Shi Pi Yin - 實脾飲 - Bolster The Spleen Decoction

English:	Bolster the Spleen Decoction
Also Known As:	Magnolia and Atractylodis Combination Spleen Reinforcing Cool Decoction Bolster the Spleen Powder Powder for Invigorating the Spleen Spleen Tonic for Edema Shi Pi San

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Rx. Aconiti Lateralis Preparata	Zhi Fu Zi	4-30g	Promotes the movement of Yang through all twelve channels, tonifies the Ming Men and disperses Cold. With Bai Zhu, for Spleen Yang Deficiency with a Cold, painful abdomen, vomiting and watery diarrhea. With Gan Jiang, warms and nourishes SP and KI. With Bai Zhu and Fu Ling, for Kidney and Spleen Yang Deficiency with water retention. With Bai Zhu and Gan Jiang, for Spleen Yang Deficiency with abdominal pain and Cold. With Zhi Gan Cao and Gan Jiang, strengthens its actions of fortifying Qi and benefiting the Yang for Cold extremities and diarrhea with undigested food due to Collapse of the Spleen and Kidney Yang. With Fu Ling, for lower body edema and dysuria.
Rz. Zingiberis Preparata	Pao Jiang	4-30g	Warms Spleen Yang , expels interior Cold, stopping bleeding associated with Deficiency Cold. stops bleeding associated with Deficiency Cold and reduces the toxicity of Zhi Fu Zi. With Zhi Gan Cao, for vomiting and epigastric pain due to Spleen and Stomach Deficiency Cold. With Hou Po, for congested Fluids due to Cold with epigastric distention and pain. With Bai Zhu, for diarrhea due to Spleen Deficiency, .hematochezia (profuse menstrual bleeding) and char both herbs for treating bloody stools and excessive uterine bleeding. With Zhi Fu Zi, warms the Spleen and Kidneys, benefits Yang, and disperses Cold for debilitated Spleen and Kidney Yang with incessant diarrhea. With Fu Ling, Bai Zhu and Zhi Gan Cao, for Cold-Dampness in the Lower Jiao leading to a sense of heaviness and cold in the lower back.
Poria	Fu Ling	4-30g	Harmonizes the Middle Jiao, Promotes urination, Resolves Dampness, Strengthens the Spleen. With Bai Zhu, strengthens the Spleen and resolves Dampness. With Zhi Fu Zi and Sheng Jiang, for edema due to Spleen and Kidney Yang Deficiencies.
Rz. Atractylodis Macrocephalae	Bai Zhu	4-30g	Tonifies the Spleen, tonifies Qi and dries Dampness. With Gan Jiang, eliminates Cold Dampness in the Spleen with loss of taste, a sticky sensation in the mouth, nausea, vomiting, diarrhea and a thick,white tongue coat, treats bleeding due to Deficiency of Spleen Yang with hemafecia or hematuria and frequent diarrhea due to Spleen and Stomach Deficiency Cold. With Fu Ling and Zhi Gan Cao, for Spleen and Stomach Qi Deficiencies. With Fu Ling and Sheng Jiang, for edema with Kidney Yang Deficiency.
Fr. Chaenomelis	Mu Gua	4-30g	Harmonizes the Stomach, Promotes urination, Strengthens the Spleen, Transforms Dampness.
Cx. Magnoliae Officinalis	Hou Po	4-30g	Moves Qi, transforms Dampness and warms and invigorates the Spleen. With Mu Xiang, Da Fu Pi and Cao Guo, descends Qi, relieves stagnation, transforms Dampness and circulates Fluids. With Gan Jiang, for acute diarrhea from Cold attacking the Middle.
Rx. Aucklandiae	Mu Xiang	4-30g	Moves Qi, strengthens the Spleen and alleviates pain With Bai Shao, for diarrhea with profuse pus and Blood.
Per. Arecae	Da Fu Pi	4-30g	Expels Dampness, Moves Qi, Promotes urination, Reduces edema.
(Sm. Arecae)	(Bing Lang)	4-30g	(Regulates Qi, reduces accumulations, drains downward, unblocks the bowels, relieves nausea and Promotes urination. Substitutes for Da Fu Pi in some versions.) (With Mu Xiang and Hou Po, for tenesmus.)
Fr. Amomi Tsaoko	Cao Guo	4-30g	Strongly dries Dampness, disperses Cold and resolves stagnation and distention.
Rx. Glycyrrhizae Preparata	Zhi Gan Cao	2-15g	Tonifies Spleen Qi. With Sheng Jiang and Da Zao, regulates and harmonizes the other herbs, benefits the Spleen and harmonizes Middle Jiao.
Rz. Zingiberis Recens	Sheng Jiang	5 slices	Disperses Cold, warms the Middle Jiao, stops vomiting and reduces the toxicity of other herbs. With Da Zao, alleviates epigastric pain, nausea, and vomiting by strengthening the Spleen, protects the Stomach Qi and reduces irritation of the gastrointestinal. tract by other herbs.
Fr. Jujube	Da Zao	1 piece	Strengthens the Spleen, tonifies Qi and moderates and harmonizes the harsh properties of other herbs.

