Tong Ge Wan from the Yuyuan Fang for Gastric Retention and Gastric Hydrops

Historically, several formulas have been named Tong Ge Wan; the Tong Ge Wan introduced in this article comes from the Yuyuan Fang (Formulas of the Imperial Pharmacy). The formula consists of Binglang (Arecae Semen) 3 liang (90 g), and Cha Chao Zhishi (bran-fried Aurantii Fructus Immaturus) 4 liang (120 g). Preparation: grind the above herbs together into a fine powder, use refined honey as an excipient, and make into pills the size of a parasol tree seed (about the size of a soybean or pea, 5-7 mm in diameter). Take 30-50 pills each time, after meals, with ginger decoction or warm water. Since there is no ready-made patent medicine of this formula, patients who want the pills must prepare them themselves according to the above method. Of course, it can also be converted into a decoction; the adult dose of the decoction is: Binglang 9 g, bran-fried Zhishi 12 g, one dose daily, decocted twice in water, taken once each in the morning and evening after meals.

This formula has the effects of downbearing qi and unblocking the diaphragm, and resolving fluid retention and promoting diuresis. It mainly treats qi obstruction and fullness in the chest with retained fluid-rheum. Such symptoms are quite similar to gastric retention and gastric hydrops in modern medicine; their common causes include gastritis, gastric ulcer, dyspepsia, gastroparesis, and gastric cancer. Patients have gastric fullness and discomfort, often with a succussion splash in the stomach; those with incomplete pyloric obstruction may also vomit, sometimes vomiting undigested food residues, and sometimes simply regurgitating gastric juice. Based on these symptoms, traditional TCM considers this to be retained fluid-rheum in the stomach.

The Binglang and Zhishi in this formula both promote gastric peristalsis and gastric emptying; Binglang also has a relatively obvious diuretic effect. Traditional TCM considers both to be qi-regulating and distension-relieving herbs that can remove distension and accumulation. Compared with Dahuang and Qianniuzi and other purgatives commonly used for similar diseases, Binglang and Zhishi are safer, and patients are unlikely to experience obvious side effects after taking them. But for relatively serious diseases such as gastric cancer, this formula only has a certain symptomatic effect and cannot be relied upon alone to fight cancer.