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Formula Exploration: Edema

Today we will have fun with formula exploration focusing on those that treat edema. Among these formulas are Wu Ling San, Wei Ling Tang, Wu Pi Yin, and Shi Pi Yin. Each of these has unique compositions and applications within the realm of TCM. This article will explore the ingredients, therapeutic uses, and cultural significance of these formulations.

🌿 A gentle reminder that this information should not be used to self-diagnose, treat, or encourage the use of herbs without the guidance of a trained professional. This information is for recreation or educational purposes only. Please, always consult a certified herbalist or trained medical professional if you wish to explore these holistic choices.💚

Formula #1: Wu Ling San

Wu Ling San, also known as “Five-Ingredient Powder with Poria,” is a fundamental formula in traditional Chinese herbal medicine, especially for water retention conditions. This formula treats Yin excess, water overflowing due to deficient Kidney Yang or deficient Spleen Qi, and Greater Yang Accumulation of Water. It is comprised of five key ingredients:

Ingredients:

Fu Ling (Poria): Derived from a fungus that grows on diverse species of pine tree roots, Fu Ling is the chief herb in Wu Ling San. It is known for its ability to promote urination and resolve dampness in the body.

Bai Zhu (Rz. Atractylodis Macrocephalae): Bai Zhu is a root that tonifies the spleen and promotes the transformation of dampness. Where Fu Ling drains the damp in a downward direction, Bai Zhu dries the damp. Together, this dui yao is a great 1-2 combo to resolve damp conditions. 

Ze Xie (Rz. Alismatis): Ze Xie is the sliced, dried tuber of water plantain. It acts as a diuretic and also helps to eliminate dampness from the body. 

Zhu Ling (Scl. Polypori): Zhu Ling is another fungus employed in this formula. It promotes urination, clears heat, and leaches out dampness from the body. 

Gui Zhi (Ram. Cinnamomi): This herb, derived from the bark of the cinnamon tree, invigorates circulation and harmonizes all of the formula ingredients.

Take-home Message:

The basic TCM formula for excess type Edema (generalized) is Wu ing San. It contains the dui yao pair Fu Ling and Bai Zhu. Wu Ling San is a traditional base formula that can be modified to create other formulas that may more directly address other specific damp conditions. 

Formula #2: Wei Ling Tang

Wei Ling Tang, or “Calm the Stomach and Poria Decoction”, is another essential herbal formula in TCM. It consists of a base formula of Wu Ling San, plus the addition of another formula, Ping Wei San. Ping Wei San is similar to Wu Ling San in its ability to tonify the Spleen and resolve dampness, however, it brings with it the added functions of harmonizing the Stomach and promotes the movement of Qi.

Fu Ling 
Wu Ling San
Promotes urinationDrains DampnessStrengthens the SpleenWarms the Yang
Bai Zhu 
Ze Xie 
Zhi Gan Cao 
Cang Zhu [chao](Dry-fried Rz. Atractylodis)



Ping Wei San
Dries DampnessStrengthens Spleen’s transporting functionPromotes movement of QiHarmonizes the Stomach
Huo Po [jiang](Ginger-fried Cx. Magnoliae Officinalis)
Chen Pi (Per. Citri Reticulatae)
Zhi Gan Cao (Rx. Glycyrrhizae Preparata)
Sheng Jiang (Rz. Zingiberis Recens)
Da Zao(Fr. Zizyphi Jujube)

Formula Take-home Message:

Wei Ling Tang is typically used to treat conditions of water-damp inundation. This condition is associated with chronic water retention, particularly those manifesting with pitting edema, chest oppression, loss of appetite, and nausea. 

Formula #3: Wu Pi Yin

Wu Pi Yin, translated as “Five-Peel Beverage,” is a traditional Chinese herbal formula used for “Pi Shui” (skin water/edema) caused by spleen deficiency with water accumulation. This presents without exterior patterns. This is a very gentle formula that is neutral in temperature and treats all 3 jiao. It is composed of five key ingredients:

Ingredients:

Di Gu Pi (Cx. Lycii): Wolfberry Root Cortex, or the peel of the goji berry plant root, cools the Blood and clears deficient heat. It drains Yin Deficiency Fire, floating fire in the Kidney channel, and clears heat in the Lung.

Shen Jiang Pi (Cx. Zingiberis Recens): The skin of the ginger root is used in TCM to promote urination and reduce edema (especially acute or during the early onset stage). Shen Jiang works to adjust the Ying and Wei, adjusting the flow of Qi. 

Fu Ling Pi (Cx. Poria Cocos): Fu Ling is featured again here, for its damp draining property. But here, Fu Ling Pi is used with Wu Jia Pi and Da Fu Pi to target the superficial layers affected by mild edema specifically. 

Wu Jia Pi (Cx. Acanthopanacis): Acanthopanax is the genus name of ginseng. In the case of Wu Jia Pi, we are only using the ginseng root peel.  

