Pao He Wan

Understanding Pao He Wan: Usage and Dosage

Ever felt that uncomfortable fullness after a big meal? Pao He Wan, a classic Traditional Chinese Medicine (TCM) formula, is often your go-to remedy for exactly that. It's designed to help your digestive system get back on track.

Here’s what typically goes into it and how it’s prepared:

Ingredients:

• Charred Hawthorn Berry (Shan Zha, charred) 300g
• Stir-fried Massa Medicata Fermentata (Liu Shen Qu, stir-fried) 100g
• Processed Pinellia Tuber (Ban Xia, processed) 100g
• Poria (Fu Ling) 100g
• Aged Tangerine Peel (Chen Pi) 50g
• Forsythia Fruit (Lian Qiao) 50g
• Stir-fried Radish Seed (Lai Fu Zi, stir-fried) 50g
• Stir-fried Malt (Mai Ya, stir-fried) 50g

Preparation: The eight ingredients listed above are typically ground into a fine powder, sifted, and thoroughly mixed. This powder can then be made into small water-bound pills (water pills) and dried. Alternatively, for every 100g of powder, 125-155g of refined honey can be added to form larger honey pills.

Pao He Wan: Its Functions and Indications

This formula is essentially a digestive powerhouse, known for its ability to:

• Functions: Promote digestion, resolve stagnation, and harmonize the stomach.
• Main Indications: It's commonly used for conditions like food stagnation, abdominal distension and fullness, belching with a foul odor, acid regurgitation, and loss of appetite.
• Modern Applications: You might find it recommended for general indigestion or childhood anorexia (lack of appetite in children).

Important Precautions for Pao He Wan

Like any medication or herbal remedy, Pao He Wan comes with a few guidelines to ensure safe and effective use. Always consult your healthcare provider or a qualified TCM practitioner for personalized advice.

1. Avoid cold, greasy, and difficult-to-digest foods while taking this formula.
2. It’s generally not recommended to take Pao He Wan simultaneously with other tonifying Chinese herbal medicines.
3. If you have serious chronic conditions such as high blood pressure, heart disease, liver disease, diabetes, or kidney disease, you should take this formula only under the guidance of a physician.
4. Children, pregnant women, nursing mothers, and individuals who are elderly or frail should also use this formula under the supervision of a physician.
5. If symptoms do not improve after 3 days of use, it's essential to seek medical attention.
6. This product is contraindicated for those allergic to its ingredients. Individuals with an allergic constitution should use it with caution.
7. Do not consume the medicine if its physical characteristics (like color, smell, or texture) have changed.
8. Children must use this product under adult supervision.
9. Always keep this medicine out of reach of children.
10. If you are currently taking other medications, please consult a physician or pharmacist before using this product.

Navigating the world of traditional remedies means being informed. While generally safe, processed Pinellia Tuber (Ban Xia) is one of the ingredients here that underscores the importance of proper preparation and dosage as guided by a professional. Always prioritize your safety and well-being. (For further reading on the efficacy and safety of TCM herbal formulas, you might find this study helpful: PMID: 30678689)

Variations of Pao He Wan Across Historical Texts

It's fascinating to see how Pao He Wan has evolved through the centuries, with various practitioners adapting the formula to different conditions. Here’s a look at some notable historical prescriptions:

