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【Cannabis Fruit Pill (Spleen Confinement Pill) 】
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Chinese Medicinal Material
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【Chinese Name】 |
麻子仁丸 (脾約丸)
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【Phonetic】 |
Ma Zi Ren Wan (Pi Yue Wan)
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【English Name】 |
Cannabis Fruit Pill (Spleen Confinement Pill) |
【Classification】 |
Purgative formulas |
【Source】 |
《Treatise on Cold Damage》Shang Han Lun《傷寒論》 |
【Combination】 |
Cannabis Fructus (Ma Zi Ren) 2 sheng (500g), Paeoniae Radix Alba (Shao Yao) 0.5 jin (250g), Aurantii Fructus Immaturus(Zhi Shi) 0.5 jin (250g), Rhei Radix et Rhizoma (Da Huang) 1 jin (500g), Magnoliae Officinalis Cortex (Hou Po) 1 chi (250g), Armeniacae Semen Amarum (Xing Ren) 1 sheng (250g) |
【Method】 |
Grind the above medicinals and make them into honey pills. Take 9g of the pills each time with warm water. It can also be prepared as a decoction by adjusting the medicinal quantities based on the original ratio. Mix the decoction with honey. |
【Action】 |
Moistens the intestines, drains heat, and moves qi to promote defecation. |
【Indication】 |
Ma Zi Ren Wan is indicated for spleen confinement constipation due to dryness-heat in the stomach and intestines. The symptoms are dry stool, frequent urination, a red tongue body, a dry slightly yellow tongue coating, and a rapid pulse. |
【Pathogenesis】 |
The pathomechanism is spleen yin deficiency due to dryness-heat in the stomach and intestines. This syndrome was called ”spleen confinement” (pi yue) in the《Treatise on Cold Damage》. “Confinement” means constraint and restriction. The spleen moves the stomach fluid upward and down to spread it to every corner of the body. When there is dryness-heat in the stomach and intestines, spleen yin is damaged. The spleen becomes too dry to move the stomach fluid so the fluids are not able to spread normally. Instead it pours down to the bladder in the form of frequent urination. The loss of moistening and descending within the intestines also causes dry stool because of the confinement. The rapid pulse and red tongue covered by dry, yellow coating are evidence of dryness-heat in the stomach and intestines. The therapeutic principles used to remedy this pattern are to moisten the intestines, drain heat and promote defecation. |
【Clarification】 |
1. Why is xing ren used in this formula to diffuse and descend the lung qi? Given the interior-exterior relation between the large intestine and the lung, the descending and free flowing action of the intestines relies on the diffusing and descending action of the lung qi. If the lung qi can descend and diffuse freely, the intestine will descend and flow freely as well, and the defecation will be normal. This formula promotes defecation by diffusing the lung and descending qi. 2. How is this formula prepared and administered? The purgation should be mild and moistening because the dryness-heat in the stomach and intestines is mild without signs of serious excess such as pi and fullness or distention and pain of the abdomen or stomach cavity. In this scenario the most suitable method of preparation is the honey pill because honey is sweet, moistening, and mild in function. In the original method of administration, only ten pills the size of a parasol tree seed are taken three times per day initially. If the efficacy is not obvious, the dosage can increase until defecation is restored to normal. |
【Application】 |
1. Essential pattern differentiation Ma Zi Ren Wan serves as the common formula used to treat spleen confinement syndrome due to dryness-heat in the stomach and intestines, deficiency of spleen fluid; and, as the representative prescription of the moistening purgative category. This clinical pattern is marked by dry stool, frequent urination, slightly yellow and dry tongue coating. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs and symptoms of dryness-heat in the stomach and intestines and fluid consumption: constipation in weak individuals due to intestinal dryness of the aged, habitual constipation, postpartum constipation and hemorrhoids, and postoperative constipation. 3. Cautions and contraindications It is not applicable to the aged, the weak, fluid inadequacy, blood insufficiency, or deficiency spleen and stomach without dryness-heat. Pregnant women should use it with caution. |
【Additonal formulae】 |
Wu Ren Wan (Five Kernels Pill, 五仁丸) [Source]《Effective Formulas from Generations of Physicians》Shi Yi De Xiao Fang《世醫得效方》 [Ingredients] Tao ren 1 liang (30g), xing ren 1 liang (30g), song zi ren 1.25 qian (5g), bai zi ren 0.5 liang (15g), yu li ren 1 qian (3g), chen pi 4 liang (crushed separately) (120g) [Preparation and Administration] Grind the five kernels into paste and chen pi into powder, add honey, and make them into pills the size of phoenix tree seed. Take 9g with warm water 1-2 times per day. [Actions] Moistens the intestines to promote defecation. [Applicable Patterns] Deficiency constipation due to fluid exhaustion and intestinal dryness. Symptoms include: dry stool, constipation due to blood deficiency in the elderly and postpartum, a dry tongue with scanty fluid, and a thin, choppy pulse. |
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