Da Fu Pi (Per. Arecae): Da Fu Pi is better known as the husk if the Betel Nut. This ingredient regulates and descends Qi, and harmonizes the middle jiao. Like many herbs discussed in this article, it too promotes urination. 

Formula Take-Home Message:

Wu Pi Yin is often utilized to treat superficial edema. One way to think of it is that “Pi” means “skin” and the five skins of these botanicals treat “shiny skin”, where the edema is stuck in the superficial layers. 

Formula #4: Shi Pi Yin

Shi Pi Yin, also known as “Bolster the Spleen Decoction” is a traditional Chinese herbal formula aimed at decreasing edema by supporting spleen health. It contains a blend of herbs chosen for their specific properties to Warm the Yang, Strengthen the Spleen, Move Qi, and promote urination. 

Ingredients:

Chiefs

Zhi Fu Zi: Cools the Blood, drains Yin Deficiency Fire, drains Fire in the Kidney channel, and clears and drains Heat in the Lung.

Pao Jiang (Cx. Zingiberis Recens): Expels (exterior) cold and warms the Spleen Yang. Importantly, this herb can reduce the toxicity of Zhi Fu Zi. Combining Pao Jiang, Bai Zhu, and Zhi Fu Zi can effectively halt diarrhea, as it addresses the underlying issue of insufficient Spleen and Kidney Yang.

Deputies

Fu Ling Pi (Cx. Poria Cocos): As mentioned before, it promotes urination, resolves Dampness, strengthens the Spleen, and harmonizes the Middle Jiao.

Bai Zhu (Cx. Acanthopanacis): Dispels Wind-Dampness, nourishes the Liver and Kidneys, strengthens sinews and bones, transforms Dampness, and reduces swelling.

Assistants

Mu Gua (Fructus Chaenomelis): Mu Gua also goes by the name Chinese quince fruit and (most commonly) papaya. Like many other herbs in this article, Mu gua drains damp, however, it is sour and balances disharmonies between the Spleen and Liver that lead to leg problems (like leg edema) and food stagnation. Because it clears painful damp obstruction and reaches the Liver, it is good for releasing the sinews and can help calm painful charlie horses, too. 

Hou Po (Cx. Magnoliae Officinalis): Here’s another herb that can stop diarrhea by drying damp. This herb can also transform phlegm, especially of the middle jiao where the phlegm causes distention, nausea, or diarrhea. Huo Po also moves the Qi and resolves stagnation, especially that which causes food stagnation. This warm aromatic acrid herb reaches the Spleen, Stomach, Large Intestine, and Lung, which means it can transform phlegm affecting the lungs. Thus, Huo Po is also effective in stopping wheezing and coughing from congestion. 

Mu Xiang (Radix Aucklandiae): Herbs that regulate Qi – promotes the movement of qi (stop pain); regulates intestinal stagnant qi, strengthens the spleen. Dispels Damp-Heat; Harmonizes the Liver and Spleen.

Da Fu Pi (Per. Arecae): People sometimes substitute Da Fu Pi with Bing Lang (Betel Nut). Da Fu Pi moves the Qi, promotes urination, expels Dampness, and reduces edema.

Cao Guo (Fr. Lanxangia Tsaoko): This is an interesting herb often confused with black cardamom (a distinctly different species with a different flavor profile). Cao Guo grows in shaded, high-altitude areas of China’s Sichuan and Yunnan provinces, as well as northern Laos and Vietnam. It undergoes drying over fire, imparting distinct smoky notes and a warm, acrid nature to it. Cao Guo strongly dries Dampness, disperses Cold, and resolves stagnation and distention.

Envoys

Zhi Gan Cao (Rx. Glycyrrhizae Preparata): This herb tonifies Spleen Qi and harmonizes the Middle Jiao. With Sheng Jiang and Da Zao, it harmonizes the other herbs in this formula. 

Sheng Jiang (Rz. Zingiberis Recens): Many people recognize Sheng Jiang for its ability to warm the Middle Jiao and stop vomiting. It also reduces the toxicity of other herbs in this formula.

Da Zao (Fr. Jujube)Jujube fruit: It strengthens the Spleen and tonifies Qi. Additionally, it helps harmonize the harsher properties of other herbs in this formula.

Formula Take-home Message:

Shi Pi Yin primarily supports the spleen and resolves severe leg edema. It addresses edema caused by Spleen deficiency or Spleen Yang decline.  

Conclusion:

In conclusion, traditional Chinese herbal formulas like Wu Ling San, Wei Ling Tang, Wu Pi Yin, and Shi Pi Yin offer valuable insights into the nuanced approach of traditional medicine. Understanding their ingredients, therapeutic uses, and cultural significance provides a glimpse into the holistic and comprehensive nature of traditional Chinese medicine. As a friendly reminder, always consult a qualified healthcare practitioner before using any herbal formulas for medicinal purposes.

This information has not been evaluated by the Food and Drug Administration. No product mentioned herein is intended to diagnose, treat, cure, or prevent any disease. For educational purposes only.

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