XIANG SHA LIU JUN ZI WAN(BP028 Saussurea & Cardamon Complex

Indication

This is a popular variant of Si Jun Zi Tang (Four Major Herbs Combination) from the ‘Formulary of the Tai Ping Welfare Dispensary Bureau’ (tai ping hui min he ji ju fang), 1151. This particular variant, however, was not recorded until 1695, when it appeared in ‘Zhang’s Dictionary of Medicine’ (zhang shi yi tong), by Zhang Lu-xuan, 1695, a comprehensive collection, covering most branches of medicine from ancient to contemporary times.

The original included Zingiber (ginger) (sheng jiang), and most modern prepared formulations also include Ziziphus (da zao). However, in a ready prepared herbal pill formulation, with each additional ingredient the dosages of the others are reduced proportionally. Therefore it is better to use only those that are strictly necessary.

In this case both Ziziphus (da zao) and Zingiber (sheng jiang) have been omitted. The former because there are already sufficient Spleen Qi tonifying ingredients in the formula; and the later because Pinellia (ban xia), which requires pre-processing to remove its inherent toxicity, has been processed with ginger juice, thus avoiding the need for additional ginger.

This formula is a good example of a treatment that addresses both the primary aspects (ben) as well as the secondary aspects (biao) of a specific condition. While effectively dispelling Phlegm, drying Damp and redirecting the Stomach Qi downwards; it also tonifies the Spleen Qi and promotes the Spleen’s transformation and transportation functions in order to prevent further Damp and Phlegm from being produced.

The distinguishing clinical features centre on Spleen and Stomach Qi deficiency and epigastric or abdominal distension with mild pain or discomfort. This is discussed further, below in Appendix 1 ‘Distinguishing Between the Spleen Tonifying Formulas’.

The synergistic actions of the herbs are as follows:

Codonopsis root (dang shen), Atractylodes rhizome (bai zu), Poria cocos (fu ling), Glycyrrhiza root (zhi gan cao): tonify the (Spleen) Qi.

Atractylodes rhiz. (bai zu), Poria cocos (fu ling), Pinellia tuber (ban xia), Citrus peel (chen pi), Ammomum fruit (sha ren), Citrus medica, fruit (fo shou): dry Damp.

Poria cocos (fu ling), Pinellia tuber (ban xia), Citrus peel (chen pi), Citrus medica, fruit (fo shou), Ammomum fruit (sha ren): regulate the Qi and harmonise the Spleen and Stomach.

Pinellia tuber (ban xia), Citrus peel (chen pi), Poria cocos (fu ling), Citrus medica, fruit (fo shou): dry Damp and resolve Phlegm.

Citrus medica, fruit (fo shou), Ammomum fruit (sha ren): promote the flow of Qi in the Stomach and Intestines to reduce epigastric or abdominal distension, reduce food stagnation and alleviate pain.

Indications:

Chronic gastritis

Chronic duodenitis

Morning sickness

Poor digestion

Food allergies

Candidiasis (gastrointestinal)

Gastroduodenal ulcers

Chronic bronchitis

Asthma

Allergic respiratory disorders

Chronic colitis

Chronic fatigue syndrome

General debility

Post-surgery debility

Signs & Symptoms:

Fatigue

Muscular weakness

Sensation of bodily heaviness

Poor appetite with a sensation of fullness after eating small amounts

Epigastric or abdominal distension with mild pain

Nausea or vomiting

Belching

Loose stools or diarrhoea

Gastro-oesophageal reflux

Productive cough with watery, clear or white sputum

Pale tongue with a white greasy or thick white coat

Weak pulse that is also slippery or and moderate

Combinations –

Bronchitis, chronic:

QING QI HUA TAN WAN

ZHI YIN GAN LU YIN

CLEAR THE PHLEGM Formula

Gastritis, chronic:

CHAI HU SHU GAN WAN

SHEN LING BAI ZHU SAN

WEN DAN TANG

XIANG SHA YANG WEI WAN

SHAO YAO GAN CAO TANG

IRRITABLE BOWEL Formula

CLEAR THE PHLEGM Formula

QI MOVER Formula

Helicobacter infection (gastritis or gastric ulcer):

WEN DAN TANG

XIANG SHA YANG WEI WAN

Morning sickness in pregnancy:

WEN DAN TANG

BAN XIA HOU PU TANG (Jia Wei)

CLEAR THE PHLEGM Formula

TCM Syndromes: Spleen-Stomach Qi deficiency, Cold-Damp disturbance of the Spleen, Phlegm-Damp obstruction of the Lung.

TCM Actions: Tonifies the Qi and strengthens the Stomach and Spleen, dries Damp and resolves Phlegm, regulates the Qi and harmonises the middle Jiao (Stomach and Spleen).