Fenxiao Tang for Tympanites / Ascites (Zhang) from Wanbing Huichun

In the Ming dynasty physician Gong Tingxian's work Wanbing Huichun (Restoring Health to Ten Thousand Diseases) there is a formula called "Fenxiao Tang." Its composition is: Cangzhu (Atractylodes, soaked in rice-water and stir-fried), Baizhu (White Atractylodes, awn removed), Chenpi (Tangerine Peel), Fuling (Poria), Houpo (Magnolia Bark, stir-fried in ginger juice), and Zhishi (Immature Bitter Orange, bran-fried), each 1 qian (3 g), Sharen (Amomum) 7 fen (2.1 g), Muxiang (Aucklandia) 3 fen (0.9 g), and Xiangfu (Cyperus), Zhuling (Polyporus), Zexie (Alisma), and Dafupi (Areca Peel), each 8 fen (2.4 g). Make the above into one dose, add one slice of Shengjiang (Fresh Ginger) and one pinch of Dengxincao (Rush Pith), decoct in water, strain, and take warm.

This formula fortifies the spleen and moves qi, transforms dampness and promotes urination. It treats spleen deficiency with qi stagnation and internal retention of water-dampness causing tympanites (zhang) or generalized edema. Such diseases correspond to ascites in modern medicine, most often caused by cirrhosis or cancer.

In this formula, Cangzhu and Baizhu fortify the spleen; Muxiang, Houpo, Xiangfu, Zhishi, Chenpi, and Sharen regulate qi and move stagnation; Fuling, Zhuling, Zexie, Dafupi, and Dengxincao promote urination; and the ginger slice warms the middle, downbears counterflow, and also aids diuresis. Combined, these herbs jointly fortify the spleen, move qi, transform dampness, and promote urination. This formula has a certain relieving effect on early ascites, but where ascites has persisted for a long time or where diuretics (Chinese or Western) have already been used frequently, its effect will not be marked.