The Efficacy of Li Dongyuan's Zhishi Xiaopi Pills in Treating Digestive Tract Diseases
Li Dongyuan was one of the four great masters of the Jin-Yuan period, and many of his formulas are remarkably effective. This article introduces his experiential formula “Zhishi Xiaopi Wan” (Immature Bitter Orange Pill for Dissipating Fullness), which is recorded in Lanshi Micang (Secret Records of the Orchid Chamber). Its composition is: Ganjiang (dried Zingiber), Zhigancao (honey-fried Glycyrrhiza), Maiyaqu (sprouted barley mash), Baifuling (white Poria), and Baizhu (Atractylodes macrocephala), each 2 qian (6g); Banxiaqu (pinellia mash) and Renshen (Ginseng), each 3 qian (9g); Houpo (Magnolia officinalis) 4 qian (12g); and Zhishi (immature Bitter Orange) and Huanglian (Coptis), each 5 qian (15g). Grind all the above into a fine powder, use soup-soaked steamed cake to make pills the size of a phoenix-tree seed. Take 50–70 pills each time, washed down with warm water after meals.
This formula's main actions are to disperse accumulation and guide out stagnation, and clear heat and transform dampness. It is indicated for internal retention of damp-heat accumulation causing fullness in the chest and abdominal pain, indigestion, and diarrhea, or dysentery with pus and blood and tenesmus; it is also commonly used to treat anorexia in children, non-ulcer dyspepsia, gastric cancer precancerous lesions, and diabetic gastroparesis. Zhishi Xiaopi Wan has a broad range of indications and marked efficacy, so patent medicines have been sold through the ages; today several manufacturers produce the Chinese patent medicine, available at offline or online pharmacies.
Zhishi Xiaopi Wan was created by Li Dongyuan by combining his teacher Zhang Yuan-su's Zhizhu Wan (made of Zhishi and Baizhu) with Zhang Zhongjing's Banxia Xiexin Tang (made of Banxia, Huanglian, Huangqin, Ganjiang, Renshen, Zhigancao, and Dazao), and then adding modifications. Such a combined formula is more effective and has broader indications than a single prescription.
In this formula, Huanglian and Zhishi are used in the largest amounts and are the sovereign herbs. Berberine extracted from Huanglian (the active component of berberine hydrochloride tablets) is a commonly used modern medicine for gastroenteritis; Zhishi has a marked effect in promoting gastrointestinal peristalsis, and Houpo also promotes gastrointestinal peristalsis and emptying. Renshen, Baizhu, Fuling, and Zhigancao are the components of Sijunzi Tang (Four-Gentleman Decoction), the classic TCM formula for treating spleen-deficiency indigestion through the ages. Banxiaqu, Maiyaqu, and Shengjiang are added to aid digestion. Combined in this way, the formula has an excellent effect on indigestion caused by digestive tract diseases.
This formula can treat not only gastritis and enteritis but also the indigestion, abdominal distension and pain, and loose stools caused by chronic hepatitis (hepatitis B or C), cirrhosis, and cholecystitis; it also has a therapeutic effect on dysentery caused by Shigella. Indigestion due to digestive tract diseases is one of the most common clinical symptoms. As a famous formula specifically for indigestion, Zhishi Xiaopi Wan, created by Li Dongyuan in the Jin-Yuan period, has been repeatedly used by clinicians and has never faded over the long years.