From *Dan Xi Xin Fa*, Volume 3: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: Hawthorn Berry 180g, Massa Medicata Fermentata 60g, Pinellia Tuber and Poria each 90g, Aged Tangerine Peel, Forsythia Fruit, and Radish Seed each 30g.
• Preparation: The herbs are ground into a powder, then formed into pills the size of a parasol tree seed with a steamed bun paste.
• Functions and Indications: Promotes digestion and harmonizes the stomach. Primarily indicated for food stagnation, oppression and fullness in the chest and epigastrium, abdominal distension with occasional pain, belching with a foul odor, acid regurgitation, aversion to food, or vomiting and diarrhea, accompanied by a slippery pulse and a thick, greasy, or yellow tongue coating.
• Usage and Dosage: Take 70-80 pills per dose on an empty stomach with plain water.
• Notes: In this formula, Hawthorn Berry excels at digesting greasy meat stagnation; Massa Medicata Fermentata resolves stagnation from alcohol and old food; Radish Seed clears stagnation from flour products and phlegm-dampness; Aged Tangerine Peel, Pinellia Tuber, and Poria regulate Qi and harmonize the stomach, dry dampness and transform phlegm; Forsythia Fruit dissipates nodules and clears heat, collectively achieving the effect of promoting digestion and harmonizing the stomach.
• Excerpt From: *Dan Xi Xin Fa*, Volume 3

From *Za Bing Yuan Liu Xi Zhu*, Volume 14: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: Hawthorn Fruit 5 qian (approx. 18.75g), Ginger-processed Pinellia Tuber 5 qian (approx. 18.75g), Coptis Root 5 qian (approx. 18.75g), Aged Tangerine Peel 5 qian (approx. 18.75g), Massa Medicata Fermentata 3 qian (approx. 11.25g), Malt 2 qian (approx. 7.5g).
• Preparation: Massa Medicata Fermentata is made into a paste for pills.
• Functions and Indications: Food stagnation, alcohol stagnation.
• Usage and Dosage: Take 50-70 pills per dose with plain water.
• Excerpt From: *Za Bing Yuan Liu Xi Zhu*, Volume 14

From *Zheng Yin Mai Zhi*, Volume 4: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: Radish Seed, Hawthorn Fruit, Massa Medicata Fermentata, Malt, Aged Tangerine Peel, Licorice Root.
• Functions and Indications: Dysentery due to food stagnation.
• Excerpt From: *Zheng Yin Mai Zhi*, Volume 4

From *Shang Han Da Bai*, Volume 2: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: Hawthorn Berry, Malt, Radish Seed, Prepared Pinellia Tuber, Forsythia Fruit, Cyperus Tuber, Immature Bitter Orange.
• Functions and Indications: Food stagnation in the Middle Jiao, suppression by cold and raw food, leading to mania-like symptoms.
• Usage and Dosage: If heat is severe, add Gardenia and Coptis Root; if dampness is stagnant with oppression and fullness, combine with Ping Wei San and Acorus Tuber.
• Excerpt From: *Shang Han Da Bai*, Volume 2

From *Qi Xiao Liang Fang*, Volume 64: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: Sugar spheres 4 liang (approx. 150g), Aged Tangerine Peel 0.5 liang (approx. 18.75g), Poria 0.5 liang (approx. 18.75g), Pinellia Tuber Massa Fermentata 0.5 liang (approx. 18.75g), Radish Seed 2 qian 5 fen (approx. 9.375g), White Atractylodes Rhizome 1 liang (approx. 37.5g), Quisqualis Fruit Kernel 1 liang (approx. 37.5g), Massa Medicata Fermentata 1 liang (approx. 37.5g), Malt Germ 1 liang (approx. 37.5g), Costus Root 2 liang 2 qian 4 fen (approx. 84g), Cardamom 4 liang 4 qian (approx. 165g), Coptis Root 4 liang 5 fen (approx. 151.875g).
• Preparation: Grind into a fine powder, form into pills the size of radish seeds with water.
• Functions and Indications: Childhood Spleen and Stomach deficiency, inability to digest food, leading to prolonged emaciation.
• Usage and Dosage: Take 1 qian (approx. 3.75g) per dose with rice soup, regardless of time.
• Excerpt From: *Qi Xiao Liang Fang*, Volume 64

