1. Class 8: Herbs and Formulas That Reduce Food stagnation Xianhui Li

2. Fructus Crataegi (Shan zha) Fructus Hordei germinatus (Mai ya) Fructus Oryzae germinatus (Gu ya) Massa fermentata medicinalis (Shen qu) Endothelium corneum gigeriae galli (Ji nei jin) Semen Raphani (Lai fu zi) Formulas that Reduce Food Stagnation

3. Fructus Crataegi (Shan zha) Taste and Property: Sour, sweet and slightly warm Meridian Tropism: Spleen, stomach and liver Actions: Promote digestion and remove retained food, activate blood flow and dissipate nodules Application: –Retained food, especially retained meat in the middle jiao marked by fullness in the epigastrium and abdomen, abdominal pain and diarrhea Used along to treat retention of meat Used together with Shen Qu and Mai Ya for retained food Used with Mu Xiang and Zhi Ke for cases with fullness of abdomen and stomach 10g powder of fried Shan Zha can be used with water to treat abdominal pain and diarrhea due to food retention –Postpartum abdominal pain and lochiarrhea caused by stagnation of blood or distending pain and lowering down sensation in hernia, often used together with Dang Gui, Chuan Xiong and Yi Mu Cao, or with Xiao Hui Xiang and Ju He. –The raw Shan Zha is often used to treat hypertention, CHD and hyperlipidemia in recent years Dosage: 10-15g or up to 30g

7. Fructus Hordei germinatus (Mai ya) Taste and Property: Sweet and bland Meridian Tropism: Spleen, stomach and liver Actions: Digest retained food, harmonize function of the middle jiao and quit secretion of milk Applications –Indigestion marked by retained food, poor appetite and fullness in the epigastrium and abdomen: This herb is specially good at digesting food containing plentiful starch, often used together with Shan Zha, Shen Qu and Ji Nei Jin. Indigestion due to weakness of the spleen and stomach can be treated with both the herbs tonifying spleen qi and this herb, which can prevent the sticky nature of the other herbs from causing stagnation –Used to quit secretion of milk or distending pain in the breats due to retention of milk. Everyday, raw and stir fried Mai Ya, 30-60g is to be decocted and taken orally –Dredge flow of the liver: Used as a assistant herb for stagnation of the liver qi and incoordination between the liver and the spleen. Dosage: 10-15g or up to 30-120g Contraindication: Not used for woman at the milk-breeding period

10. Fructus Oryzae germinatus (Gu ya) Taste and Property: Sweet and bland Meridian Tropism: Spleen and stomach Actions: Promote digestion and harmonize function of the middle jiao, strengthen the spleen and stomach Application: –Indigestion, retained food and poor appetite due to spleen deficiency: This function of the herb is similar to Mai Ya, but mild, so it can promote digestion without impairment of the stomach. Often used with Mai Ya in order to strengthen the effect. For indigestion, it is often used together with Shen Qu and Shan Zha and for poor appetite due to spleen deficiency, often used with Dang Shen, Bai Zhu and Chen Pi Dosage: 10-15g and up 30g

14. Massa fermentata medicinalis (Shen qu) Taste and Property: Sweet, pungent and warm Meridian Tropism: Spleen and stomach Actions: Promote digestion and harmonize function of the stomach Application: –Indigestion marked by fullness in the epigastrium and abdomen, poor appetite, borborygmus and diarrhea, often used with Shan Zha and Mai Ya –Shen Qu Hu bills is often taken together with a formula containing metal or stone source herbs such as Ci Zhu Wan Dosage: 6-15g

16. Endothelium corneum gigeriae galli (Ji nei jin) Taste and Property: Sweet and neutral Meridian Tropism: Spleen, bladder, small intestine and stomach Actions: reduces all types of food stagnation, stops enuresis, dissolves stones Application: –For various types of food stagnation, used alone for mild cases, also important in the treatment of childhood nutritional impairment. Used with mai ya, shan zha for indigestion, fullness and distention of epigastrium and abdomen, used with dang shen, bai zhu for child hood nutritional impairment –For bed-wetting, urinary frequency, and urination at night, used with sang piao xiao, long gu, mu –For stones in either urinary or biliary tract, used with jin qian cao Dosage: 3-9g

