Fuling Wuwei Wan for Stomach-Heat Vomiting and Counterflow
Fuling Wuwei Wan comes from the Waitai Miyao (citing the Xu Renzhe Fang). Its composition is: Fuling (Poria) 5 liang (150 g), Renshen (Ginseng) 3 liang (90 g), Maimendong (Ophiopogon) 4 liang (120 g, core removed), Shengjiang (Fresh ginger, grated) 6 liang (180 g), Qingzhuru (bamboo shavings) 4 liang (120 g). Preparation: grind the above into a fine powder, refine with honey as excipient into pills the size of a Wutongzi seed.
Start with 15 pills, gradually increasing to 30, taken with an appropriate decoction of Luggen (Phragmites root). This formula clears heat and stops vomiting, boosts qi and nourishes yin. It mainly treats chronic vomiting and counterflow with accumulated heat in the stomach, where vomiting prevents eating. Today it is mainly used for chronic gastritis and reflux esophagitis presenting with nausea and vomiting, belching, acid regurgitation, and poor appetite. It is especially suitable for frail middle-aged and elderly patients.
The Qingzhuru in this formula is the bamboo shavings sold in pharmacies; it clears heat, resolves phlegm, and stops vomiting, and is a key herb for heat-type vomiting. It is often combined with Huangqin (Scutellaria) and Zhizi (Gardenia), but here it is paired with Luggen (Phragmites root) to clear heat. This pairing is more suitable for those with a weak spleen and stomach and poor digestion, because Huangqin and Zhizi are bitter-cold and injure the stomach; although they clear heat and downbear counterflow, they are too bitter-cold. Maimendong is sweet-cold, nourishes yin, and also clears heat; it is a key herb for nourishing stomach yin.
The Renshen in the formula supplements qi and blood, boosts immunity, and strengthens the stomach. Paired with Fuling, it both supplements qi and fortifies the stomach, and strengthens the spleen and transforms dampness. Its nature is mild and it irritates the stomach little. But Renshen is generally suitable only for the frail and diseased; robust people who take it gain nothing and may even develop ginseng-abuse syndrome with dry mouth and irritability. Robust people may replace Renshen with Dangshen (Codonopsis) or Shashen (Adenophora), at the same dosage.
Shengjiang both strengthens the stomach and stops vomiting. In this formula it assists Zhuru in stopping vomiting while aiding digestion. If digestion is poor, add stir-fried Maiya (barley sprout) 90 g, stir-fried Guya (rice sprout) 90 g, and charred Shanzha (Crataegus) 120 g.
No prepared Fuling Wuwei Wan is sold commercially; if needed, the pills may be self-made from this formula, or the formula may be converted to a decoction.
Adult decoction dosage: Fuling (Poria) 10 g, Renshen (or Dangshen) 6 g, Maidong (Ophiopogon) 8 g, Shengjiang (Fresh ginger) 12 g, Zhuru (bamboo shavings) 8 g, Luggen (Phragmites root) 30 g. One dose daily, decocted in water, morning and evening; reduce for children. The formula is mild and may be taken by pregnant women; it can be used for morning sickness.