Wu Pi San - 五皮散 - Five-Peel Powder - Hoelen And Areca Combination

English:	Five-Peel Powder
Also Known As:	Hoelen and Areca Combination

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Cx. Mori	Sang Bai Pi	9-15g	Descends Lung Qi, promotes urination and reduces edema. With Sheng Jiang Pi, disperses and descends, restoring the water function of the Lung and facilitating smooth flow into the Bladder. With Da Fu Pi and Fu Ling Pi, for superficial edema with difficult urination.
Cx. Zingiberis Recens	Sheng Jiang Pi	3-10g	Disperses edema and transforms Dampness.
Poria Cutis	Fu Ling Pi	9-20g	Leaches out Dampness, strengthens transporting function of the Spleen and promotes urination.
Per. Citri Reticulatae	Chen Pi	6-9g	Adjusts the Middle and relieves the diaphragm, Dries Dampness, Regulates Qi, Transforms Phlegm. With Da Fu Pi, eliminates Qi Stagnation to allow free flow of Qi and fluids.
Per. Arecae	Da Fu Pi	9-15g	Descends Qi, Expels Dampness, Promotes movement of Qi, Promotes urination, Reduces edema. With Sheng Jiang Pi and Fu Ling Pi, for mild edema or superficial facial edema.

Formula Actions

• Resolve Dampness
• Reduces edema
• Regulates Qi
• Strengthens the Spleen
• Reduces swelling

Syndromes

• Spleen Deficiency with vigorous Dampness and Qi Stagnation (Pi Shui - Skin Water)
• Spleen Qi deficiency with excessive Damp causing skin edema (Pi Shui) (Secondary source)

Clinical Manifestations

Generalized edema Sensation of heaviness, distention and fullness in the epigastrium and abdomen. Labored, heavy breathing Shortness of breath Urinary difficulty Oliguria Asthma Chest distention Edema during pregnancy.

General edema in summer Heavy extremities Dyspnea Gasping Rapid breathing T: Normal C: White and slippery P: Thready and moderate or Slippery or Deep and moderate or Deep and slow T: White, greasy coat (Secondary source)

Treats

Edema during pregnancy Protein deficiency (malnutritional) edema Ascites from cirrhosis of the Liver Congestive Heart failure Urticaria Chronic nephritis Hypertension Asthma Chronic glomerulonephritis Dyspnea

Menopausal edema Cardiac edema Nephritic edema Dropsy Nephritis Traumatic injuries Nephrotic syndrome Nausea/Vomiting Gasping

Contraindications And Herb/Drug Interactions

Notes

• Water accumulation comparison: Wu Ling San - dysfunction of Bladder Qi transformation; Zhu Ling Tang - Heat accumulation causing Yin Deficiency; Wu Pi San - Spleen Qi Deficiency causing skin edema; Zhen Wu Tang - Kidney/Spleen Yang Deficiency causing edema and pain.

Modifications

For chronic glomerulonephritis:		For Wind-edema in the upper body:
+ A larger dosage of all herbs	30-60g	+ Rx. Saposhnikoviae	Fang Feng
+ Rx. et Rz. Notopterygii	Qiang Huo
For lower body edema:		Or
+ Rx. Stephaniae Tetrandrae	Han Fang Ji	+ Rx. Saposhnikoviae	Fang Feng
+ Fol. Perillae	Zi Su Ye
+ Rz. Alismatis	Ze Xie	+ Flos Schizonepetae	Jing Jie
Or		+ Rx. Angelica Dahuricae	Bai Zhi
+ Rx. Stephaniae Tetrandrae	Han Fang Ji	Or
+ Rx. Saposhnikoviae	Fang Feng
+ Sm. Plantaginis	Che Qian Zi	+ Fol. Perillae	Zi Su Ye
Or
+ Flos Schizonepetae	Jing Jie
+ Rx. Gentianae Macrophyllae	Qin Jiao
+ Sm. Phaseoli	Chi Xiao Dou
+ Poria	Fu Ling
+ Rz. Alismatis	Ze Xie	For marked Spleen Deficiency:
+ Rx. Stephaniae Tetrandrae	Han Fang Ji	+ Rx. Codonopsis	Dang Shen
+ Rz. Atractylodes Macrocephalae	Bai Zhu
+ Sm. Plantaginis	Che Qian Zi
For edema:		For constipation due to accumulation in the Stomach and intestines:
+ Exo. Benincasae	Dong Gua Pi	+ Rx. & Rz. Rhei	Da Huang
+ Hb. Plantaginis	Che Qian Cao	+ Fr. Aurantii Immaturus	Zhi Shi
+ Rx. Astragali	Huang Qi	For severe abdominal distention:
For Internal Cold-Damp:		+ Sm. Raphani	Lai Fu Zi
+ Rz, Zingiberis	Gan Jiang	+ Cx. Magnolia	Hou Po
+ Rx. Aconiti Lateralis Preparata	Zhi Fu Zi	For Damp-Heat lodged in the Lower Jiao with edema below the waist:
For edema during pregnancy:		+ Talcum	Hua Shi
+ Stigma Maydis	Yu Mi Xu	+ Sm. Plantaginis	Che Qian Zi
Or		+ Sm. Coicis	Yi Yi Ren
- Cx. Mori	Sang Bai Pi	For facial edema:
+ Rz. Atractylodis Macrocephalae	Bai Zhu	+ Per. Citri Reticulatae	Chen Pi
For severe edema
For generalized weakness and Deficiency:		+ Five-Ingredient Powder with Poria Wu Ling San
+ Rx. Codonopsis	Dang Shen
+ Rx. Astragali	Huang Qi	For Coldness:
+ Rz. Atractylodis Macrocephalae	Bai Zhu	+ Rz. Zingiberis	Gan Jiang
+ Cx. Cinnamomi	Rou Gui
For traumatic injury with swelling and inflammation:		For abdominal fullness and distention:
+ Rz. Atractylodis Macrocephalae	Bai Zhu
+ Rz. Atractylodis Macrocephalae	Bai Zhu
+ Rz Atractylodis	Cang Zhu
+ Rx. Notoginseng	San Qi	For traumatic injury with swelling and inflammation in the upper limbs:
For traumatic injury with swelling and inflammation in the lower limbs:
+ Rz. Atractylodis Macrocephalae	Bai Zhu
+ Rz. Atractylodis Macrocephalae	Bai Zhu
+ Rx. Notoginseng	San Qi
+ Rx. Notoginseng	San Qi	+ Ram. Cinnamomi	Gui Zhi
+ Rx. Cyathulae	Chuan Niu Xi	+ Ram. Mori	Sang Zhi
For nephrotic syndrome:		For Beriberi due to Spleen Deficiency with Dampness:
+ Dang Gui and Peony Powder Dang Gui Shao Yao San
- Cx. Mori	Sang Bai Pi
Or		+ Rz. Atractylodis Macrocephalae	Bai Zhu
+ Cinnamon and Poria Pills Gui Zhi Fu Ling Wan