Li Dongyuan’s “Hezhong Pills” for Stomach Cold and Poor Appetite, from Treatise on the Spleen and Stomach
Li Dongyuan, one of the four great masters of the Jin-Yuan period, is known for famous formulas such as Buzhong Yiqi Decoction and Guipi Decoction, which many people know and use. But a formula like “Hezhong Pills” is not so widely circulated. In fact, this small formula he created is also an excellent remedy for stomach disorders.
Hezhong Pills are composed of ginseng (Renshen), dried ginger (Ganjiang), and tangerine red (Juhong), each 1 qian (3 g), dried papaya (Gan Mugua) 2 qian (6 g), and honey-fried licorice (Zhigancao) 3 qian (9 g). The method recorded in Treatise on the Spleen and Stomach (Piweilun) is to grind all the herbs finely and, with soup-soaked steamed cake, form pills the size of a parasol seed. Take 50 pills each time, washed down with plain water before meals. This preparation is rather elaborate, but it has its benefit: the herbs are milder and less irritating to the stomach.
Li Dongyuan’s Hezhong Pills tonify the spleen and warm the stomach, move qi and disperse stagnation. They address spleen-stomach deficiency-cold with poor appetite. In Chinese medicine, spleen-stomach deficiency-cold is a subjective condition: the patient has stomach pain and poor appetite, feels somewhat better with warmth, and prefers warmth and pressure; traditional TCM calls this typical presentation stomach cold or spleen-stomach deficiency-cold.
In Hezhong Pills, dried ginger warms the stomach and disperses cold; ginseng fortifies the spleen and boosts qi, greatly supplementing primordial qi; tangerine red moves qi and resolves stagnation; papaya dispels dampness and relieves pain; honey-fried licorice moderates urgency and stops pain, and also fortifies the spleen and boosts qi. So this formula offers some relief for gastric bloating and pain due to spleen-stomach deficiency-cold. Fearing that these herbs might still be too drying and harsh, Li Dongyuan used the soup-soaked (usually rice-water-soaked) steamed-cake method to make the pills, which shows how cautious he was in prescribing.
Li Dongyuan’s mother died of a spleen-stomach disease; grieved by her death, he resolved to study medicine, and throughout his life he devoted enormous effort to treating spleen-stomach disorders. Every formula he assembled for these disorders was carefully considered, and is worth our study and emulation.