This formula is a modification of Li Dong-yuan’s Huang Qi Ren Shen Tang as found in the Pi Wei Lun (Treatise on the Spleen & Stomach). It may also be referred to as a combination of Bu Zhong Yi Qi Tang (Supplement the Center & Boost the Qi Decoction) plus Yu Ping Feng San (Jade Wind-screen Powder) with added ingredients. Our version is a 10:1 extract.

Rx:
Shan Zhu Yu (Fructus Corni)
Huang Qi (Radix Astragali)
Mai Men Dong (Tuber Ophiopogonis)
Dang Shen (Radix Codonopsitis)
Bai Zhu (Rhizoma Atractylodis Macrocephalae)
Cang Zhu (Rhizoma Atractylodis)
Da Zao (Fructus Jujubae)
Sheng Jiang (uncooked Rhizoma Zingiberis)
Fang Feng (Radix Saposhnikoviae)
Wu Wei Zi (Fructus Schisandrae)
Wu Mei (Fructus Mume)
Ban Xia (Rhizoma Pinelliae)
Huang Bai (Cortex Phellodendri)
mix-fried Gan Cao (Radix Glycyrrhizae)
Chen Pi (Pericarpium Citri Reticulatae)
Dang Gui (Radix Angelicae Sinensis)
Chai Hu (Radix Bupleuri)
Sheng Ma (Rhizoma Cimicifugae)
 

Indications
This formula is for the treatment of spleen qi vacuity resulting in lung qi vacuity and thus insecure defensive qi and/or lingering wind evils retained in the defensive exterior. Because of the close reciprocal relationship of the lungs, spleen, and kidneys vis à vis the engenderment and functioning of the qi or due to immaturity, such a lung-spleen vacuity is often complicated by a kidney vacuity. In addition, because the lungs, spleen, and kidneys are the three viscera which control the movement and transformation of body fluids, there is concomitant enduring phlegm dampness.
 
In terms of diseases, this formula is meant to be taken preventively for allergic rhinitis of wind cold nature. That means allergic rhinitis with profuse, clear, phlegm, sneezing, and nasal congestion. However, this formula, by itself, is not meant for the treatment of acute allergic episodes. In particular, this formula is best for the prevention of allergic rhinitis occurring in the fall. In that case, these capsules can be begun in June to prevent autumn attacks or administered at least two weeks before expected seasonal recurrences.
 
The symptoms of spleen qi vacuity include:

• fatigue, especially after eating  

• a tendency towards loose stools

• abdominal bloating after eating  

• a craving for sweets

• possible cold hands and feet (though often not)

• possible white, slimy tongue fur at least at the tongue root

• a possible history of antibiotic use     

• a wet, swollen tongue with teeth marks on its edges

• a typically slippery pulse

However, according to many Chinese doctors, if one has allergic rhinitis, one does have at least a constitutional spleen-lung vacuity. This is based on the middle burner being the source of the engenderment of the defensive qi, and everyone who is invaded by an unseen airborne pathogen which does not cause problems for the majority of other people exposed to such allergens does have, ipso facto, a defensive qi vacuity.

Symptoms of a kidney qi vacuity may not be readily apparent. Often, such kidney vacuity is a function of immaturity or, on the other end of the spectrum, aging.

Phlegm dampness is evidenced by:
 

• profuse phlegm

• a wet tongue with possibly slimy fur

• a tendency towards runny nose

According to Chinese medical theory, the vast majority of allergic rhinitis sufferers do have chronic, enduring deep-lying phlegm dampness. "The spleen is the root of phlegm engenderment; the lungs are the place where phlegm is stored."
 

In addition, most sufferers of allergic rhinitis will have some element of liver depression, as evidenced by the almost ubiquitous bowstring or wiry pulse. Such liver depression qi stagnation negatively effects the lung and spleen function and the movement and transportation of body fluids. Conversely, phlegm dampness and poor lung-spleen function adversely effect the free and easy flow of qi.