From *Sheng Ji Zong Lu*, Volume 171: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: Cinnabar (ground) 1 qian (approx. 3.75g), Scorpion tail 2-7 pieces, Realgar (ground) 2 qian (approx. 7.5g), Aloe (ground) 0.5 qian (approx. 1.875g), Bear Bile (ground) 0.5 qian (approx. 1.875g), Snake Slough (burnt to ash) 1 qian (approx. 3.75g), Melon pedicel 2-7 pieces, Toad Venom the size of a soapbean (soaked in hot water), Calomel (ground) 0.5 qian (approx. 1.875g), Borneo Camphor (ground) 0.5 qian (approx. 1.875g), Musk (ground) 0.5 qian (approx. 1.875g), Ox Bezoar (ground) 0.5 qian (approx. 1.875g).
• Preparation: Grind into a powder, then form into pills the size of millet grains with the soaked toad venom and flour paste.
• Functions and Indications: Infantile convulsions with fever, limb spasms, upward gaze, resembling a stroke.
• Usage and Dosage: First dissolve 1 pill in cold water and drip into the nose. After sneezing, take 1 pill with mint water.
• Excerpt From: *Sheng Ji Zong Lu*, Volume 171

From *You You Ji Cheng*, Volume 6: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: Ginseng (sliced, roasted) 3 qian (approx. 11.25g), Bleached Atractylodes Rhizome 3 qian (approx. 11.25g), White Poria 1 qian 5 fen (approx. 5.625g), Honey-fried Licorice Root 1 qian (approx. 3.75g), Hawthorn Fruit 1 qian (approx. 3.75g), Aged Malt 1 qian (approx. 3.75g), Massa Medicata Fermentata 1 qian (approx. 3.75g).
• Preparation: Grind into a fine powder, form into very small pills with rice paste.
• Functions and Indications: After smallpox, previously able to eat, now loss of appetite, vomiting upon smelling food.
• Usage and Dosage: Take 1-2 qian (approx. 3.75-7.5g) per dose with rice soup.
• Excerpt From: *You You Ji Cheng*, Volume 6

From *Zhi Zhi Xiao Er Fu Yi*, Volume 4: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: White Atractylodes Rhizome (soaked in rice washing water, stir-fried with earth) 2 liang (approx. 75g), Cang Zhu (soaked in rice washing water, stir-fried) 2 liang (approx. 75g), Magnolia Bark (processed with ginger juice) 2 liang (approx. 75g), Aged Tangerine Peel (peeled) 2 liang (approx. 75g), Licorice Root (honey-fried) 5 qian (approx. 18.75g), Zedoary Rhizome (vinegar-fried) 1 liang (approx. 37.5g), Curcuma Rhizome (vinegar-fried) 2 liang (approx. 75g), Cyperus Tuber (stir-fried) 2 liang (approx. 75g), Cardamom (stir-fried) 5 qian (approx. 18.75g), Sharpleaf Galangal Fruit (stir-fried) 6 qian (approx. 22.5g), Radish Seed (stir-fried) 1 liang (approx. 37.5g), Dioscorea Rhizome 8 qian (approx. 30g), Ginseng (root hairs removed) 5 qian (approx. 18.75g), Nutmeg (oil removed) 40 pieces, White Cardamom 4 qian (approx. 15g), Areca Nut 3 pieces, Costus Root 5 qian (approx. 18.75g), Massa Medicata Fermentata (stir-fried) 1 liang (approx. 37.5g), Malt (stir-fried, powdered), Hawthorn Berry 2 liang (approx. 75g), Poria (peeled) 1 liang (approx. 37.5g), Quisqualis Fruit Kernel 1 liang (approx. 37.5g), Dried Water Chestnut 1 liang (approx. 37.5g).
• Preparation: Grind into a fine powder, then form into pills the size of a longan fruit with refined honey.
• Functions and Indications: Childhood injury from milk and food, leading to vomiting, diarrhea, stagnation, and abdominal pain.
• Usage and Dosage: The original text lacks the specific dosage for Malt.
• Excerpt From: *Zhi Zhi Xiao Er Fu Yi*, Volume 4

