Pinellia Decoction to Drain the Epigastrium
半夏瀉心湯 · bàn xià xiè xīn tāng
When nausea, gut gurgling, and epigastric tightness all hit at the same time.
What it's for
Built for a stomach that can't settle: tight and full just below the sternum, not quite painful, while nausea or vomiting and loose stools arrive together. In TCM, this is called a mixed hot-and-cold pattern, where heat and cold stagnate in the digestive system at the same time. Pinellia leads qi, your body's baseline energy, back downward, while bitter cold herbs clear the heat and warm herbs shore up what's weakened.
Signs this formula is a fit
At least 2 of the 3 main signs below should sound like you. The tight, full pressure just below your sternum is the core signal.
Main signs
Tight pressure just below your sternum
a bloated, full feeling that doesn't quite cross into real pain
Stomach pushing food back up
dry heaves or actual vomiting, especially after eating
Gut gurgling and loose stools arriving with the nausea
cramping goes up and down at once, not one or the other
Extra signs
- Poor appetite, nothing sounds good
- Thin yellowish tongue coating, may look greasy
- Wiry, rapid pulse
Signs it isn't
- Your symptoms are pure cold: no heat signs, everything feels slow and cold, no yellow tongue coating
- This is simple food stagnation from overeating, without the characteristic tight fullness
- Your fullness comes from qi stagnation rather than the hot-cold mix this formula resolves
What's in it
Safety
- Built for mixed hot-cold gut patterns. Not the right fit for plain food stagnation or qi stagnation.
- Bensky does not list a pregnancy contraindication, and names morning sickness among this formula's uses.
- Avoid if you have any active bleeding, which is a documented caution for pinellia.
- Use caution with a dry cough from yin deficiency or a sore throat from excess fire.
- Generally well tolerated at standard teapill doses. Pinellia here is the processed form, which is safe at normal dosage.
- Ginseng may interact with blood thinners, MAOIs, and diabetes medication.
How to take it
This formula is best obtained through a licensed TCM practitioner who can confirm it matches your pattern.
Find a practitioner (NCCAOM directory)