Ginseng, Poria, and Atractylodes

參苓白朮散 · shēn líng bái zhú sǎn

For loose stools, fatigue, and poor appetite when dampness has settled into the gut

What it's for

This powder, recorded in 1107, is the standard formula for Spleen deficiency that has allowed dampness to settle in. Where Four Gentlemen and Six Gentlemen drain dampness as a side effect of strengthening the Spleen, this formula does both deliberately and gently. It adds grain-like foods including lotus seed, coix seed, and white hyacinth bean that nourish the Spleen without straining it, plus sha ren to open qi, the energy that moves through your body, in the middle burner so the nourishing herbs can be properly absorbed. Platycodon, ascending upward, acts as an envoy to carry the formula's effects from the Spleen to the Lungs and out to the periphery, completing the cycle of digestion and distribution.

Signs this formula is a fit

At least 2 of the 3 main signs below should sound like you. Chronic, gentle onset with a pale tongue and deficiency picture is the key signal.

Main signs

Chronic loose stools or diarrhea
soft, unformed, or frequent stools that have been going on for weeks or months
Fatigue and weakness, especially in the limbs
arms and legs feel heavy or weak, energy is consistently low
Reduced appetite
food sounds unappealing or you fill up after very little

Extra signs

Gradual weight loss despite eating
Distention or stifling sensation in the chest and epigastrium
Pale, wan complexion
Pale tongue with white coating
Thin, moderate or deficient, moderate pulse
Possible nausea or vomiting

Signs it isn't

Your diarrhea is from damp-heat: burning, urgent stools with yellow tongue coating
You have a full, excess pattern with a thick, greasy tongue coating
Your pattern is Kidney yang deficiency: cold limbs, very early morning diarrhea, aversion to cold
You have dryness and heat from yin deficiency: a red tongue with little coating, night sweats, or hot palms and soles

What's in it

Safety

For Spleen qi deficiency with dampness. Not for diarrhea from damp-heat or Kidney yang deficiency.
Avoid this formula during pregnancy. Coix seed is traditionally avoided, especially long term.
Use only with significant modification if you also have heat from yin deficiency.
Contains licorice. Avoid with high blood pressure, edema, low potassium, or heart, liver, or kidney disease.
Not for prolonged daily use at high doses without practitioner supervision.
Not appropriate when tongue coating is thick, yellow, or greasy, pointing to excess rather than deficiency.
Ginseng may raise blood pressure; those with hypertension should monitor carefully.
Ginseng may interact with blood thinners, MAOI antidepressants, and diabetes medication.

How to take it

What to get

Shen Ling Bai Zhu Pian Tablets

Plum Flower100 ct

Find on Amazon

We may earn a small commission, which keeps Field Guide free. We do not make or sell these products.

Dose

Take 4 tablets, 3 times a day. Other brands and forms use different doses, so follow the label on what you buy.

How long

Follow any time limit on the product label. If it gives none, ask a qualified TCM practitioner when to reassess. Do not keep taking it unchanged if nothing improves.