19. Semen Raphani (Lai fu zi) Taste and Property: Acrid, sweet, and neutral Meridian Tropism: Lung, spleen and stomach Actions: reduced food stagnation and eliminates distention; causes qi to descend and reduces phlegm, Application: –For food stagnation accumulating in the middle burner with fullness and distention, belching with a rotten smell, acrid regurgitation, or abdominal pain with diarrhea, used with shan zha, shen qu, chen pi, i.e. bao he wan –For chronic productive cough or wheezing, most effective in cases due to excess, used with zi su zi, bai jie zi for chronic cough and wheezing, especially that due to excessive phlegm disorders, i.e. san zi yang qin tang –recently used for hypertension Dosage: 4.5-9g

22. Formulas that Reduce Food Stagnation Preserve Harmony Pill (bao he wan) Strengthen the Spleen Pill (jian pi wan) Immature Bitter Orange and Atractylodes Macrocephala Pill (zhi zhu wan)

23. Preserve Harmony Pill (bao he wan) Ingredients: Shan zha 9-15g, Shen qu 9-12g, Lai fu zi 6-9g, Chen pi 6-9g, Ban xia 9-12g, Fu ling 9-12g, Lian qiao 3-6g, Mai ya 6-9g

24. Actions and indications of the formula Actions –Reduce food stagnation and harmonize the stomach. Indications –Focal distension, rotten smelling belching, acid regurgitation, nausea and vomiting, aversion to food, a yellow, greasy tongue coating, and a slippery pulse.

25. Analysis of Formula Chief : Shan zha –reduce all types of food stagnation, especially that of meat and fatty food Deputy: –Shen qu: reduce the stagnant accumulation of alcohol and food. –Lai fu zi: reduce the accumulation of phlegm from stagnant grains and descend stomach qi. Assistant: –Ban xia, Chen pi, Fu ling: strengthen spleen, leach out dampness, harmonize the middle Jiao. –Lian qiao: clear heat from constraint of food –Mai ya: reduce stagnation from grains.

26. Modern application and attention Modern application: –Acute or chronic gastroenteritis, hepatitis, acute pancreatitis Attention –Not suitable for Spleen deficiency

27. Strengthen the Spleen Pill (jian pi wan) Ingredients: Chao bai zhu, Fu ling, Ren shen, Shan yao, Rou dou kou, Shan zha, Chao shen qu, Chao mai ya, Mu xiang, Chen pi, Sha ren, Jiu chao huang lian, Gan cao

28. Actions and indications of the formula Actions –Strengthen spleen, reduce food stagnation and stop diarrhea. Indications –Reduced appetite, bloating and focal distention on the epigastrium and abdomen, loose and watery diarrhea, a greasy, slight yellow tongue coating, and a deficient, frail pulse.

29. Analysis of Formula Chief : Chao bai zhu, Fu ling, Ren shen –strengthen spleen, leach out dampness to stop diarrhea Deputy: –Shan yao: tonify spleen and bind intestines. –Rou dou kou: warm the middle Jiao and bind up the intestines. Assistant: –Shan zha, Chao shen qu ma ya: reduce food stagnation –Mu xiang, sha ren, Chen pi: regulate qi and harmonize stomach –huang lian: clear heat and dry dampness Envoy: Gan cao –tonify middle jiao and harmonize other herbs.

30. Modern application and Modifications Modern application: –Chronic gastritis, peptic ulcer, gastric prolapse Modifications: –For nausea and vomiting, add Ban xia and Sheng jiang –For cases with no symptoms of heat, omit Jiu chao huang lian. If there are signs of cold, add Gan jiang –For daybreak diarrhea with symptoms of food stagnation, take with Fu zi li zhong wan Attention: –Not suitable for Spleen deficiency without stagnation or food stagnation due to contaminated food or from overconsumption of food and drink

31. Immature Bitter Orange and Atractylodes Macrocephala Pill (zhi zhu wan) Ingredients: Bai zhu 12-18g, Zhi shi 6-9g

32. Actions and indications of the formula Actions –Tonify spleen and reduce focal distension. Indications –Loss of appetite, focal distention in the epigastrium and abdomen, a white tongue coating, and a deficient pulse.

33. Analysis of Formula Chief : Bai zhu –strengthen spleen, and eliminate dampness. Deputy: Zhi shi –transform stagnation and direct qi downward. Assistant: He ye –raise the clear Yang of Spleen

34. Modern application and Modifications Modern application: –Acute or chronic gastroenteritis, hepatitis, acute pancreatitis Modifications: –For severe abdominal distention add Hou po –For food stagnation, add Shen qu, Mai ya –For gastric pain, add Mu xiang, Sha ren Attention: –Not suitable for Spleen deficiency