Qiwei Baizhu San: A Spleen-Strengthening, Diarrhea-Stopping, Anti-Infective Formula
Qiwei Baizhu San comes from the Xiao’er Yaozheng Jue (Key to Therapeutics of Children’s Diseases) and is an experienced formula of Qian Yi, the great Song-dynasty pediatrician. It is built on Sijunzi Tang (Four-Gentlemen Decoction), with the addition of Huoxiang Ye (Agastaches Folium), Muxiang (Aucklandiae Radix), and Gegen (Puerariae Radix). It has the actions of strengthening the spleen and boosting qi, harmonizing the stomach and generating fluids. It is indicated for spleen-stomach weakness with fluid deficiency and internal heat: vomiting and diarrhea, feverish skin, dry mouth and throat. Today it is mostly used not as a powder but directly as an oral decoction. The adult decoction dose is: Renshen (Ginseng) 6 g, Baizhu (Atractylodis Macrocephalae Rhizoma) 12 g, Fuling (Poria) 12 g, Gancao (Glycyrrhizae Radix) 3 g, Huoxiang Ye (Agastaches Folium) 12 g, Muxiang (Aucklandiae Radix) 6 g, Gegen (Puerariae Radix) 15 g; children’s doses are reduced as appropriate.This formula is now mostly used for sequelae of various infectious diseases presenting with diarrhea, dry mouth, fever, and similar symptoms; in TCM terms such patients have spleen deficiency with concomitant internal heat.Modern pharmacological research shows this formula has anti-rotavirus activity and can regulate human immunity; it also has some effect on patients who develop similar symptoms after infection with other pathogens. In addition, studies indicate it has a definite effect on pediatric diarrhea, pediatric anorexia, chronic idiopathic colitis, diarrhea-predominant irritable bowel syndrome, deficiency-cold stomach pain, post-chemotherapy diarrhea, and radiation enteritis.Sijunzi Tang is the premier TCM formula for strengthening the spleen and boosting qi. Gegen both releases the muscle layer and clears heat, lifts yang to stop diarrhea, and engenders fluids to quench thirst. Muxong moves qi and stops pain, strengthens the spleen and promotes digestion, and stops diarrhea and dysentery. Huoxiang transforms dampness and awakens the spleen, dispels turbidity and harmonizes the middle, relieves summerheat and stops diarrhea, and releases the exterior to clear heat; it is the main active ingredient of Huoxiang Zhengqi San, a common treatment for gastrointestinal-type cold. Thus, Sijunzi Tang plus Gegen, Muxiang, and Huoxiang is an excellent formula for warming the spleen, stopping diarrhea, expelling pathogen, and checking dysentery.Qiwei Baizhu San can also be combined with other classic TCM antidiarrheal formulas to treat refractory diarrhea. Combined with Huanglian Jiedu Tang (Coptis Detoxifying Decoction), it treats diarrhea due to spleen deficiency with damp-heat pouring downward; such patients often have a burning sensation in the anus. If the patient’s problem is caused by food stagnation, it may be used together with digestion-promoting Shanzha (Crataegi Fructus), Jineijin (Galli Gigerii Endothelium Corneum), fried Maiya (Hordei Fructus Germinatus), and Laifuzi (Raphani Semen). For stubborn chronic diarrhea such as chronic idiopathic colitis and irritable bowel syndrome, it may also be combined with Baitouweng Tang (Pulsatilla Decoction) and similar formulas.This formula has a definite effect on nausea, vomiting, and diarrhea caused by radiotherapy and chemotherapy. If vomiting is severe, it may be further combined with Erchen Tang (Two-Aged Decoction), Jupi Zhuru Tang (Tangerine-Peel and Bamboo-Shavings Decoction), Xuanfu Daizheshi Tang (Inula and Haematitum Decoction), or Dingxiang Shidi San (Clove and Persimmon-Calyx Powder).