Formula Actions

• Warms Yang
• Strengthens the Spleen
• Promotes Qi movement
• Promotes urination

Syndromes

• Spleen Deficiency Edema
• Spleen and Kidney Yang Deficiency with Water Flooding (Yin edema)
• Yin edema due to Spleen & Kidney Yang deficiency (Secondary source)

Clinical Manifestations

Generalized, severe edema, more severe below the waist Cold extremities Heavy sensation of the body Chest and abdominal fullness and distention Absence of thirst Semi liquid, unformed stools

Scanty urine Pitting edema Loss of appetite T: Pale C: Thick and greasy P: Deep and slow or Deep and thready

Treats

Pitting edema Chronic nephritis Rheumatic valvular Heart disease Congestive Heart failure Cirrhosis of the Liver Chronic hepatic diseases Ascites Hypothyroidism Oliguria Chronic hepatitis Acute glomerulonephritis Anorexia Nephrotic syndrome Paralysis Indigestion

Chronic enteritis Intestinal tuberculosis Cardiac edema Anasarca Menopause Tympanites Hydramnios Gastralgia Abdominal fullness and distention Chronic glomerulonephritis Low back pain Fatigue Palpitations Liver cancer Dyspnea

Contraindications And Herb/Drug Interactions

Notes

• Composition: Fu Zi 6g, Gan Jiang 6g, Fu Ling 6g, Bai Zhu 6g, Mu Gua 6g, Hou Po 6g, Mu Xiang 6g, Da Fu Pi 6g, Cao Guo 6g, Zhi Gan Cao 5g, Sheng Jiang 5 pieces, Da Zao 1 piece (Secondary source)
• Shi Pi Yin and Zhen Wu Tang both treat Yin edema from Kidney/Spleen Yang Deficiency: Shi Pi Yin focuses on the Spleen, Zhen Wu Tang on the Kidney.