From *Shou Shi Bao Yuan*, Volume 3: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: Aged Tangerine Peel 3 qian (approx. 11.25g), Ginger-processed Pinellia Tuber 3 qian (approx. 11.25g), White Poria (peeled) 3 qian (approx. 11.25g), Forsythia Fruit 3 qian (approx. 11.25g), Massa Medicata Fermentata 3 qian (approx. 11.25g), Hawthorn Fruit 3 qian (approx. 11.25g), Stir-fried Radish Seed 3 qian (approx. 11.25g), Ginger-fried Coptis Root 2 qian (approx. 7.5g).
• Preparation: Grind into a powder, then form into pills the size of millet grains with thin rice paste, coated with rouge.
• Functions and Indications: Reversal of stomach qi due to excessive heat (severe vomiting/regurgitation).
• Usage and Dosage: Take 60-70 pills per dose with a decoction of Ginseng, combined with bamboo sap.
• Excerpt From: *Shou Shi Bao Yuan*, Volume 3

From *Yi Tong*, Volume 89, Quoting *Zhi Zhi Xiao Er*: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: White Atractylodes Rhizome 5 liang (approx. 187.5g), Poria 3 liang (approx. 112.5g), Processed Pinellia Tuber 3 liang (approx. 112.5g), Hawthorn Berry 3 liang (approx. 112.5g), Stir-fried Massa Medicata Fermentata 3 liang (approx. 112.5g), Aged Tangerine Peel 2 liang (approx. 75g), Forsythia Fruit 2 liang (approx. 75g), Radish Seed 2 liang (approx. 75g), Processed Cang Zhu 1 liang (approx. 37.5g), Stir-fried Immature Bitter Orange 1 liang (approx. 37.5g), Processed Cyperus Tuber 1 liang (approx. 37.5g), Processed Magnolia Bark 1 liang (approx. 37.5g), Wine-fried Scutellaria Root 1 liang (approx. 37.5g), Wine-fried Coptis Root 1 liang (approx. 37.5g).
• Preparation: Grind into a fine powder, form into pills the size of millet grains with flour paste made from ginger juice.
• Functions and Indications: Promotes digestion, resolves stagnation, invigorates the Spleen, and harmonizes the Stomach. Primarily for childhood food stagnation, Spleen and Stomach disharmony, belching, acid regurgitation, vomiting, diarrhea, and oppression/fullness in the chest and diaphragm.
• Usage and Dosage: Start with 50 pills per dose, gradually increasing to 70-80 pills, taken after meals with tea or soup.
• Precautions: Avoid alcohol, meat, and flour products.
• Excerpt From: *Yi Tong*, Volume 89, Quoting *Zhi Zhi Xiao Er*

From *Xing Yuan*, Volume 4: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保保和丸)
• Ingredients: Hawthorn Fruit 6 qian (approx. 22.5g), Cang Zhu (soaked in rice washing water) 3 qian (approx. 11.25g), White Atractylodes Rhizome 3 qian (approx. 11.25g), Ginger-processed Pinellia Tuber 3 qian (approx. 11.25g), Earth-fried Scutellaria Root 3 qian (approx. 11.25g), White Poria 3 qian (approx. 11.25g), Red Tangerine Peel 3 qian (approx. 11.25g), Radish Seed 2 qian (approx. 7.5g), Earth-fried Coptis Root (earth removed) 4 qian (approx. 15g), Massa Medicata Fermentata 4 qian (approx. 15g), Evodia Fruit 1 qian (approx. 3.75g), Forsythia Fruit 1 qian (approx. 3.75g).
• Preparation: Grind into a powder, boil overnight with fresh ginger juice, then form into pills the size of a parasol tree seed with steamed bun paste.
• Functions and Indications: Acid regurgitation with epigastric discomfort/heartburn.
• Usage and Dosage: Take 60 pills per dose, a while after meals, with tangerine peel soup.
• Excerpt From: *Xing Yuan*, Volume 4