Combinations
During acute allergic rhinitis episodes, this formula can be taken with Bi Yan Pian (Rhinitis Tablets). In cases with pronounced symptoms of kidney yang vacuity, it can be combined with Ba Wei Di Huang Wan (Eight Flavors Rehmannia Pills) or Jin Gui Shen Qi Wan (Kidney Qi Pills). In cases with pronounced symptoms of yin vacuity, this formula can be combined with Liu Wei Di Huang Wan (Six Flavors Rehmannia Pills). For more pronounced phlegm dampness, it may be combined with Er Chen Wan (Two Aged [Ingredients] Pills). For more pronounced liver depression, it may be combined with Xiao Yao Wan (Rambling Pills). If cold evils have transformed into heat, it may be combined with either Dan Zhi Xiao Yao Wan (Moutan & Gardenia Rambling Pills) or Xiao Chai Hu Tang Wan (Minor Bupleurum Decoction Pills). If allergic episodes recur monthly around a woman’s menses and there are signs and symptoms of blood vacuity and/or blood stasis, consider combining with Tao Hong Si Wu Tang Wan (Persica & Carthamus Four Materials Decoction Pills). For more obvious fluid dryness, combine with Sheng Mai San Wan (Engender the Pulse Powder Pills).

Formula explanation
Astragalus, Codonopsis, the two Atractylodes, mix-fried Licorice, and Red Dates all fortify the spleen the spleen and supplement the qi. Because the spleen is the source of the lung qi, and the latter heaven supports and bolsters the former heaven, these medicinals also supplement the lung and kidney qi. This is why Li Dong-yuan referred to the spleen qi as the original qi and said that these medicinals supplement the original qi. Bupleurum and Cimicifuga both upbear yang, thus helping to boost the qi and supplement the great or lung qi. Schisandra, Mume, and Cornus are all astringents. They secure the exterior, thus preventing invasion by external evils, and they astringe leakage. In addition, although Cornus is described as a kidney yang supplement, it supplements kidney yin and yang in a balanced manner. Hence it addresses elements of either kidney yin or yang vacuity, depending on the individual case. Pinellia, Orange Peel, and uncooked Ginger transform phlegm and eliminate dampness. Ophiopogon and Dang Gui help Licorice prevent the windy, dry-natured medicinals in this formula from damaging yin fluids. Ophiopogon does also transform phlegm and Dang Gui does also soften and, therefore, harmonize the liver. Ledebouriella resolves the exterior and dispels wind without harming the righteous qi. It is used to out-thrust any evils which might be lingering in the exterior. Phellodendron clear any vacuity and/or damp (i.e., summerheat) heat which may be damaging the spleen, lung, and kidney qi.
 

On page 85 of the Pi Wei Lun (Blue Poppy edition), Li says, "When the spleen and stomach are vacuous and weak, the qi of the upper burner is insufficient." Li then goes on to say that, if due to invasion of external evils taking advantage of this vacuity, symptoms of lung (respiratory) and large intestine (defecatory) disturbance may arise. In that case, one must first assist the original qi (meaning the spleen qi) and regulate insufficient lung and large intestine metal. For this, Li recommends Huang Qi Ren Shen Tang. Li further goes on to describe how the heat of summer may damage the spleen, lungs, and kidneys and how one can use this formula to treat and prevent such damage.
If, in the heat of summer, a person with perduring disease due to vacuous and damaged spleen and stomach neglects to nurture and adapt themselves, acting counter to the season..., they will inevitably contract drowsiness and weakness, disinclination to speak, shortness of breath, qi weakness, dyspneic distressed rapid breathing, fatigued and weak bones, a dreamy appearance, clouded vision as if shrouded in clouds of smoke, and lack of consciousness of one’s own body.
 

In the following paragraph, Li goes on to explain how, in this case, invading wind may give rise to a "struggle between wind and dampness (with) headache, heavy-headedness, congested exuberant heat in the upper (burner or part of the body), shortness of breath through mouth or nose, distressed rapid breathing, vexed and agitated body and heart, pessimism, sadness, and despondency (all emotions associated with the lungs, which) demonstrate yin overwhelming yang in the extreme."

Dosage
Three capsules two times per day. Since Blue Poppy Herb’s version of this formula is a 10:1 extract, this equals not less than 30 grams of raw herbs. However, because our ability to extract the active ingredients from these herbs is so much more efficient than stove-top decoction at home, we believe that this amount of this formula is actually more like the equivalent of 45-60 grams of bulk-dispensed herbs.

Note
For more information about the Chinese medical prevention and treatment of allergic rhinitis, see Bob Flaws’s Curing Hayfever Naturally with Chinese Medicine published by Blue Poppy Press.