Xingpi Yiwei Tang: Awakening the Spleen and Benefiting the Stomach

Xingpi Yiwei Tang is from "Waike Zhengzong" (Orthodox External Medicine), by Chen Shigong. It was used for spleen-stomach weakness and failure of transportation arising after a sore or ulcer has ruptured and the patient has over-eaten raw and cold foods. Clinically, its indications are fullness and oppression in the chest and diaphragm, poor appetite, swelling of the limbs and face, and difficult urination.

This formula consists of: Renshen (Ginseng), Chenpi (tangerine peel), Fuling (Poria), Fabanxia (processed Pinellia), Huaishanyao (Chinese yam), and Baizhu (Atractylodes macrocephala), each one qian (now 3 g each); Cangzhu (Atractylodes lancea), Houpo (Magnolia bark), Zexie (Alisma), Maiya (germinated barley), Muxiang (Aucklandia), Shanzha (hawthorn), Suzi (perilla seed), and Zhuling (Polyporus), each five fen (now 1.5 g each); and Lao Huangmi (old yellow rice), one qian (now 3 g). Each decoction adds 20 duncao rush stems (Juncus) and three slices of ginger, decocted in water and taken before meals.

Xingpi Yiwei Tang is essentially based on Liujunzi Tang combined with Pingwei San, minus honey-fried Licorice, plus Huaishanyao, Zexie, Maiya, Muxiang, Shanzha, Suzi, Zhuling, and yellow rice. Honey-fried Licorice is removed because the patient has edema and difficult urination, in which case Licorice would be counterproductive. Adding Chinese yam and yellow rice strengthens the spleen; adding yellow rice, barley, and hawthorn promotes digestion; adding Alisma, Polyporus, Juncus, and Ginger promotes diuresis and reduces swelling; adding Aucklandia and Perilla seed moves qi and downbears counterflow. Combined, these herbs strengthen the spleen and drain water, stimulate appetite, and aid digestion.

Xingpi Yiwei Tang can be used for digestive disturbance caused by mild ascites or pleural effusion in cancer patients, and also for edema and indigestion caused by chemotherapy. For patients with weak spleen and stomach, the dosage should not be too large, as excessive dosage causes side effects; hence the small quantities used here. If symptoms persist long-term, the herbs may be ground into powder, blended with boiled honey into pills, and taken 3-6 g, two to three times a day, for gradual treatment.