【Source】

Quoted from “Yan Nian Mi Lu” in Vol. 8 of “Waitai”.

 【Composition】

Poria cocos, Ginseng, White atractylodes, Immature bitter orange, Tangerine peel, Fresh ginger
(6)

 【Classification】

<Regulating Qi>: Tangerine peel, Immature bitter orange

<Tonifying Spleen and Middle Jiao>: White atractylodes

<Tonifying Qi>: Ginseng

<Resolving the Exterior with Acrid Warmth>: Fresh ginger

<Tonifying Spleen and Promoting Water Elimination>: Poria cocos

【Formula Meaning】

According to “Jian”, the middle and upper Jiao are weak in Qi, and water-phlegm enters the stomach. The spleen cannot transport it to the lungs, and the lungs cannot regulate the water channels. This leads to stagnation as phlegm or accumulated water. Vomiting causes the Qi to descend and then ascend against the natural flow. Weakness combines with Qi stagnation, leading to fullness and inability to eat. Therefore, it is necessary to tonify the middle Qi, using Ginseng and White atractylodes as the ruler; Poria cocos expels accumulated water, and Immature bitter orange breaks down Qi stagnation, acting as a powerful agent. Opening the spleen and stomach, promoting circulation in the upper Jiao, and dispersing stagnant Qi involves Tangerine peel and fresh ginger as the envoy. Once the accumulated water is removed, but Qi deficiency causes fullness and inability to eat, this condition is very common. According to “Shan Bu”, the formula uses Pinellia tuber‘s acrid warmth and fresh ginger‘s acrid dispersal to expel the water that is about to emerge, thus eliminating the remaining evil. Both Pinellia tuber and fresh ginger are acrid in taste and can treat phlegm above the diaphragm, hardness below the heart, vomiting, and dizziness. However, palpitations are caused by water invading the heart, so Poria cocos is added to remove water and pacify the kidney evil, thus calming the spirit. The later formula adds Ginseng, Immature bitter orange, and tangerine peel, with Ginseng and White atractylodes as the ruler. Poria cocos expels accumulated water, and Immature bitter orange breaks down Qi stagnation, acting as the minister. Tangerine peel and fresh ginger serve as the envoy. This opens the spleen and stomach, promotes circulation in the upper Jiao, and disperses stagnant Qi. Once the accumulated water is removed, Qi deficiency causes fullness and inability to eat, which is a very common condition.

 【Functions】

Resolves phlegm and Qi, enabling eating.

 【Efficacy】

Accumulated phlegm and water in the chest and heart, accumulated phlegm and foul water in the stomach. After vomiting water, the heart and chest are deficient, and there is fullness and inability to eat. “Han Dian” states that it is “used to treat accumulated phlegm and water in the chest. After vomiting, there is deficiency of heart Qi and fullness, leading to inability to eat.” This refers to the condition where the stomach is filled with gas, causing inability to eat, accompanied by belching, nausea, and gnawing hunger. Abdominal signs include epigastric fullness and hardness, which is slightly more solid than in cases treated with Ginseng Decoction. This formula has the effect of removing accumulated water in the stomach and resolving the resulting gas fullness.

 【Indications】

Chronic gastritis, gastroptosis, shoulder relaxation, gastric dilation, etc.

 【Mnemonic】

Four Gentlemen (- Licorice) + immature bitter orange, fresh ginger, tangerine peel → Only ginger and tangerine are lucky. (Literally: Only born has good fortune.)