Yiwei Tang (Stomach-Nourishing Decoction): Nourishing Yin and Benefiting the Stomach

Among patients with chronic gastritis, gastric ulcer, gastroptosis, gastric polyps, gastroduodenal ulcer, Helicobacter pylori infection, anorexia, and diabetes, some present with dry throat and mouth, burning dull pain in the epigastrium, hunger without appetite, constipation, or retching and hiccup, a red tongue with little fluid, and a rapid fine pulse. Cancer patients after radiotherapy also frequently develop these symptoms. For such patients, one may consider treating them chiefly with Yiwei Tang, modified according to the patient's specific symptoms.

Yiwei Tang is an empirical formula from the Wenbing Tiaobian (Systematic Identification of Cold-Warm Diseases), composed of Glehnia root (Sha Shen), Ophiopogon (Mai Dong), raw Rehmannia (Sheng Di), Solomon's seal (Yu Zhu), and rock sugar (Bingtang). The usual decocted dose is: Glehnia root 10 g, Ophiopogon 15 g, raw Rehmannia 15 g, Solomon's seal 6 g, and rock sugar 3 g. The rock sugar need only be dissolved in the decoction after the other herbs are cooked. According to the warm-disease school of TCM, this is a formula for treating insufficient stomach yin, so all the herbs used belong to the category of herbs that nourish yin and engender fluids.

Usually, such patients also have some accompanying symptoms. Some patients have severe anorexia—I once met a patient who had not eaten staple foods for years, surviving on liquids. For such patients, one may add roasted malt (Chao Mai Ya), roasted grain sprout (Chao Gu Ya), hawthorn (Shan Zha), and medicated leaven (Shen Qu) to the above to open the stomach and digest food; one may also have the patient take some yeast and vitamins to aid digestion. Some patients have a dry mouth and heavy drinking, especially those after radiotherapy, whose dry mouth is worse; drinking large amounts all day does not relieve the dryness. Such patients may be given dendrobium (Shi Hu), Jiaogulan, Trichosanthes root (Tian Hua Fen), and smoked plum (Wu Mei) to generate fluids and nourish yin. Some patients have dry, constipated stool; when using Yiwei Tang, one may appropriately add hemp seed (Huo Ma Ren), bush cherry seed (Yu Li Ren), senna leaf (Fan Xie Ye), Chinese angelica (Dang Gui), white peony (Bai Shao), black sesame (Hei Zhi Ma), and cistanche (Rou Cong Rong) to moisten the intestines and relieve constipation; those with severe constipation may use stronger laxatives such as rhubarb (Da Huang) and mirabilite (Mang Xiao), but these should not be used for long so as not to damage the healthy qi. Patients with hiccup may add persimmon calyx (Shi Di), clove (Ding Xiang), bamboo shavings (Zhu Ru), inula flower (Xuan Fu Hua), and haematitum (Dai Zhe Shi) to downbear counterflow and stop vomiting. Diabetic patients using the above may consider adding American ginseng (Xi Yang Shen), winter mulberry leaf (Dong Sang Ye), and Saururus (San Bai Cao).

Firmly grasping the indications for Yiwei Tang, and taking Yiwei Tang as the chief formula, one can combine a variety of formulas to treat patients differentiated as having stomach-yin deficiency.