Guxia Wan: Pills for Treating Protracted Diarrhea due to Kidney Deficiency

"Guxia Wan" comes from the Ming-dynasty physician Sun Yikui's Chishui Xuanzhu (Cinnabar Pearls of the Red Water). Its composition is: Atractylis (Cangzhu), nutmeg (Roudoukou, simmered), and psoralea (Buguzhi, stir-fried), equal parts. Grind the herbs together to powder and, using congee as the excipient, form into pills the size of a phoenix-tree seed. Take 50 pills each time with warm boiled water, twice daily.

This formula supplements the kidney and assists yang, dries dampness and stops diarrhea. It is indicated for protracted diarrhea due to kidney deficiency. This condition closely resembles the clinical symptoms of chronic colitis in modern medicine: the patient has intractable diarrhea that drags on and is hard to cure. According to traditional TCM theory, Cangzhu dries dampness and fortifies the spleen, Roudoukou warms the spleen and stops diarrhea, and Buguzhi tonifies the kidney and stops diarrhea; used together, the three address both root and branch. From the perspective of modern pharmacology, Cangzhu has broad-spectrum antibacterial and anti-inflammatory action and can root out diarrhea caused by a variety of pathogens, while Roudoukou and Buguzhi also have antidiarrheal action; thus the three together indeed stop diarrhea.

The composition of this formula is quite similar to Sishen Wan (Four-Spirit Pills), which consists of nutmeg, psoralea, schisandra, and evodia and also warms the kidney and stops diarrhea. Sishen Wan is sold as a ready-made patent medicine; patients with the corresponding symptoms may first try Sishen Wan, and if it fails, switch to this formula. This formula may also be given as a decoction instead of pills; the adult daily decoction dose is: Cangzhu 10 g, Roudoukou 10 g, Buguzhi 10 g, reduced for children.