Fuling Wuwei Wan, a Pill Formula for Harmonizing the Stomach and Stopping Vomiting
"Fuling Wuwei Wan" (Poria Five-Ingredient Pill) comes from the Waitai Miyao (Arcane Essentials from the Imperial Medical Library), which quotes from the Xu Renzel Fang. The formula consists of: Fuling (Poria) 5 liang (150 g), Renshen (Ginseng) 3 liang (90 g), Maimentong (Ophiopogon) 4 liang (120 g), Shengjiang (Fresh Ginger) 6 liang (180 g), and Qing Zhuru (bamboo shavings) 4 liang (120 g).
Grind the above herbs together into a fine powder, refine with honey into pills the size of a parasol seed (6-9 mm in diameter). Initially take 15 pills; if there is no discomfort, gradually increase to 30 pills each time, taken with a decoction of Lugen (Phragmites rhizome), twice daily.
Fuling Wuwei Wan has the actions of clearing heat and stopping vomiting, and boosting qi and nourishing yin. It mainly treats prolonged rebellious upward vomiting with accumulated heat in the stomach, causing vomiting and inability to eat. During medication, avoid all vinegar-prepared foods.
Judging from the description of this indication, this formula mainly treats chronic reflux esophagitis or reflux gastritis, particularly in patients with a long disease course.
Reflux esophagitis is caused by reflux of gastric acid, while reflux gastritis is caused by reflux of bile; both cause vomiting and are difficult to cure completely.
In this formula, Renshen strengthens the spleen, Fuling drains dampness, Maimentong clears heat, and Shengjiang and Zhuru stop vomiting and counteract rebellious qi; it can indeed relieve the symptoms of vomiting. Using pills rather than a decoction is because these patients have a long disease course and require lengthy treatment, so the principle of treating chronic diseases slowly with pills is followed for gradual regulation. The reason vinegar-prepared foods should be avoided is that vinegar aggravates gastric acid reflux. For patients with reflux esophagitis caused by gastric ulcer or chronic gastritis, this formula may be combined with Wuji San: on the basis of this formula, add 150 g of Wuzeigu (cuttlebone) and 120 g of Baiji (Bletilla) to jointly make pills, with the single-dose amount unchanged.