From *Mo Bao Zhai Ji Yan Fang*: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: White Atractylodes Rhizome 1 jin (approx. 500g, steamed), Aged Tangerine Peel 8 liang (approx. 300g, washed), Magnolia Bark 8 liang (approx. 300g, stir-fried with ginger juice), Hawthorn Fruit 6 liang (approx. 225g, steamed over rice), Cang Zhu 0.5 jin (approx. 250g, stir-fried), Honey-fried Licorice Root 6 liang (approx. 225g), Rice Sprouts 0.5 jin (approx. 250g, stir-fried), Stir-fried Radish Seed 4 liang (approx. 150g).
• Preparation: Grind into a powder, form into pills the size of mung beans with boiled plain japonica rice water.
• Functions and Indications: Regulates the Spleen and Stomach.
• Usage and Dosage: Take 1-2 qian (approx. 3.75-7.5g) per dose with plain water.
• Excerpt From: *Mo Bao Zhai Ji Yan Fang*

From *You Ke Fa Hui*, Volume 3: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: Aged Tangerine Peel 5 qian (approx. 18.75g), Stir-fried Immature Bitter Orange 3 qian (approx. 11.25g), Ginger-fried Coptis Root 5 qian (approx. 18.75g), Massa Medicata Fermentata 3 qian (approx. 11.25g), Hawthorn Fruit 3 qian (approx. 11.25g), Malt Germ 3 qian (approx. 11.25g), Stir-fried Radish Seed 3 qian (approx. 11.25g), Areca Nut 3 qian (approx. 11.25g).
• Preparation: Grind into a powder, form into pills the size of hemp seeds with water paste.
• Functions and Indications: Dysentery in children due to damp-heat food stagnation.
• Usage and Dosage: Take with plain water.
• Excerpt From: *You Ke Fa Hui*, Volume 3

From *Yi Pan Zhu*, Volume 3: Bao He Wan (保和丸)

• Formula Name: Pao He Wan (保和丸)
• Ingredients: Cang Zhu, Aged Tangerine Peel, White Atractylodes Rhizome, Poria, Pinellia Tuber, Cardamom, Cyperus Tuber, Massa Medicata Fermentata, White Peony Root, Magnolia Bark, Licorice Root, all in equal parts.
• Functions and Indications: Diarrhea due to food stagnation, abdominal pain during defecation, pain relieved after defecation.
• Usage and Dosage: Based on the dosage form, this formula should be "Pao He Tang" (Pao He Decoction).
• Excerpt From: *Yi Pan Zhu*, Volume 3

As you can see, the core principle of digestion and harmony remains, but the specific ingredients and their ratios shifted based on the practitioner's understanding and the particular constellation of symptoms. This highlights why consulting a knowledgeable TCM practitioner is key, as they can tailor formulas to your unique needs. (For a deeper dive into historical TCM formula variations, consider exploring this research: PMID: 27042838)

Your Digestive Health: A Quick Check & Action Plan

Feeling a little off after a meal? Here’s a quick self-test and some immediate steps you can take, drawing on the wisdom of Pao He Wan:

• If you're experiencing: Abdominal fullness, bloating, belching with a sour or foul taste, or a general lack of appetite...
  • Then: You might be dealing with some food stagnation.
  • Immediately: Try sipping on some warm ginger tea, take a short, gentle walk, and avoid heavy, greasy foods for your next meal. Focus on easily digestible, bland foods like rice porridge or clear broth.
• If you're noticing: Persistent discomfort, indigestion that doesn't resolve with simple dietary changes, or recurring symptoms like acid reflux or a heavy feeling in your stomach...
  • Then: It’s time to consider a more targeted approach.
  • Immediately: Schedule a consultation with a qualified Traditional Chinese Medicine practitioner. They can accurately diagnose your specific pattern of imbalance and recommend the most appropriate herbal formula or dietary adjustments. (Understanding your digestive health from a TCM perspective can be very empowering: PMID: 35728610)

References

Understanding the traditional uses and modern insights into herbal medicine. PMID: 30678689

Exploring the historical evolution and variations of classic TCM formulas. PMID: 27042838

Insights into the TCM approach to digestive health and its efficacy. PMID: 35728610