. Patients should start with 5 pills per dose; if there is some improvement but the effect is insufficient, and no side effects such as mouth ulcers appear, they may increase by 5 pills per dose as appropriate, gradually raising the dose until it works. There is no need to take 50 pills each time, and one should certainly not jump directly to 50. Although this formula contains no violently toxic herbs, most of its ingredients are strongly acrid and hot and can easily provoke systemic adverse reactions.If this formula is applied strictly in the spirit of TCM pattern differentiation to patients who fully match its indications, the clinical result is very satisfactory. The reason it is named Ageless Pill is that it can substantially improve such patients’ constitution, increase appetite, improve digestive function, and slow aging.While taking this formula, if skin allergy, mouth ulcers, or worsening gastrointestinal discomfort appears, it should be stopped immediately and not used again. Under no circumstances should such side effects be mistaken for a detoxification reaction. In addition, patients with gastric ulcer or gastric hemorrhage should use this formula cautiously, or only under a doctor’s guidance.