Qishuang Dan for Acid Regurgitation and Abdominal Distension and Pain
Qishuang Dan (Qi-Refreshing Elixir) comes from Shi Shi Mi Lu (Secret Records of the Stone Chamber), an empirical formula of the Qing-dynasty physician Chen Shiduo. It is composed of Baishao (Paeoniae Radix Alba) 5 qian (15g), Chaihu (Bupleurum Radix) 2 qian (6g), Chao Zhizi (Gardeniae Fructus, stir-fried) 1 qian (3g), Cangzhu (Atractylodis Rhizoma) 1 qian (3g), Fuling (Poria) 1 qian (3g), Liu Shenqu (mass medicament, i.e., Shenqu) 5 fen (1.5g), Banxia (Pinelliae Rhizoma) 1 qian (3g), Gancao (Glycyrrhizae Radix) 1 qian (3g), and Danpi (Moutan Cortex) 3 qian (9g). Decoct in water, remove the dregs, and take warm, twice daily.
This formula soothes the liver and regulates qi, and fortifies the spleen and harmonizes the stomach. Chen Shiduo used it for fullness and distension of both hypochondria and acid regurgitation and vomiting of acid caused by liver-channel disease. This is what modern medicine calls gastroesophageal reflux disease: stomach acid refluxes into the mouth and throat, giving the symptoms of acid regurgitation and vomiting acid. It is a common digestive symptom seen in many conditions, such as chronic gastritis, esophagitis, cholecystitis, and pyloric obstruction. Some patients also develop these symptoms when taking Chinese or Western medicines to treat other diseases—for example, cancer patients on chemotherapy.
Because TCM formulas mainly treat symptoms, Qishuang Dan is not limited to a single disease. As long as a patient presents with fullness and distension of both hypochondria and acid regurgitation or vomiting acid, whatever the underlying cause, Qishuang Dan may be used.
The composition of Qishuang Dan resembles that of Xiaoyao San (Free and Easy Wanderer Powder), but with differences. Xiaoyao San is composed of Zhi Gancao (prepared licorice), Danggui (Angelicae Sinensis Radix), Fuling, Baishao, Baizhu (Atractylodis Macrocephalae Rhizoma), and Chaihu (sprouts removed), and treats liver stagnation with blood deficiency and spleen weakness. Its manifestations include pain in both hypochondria, headache and vertigo, dry mouth and throat, fatigue and poor appetite, or irregular menstruation and distending pain in the breasts, with a wiry and deficient pulse.
In Qishuang Dan, Chaihu soothes the liver and resolves stagnation; Baishao softens the liver and relieves pain; Zhizi clears and drains interior heat; Cangzhu fortifies the spleen and removes distension; Fuling fortifies the spleen and drains dampness; Shenqu digests food and promotes stagnation; Banxia resolves phlegm and dries dampness; Mudanpi activates blood and resolves stasis. Combined, these herbs soothe the liver and regulate qi, clear heat and drain dampness, fortify the spleen and disperse distension, so that the upward-rushing stomach qi is downborne, and the symptoms of acid regurgitation and vomiting acid are naturally eliminated.