Modifications

For ascites due to liver cirrhosis:		For scanty urination and severe edema:
+ Rx. Codonopsis	Dang Shen	+ Rz. Alismatis	Ze Xie
+ Rz. Alismatis	Ze Xie	+ Scl. Polypori	Zhu Ling
+ Tub. Curcumae	Yu Jin	Fro Qi Deficiency with shortness of breath, fatigue and disinclination to talk:
+ Per. Citri Reticulatae	Chen Pi	+ Rx. Codonopsis	Dang Shen
For abdominal distention:		+ Rx. Astragali	Huang Qi
+ Per. Citri Reticulatae	Chen Pi	Or
+ Fr. Amomi	Sha Ren	+ Rx. Codonopsis	Dang Shen
For palpitations:		+ Rx. Astragali	Huang Qi
+ Less Rx. Aconiti Lateralis Preparata	Zhi Fu Zi	+ Rx. Atractylodis Macrocephalae	Bai Zhu
+ Fossilia Ossis Mastodi	Long Gu	For proteinuria:
+ Magnetitum	Ci Shi	+ Hb. Pyrolae	Lu Xian Cao
For painful distention of the Liver area:		+ Sm. Euryales	Qian Shi
+ Per, Citri Reticulatae Viride	Qing Pi	For constipation:
+ Rz. Sparganii	San Leng	+ Sm. Pharbitidis	Qian Niu Zi
+ Rz. Curcumae	E Zhu	For tympanites:
For diarrhea:		- Rx. Glycyrrhizae Preparata	Zhi Gan Cao
- Rx. Glycyrrhizae Preparata	Zhi Gan Cao	+ Ram. Cinnamomi	Gui Zhi
+ Sm. Arecae	Bing Lang	For fibromyalgia due to Cold Stagnation Blocking the Channels:
For fibromyalgia due to Spleen and Kidney Deficiencies:		+ Ephedra, Prepared Aconite and Asarum Decoction Ma Huang Fu Zi Xi Xin Tang
+ Lycium Fruit, Chrysanthemum and Rehmannia Pill Qi Ju Di Huang Wan		+ Pinellia Decoction to Extend Life Yan Nian Ban Xia Tang
+ Restore the Left (Kidney) Pill Zuo Gui Wan		For fibromyalgia due to Phlegm Stagnation Blocking the Channels:
For ascites:		+ Kudzu Decoction modified Ge Gen Tang modified
- Fr. Amomi Tsaoko	Cao Guo
+ 10g Rx. Curcumae	Yu Jin	+ Three Painful Obstruction Decoction San Bi Tang
+ 10g Fr. Aurantii	Zhi Ke
For ascites with scanty urination:		For ascites with abdominal pain:
- Fr. Amomi Tsaoko	Cao Guo	- Fr. Amomi Tsaoko	Cao Guo
+ 10g Rx. Curcumae	Yu Jin	+ 10g Rx. Curcumae	Yu Jin
+ 10g Fr. Aurantii	Zhi Ke	+ 10g Fr. Aurantii	Zhi Ke
+ 3g Cx. Cinnamomi	Rou Gui	+ 10g Per. Citri Reticulatae Viride	Qing Pi
+ 10g Polyporus	Zhu Ling
For chronic glomerulonephritis:		+ 6g Rz. Cyperi	Xiang Fu
- Fr. Chaenomelis	Mu Gua	+ 10g Rz. Corydalis	Yan Hu Suo
+ 30g Sm. Plantaginis	Che Qian Zi	For chronic glomerulonephritis with marked fatigue and weakness:
+ 30g Epicarpium Benincasae	Dong Gua Pi
- Fr. Chaenomelis	Mu Gua
+ 15g Sm. Phaseoli	Chi Xiao Dou	+ 30g Sm. Plantaginis	Che Qian Zi
+ 9g Fr. Amomi Tsaoko	Cao Guo	+ 30g Epicarpium Benincasae	Dong Gua Pi
+ 9g Fr. Amomi	Sha Ren
+ 9g Fr. Amomi Rotundus	Bai Dou Kou	+ 15g Sm. Phaseoli	Chi Xiao Dou
+ 9g Fr. Amomi Tsaoko	Cao Guo
For chronic glomerulonephritis with more marked Kidney Deficiency:		+ 9g Fr. Amomi	Sha Ren
+ 9g Fr. Amomi Rotundus	Bai Dou Kou
- Fr. Chaenomelis	Mu Gua
+ 30g Sm. Plantaginis	Che Qian Zi	+ 15g Rx. Astragali	Huang Qi
+ 30g Epicarpium Benincasae	Dong Gua Pi
+ 15g Rx. Codonopsis	Dang Shen
For chronic glomerulonephritis with nausea:
+ 15g Sm. Phaseoli	Chi Xiao Dou	- Fr. Chaenomelis	Mu Gua
+ 9g Fr. Amomi Tsaoko	Cao Guo	+ 30g Sm. Plantaginis	Che Qian Zi
+ 9g Fr. Amomi	Sha Ren	+ 30g Epicarpium Benincasae	Dong Gua Pi
+ 9g Fr. Amomi Rotundus	Bai Dou Kou
+ 15g Sm. Phaseoli	Chi Xiao Dou
+ 9g Rx. Achyranthis Bidentatae	Niu Xi	+ 9g Fr. Amomi Tsaoko	Cao Guo
+ 9g Fr. Amomi	Sha Ren
+ 9g Hb. Taxilli	Sang Ji Sheng	+ 9g Fr. Amomi Rotundus	Bai Dou Kou
+ 9g Hb. Epimedii	Yin Yang Huo
For chronic glomerulonephritis with abdominal fullness after eating abdominal edema, borborygmus and flatulence:		+ 12g Rz. Pinelliae Preparatum	Zhi Ban Xia
+ 12g Per. Citri Reticulatae	Chen Pi
- Fr. Chaenomelis	Mu Gua
+ 30g Sm. Plantaginis	Che Qian Zi	For chronic glomerulonephritis with Blood Stagnation:
+ 30g Epicarpium Benincasae	Dong Gua Pi
- Fr. Chaenomelis	Mu Gua
+ 15g Sm. Phaseoli	Chi Xiao Dou	+ 30g Sm. Plantaginis	Che Qian Zi
+ 9g Fr. Amomi Tsaoko	Cao Guo	+ 30g Epicarpium Benincasae	Dong Gua Pi
+ 9g Fr. Amomi	Sha Ren
+ 9g Fr. Amomi Rotundus	Bai Dou Kou
+ 15g Sm. Phaseoli	Chi Xiao Dou
+ 9g Sm. Arecae	Bing Lang	+ 9g Fr. Amomi Tsaoko	Cao Guo
+ 9g Fr. Aurantii Immaturus	Zhi Shi	+ 9g Fr. Amomi	Sha Ren
+ 9g Fr. Amomi Rotundus	Bai Dou Kou
For paralysis due to Cold-Damp:
- Per. Arecae	Da Fu Pi	+ 12g Hb. Lycopi	Ze Lan
+ 9g Sm. Areca	Bing Lang	+ 12g Hb. Leonuri	Yi Mu Cao
- Fr. Tsaoko	Cao Guo	For paralysis due to Cold-Damp with inhibited urination and severe edema:
+ 9g Sm. Alpiniae Katsumadai	Cao Dou Kou
- Per. Arecae	Da Fu Pi
For paralysis due to Cold-Damp with severe Spleen Qi Deficiency:		+ 9g Sm. Areca	Bing Lang
- Fr. Tsaoko	Cao Guo
- Per. Arecae	Da Fu Pi	+ 9g Sm. Alpiniae Katsumadai	Cao Dou Kou
+ 9g Sm. Areca	Bing Lang
- Fr. Tsaoko	Cao Guo	+ 9g Polyporus	Zhu Ling
+ 9g Sm. Alpiniae Katsumadai	Cao Dou Kou	+ 9g Rz. Alismatis	Ze Xie
For paralysis due to Cold-Damp with severe, encumbered heavy limbs:
+ 18g Rx. Astragali	Huang Qi
For liver cancer:		- Per. Arecae	Da Fu Pi
- Fr. Chaenomelis	Mu Gua	+ 9g Sm. Areca	Bing Lang
- Fr. Tsaoko	Cao Guo	- Fr. Tsaoko	Cao Guo
- Rx. Glycyrrhizae Preparata	Zhi Gan Cao	+ 9g Sm. Alpiniae Katsumadai	Cao Dou Kou
+ 9g Sm. Alpiniae Katsumadai	Cao Dou Kou	+ 9g Rz. Atractylodis	Cang Zhu
+ 9g Rx. Codonopsis	Dang Shen
+ 15g Sm. Plantaginis	Che Qian Zi
+ 9g Rz. Alismatis	Ze Xie