“Wu Pi San” and “Wu Pi Yin”. Oksana Nachataia.

Good afternoon, dear colleagues! If you had a minute of free time, and you wanted to clarify for yourself some vague questions related to TCM recipes, then here is one of them. At the recipe seminars, we try to focus on the differential diagnosis of prescriptions (by the way, very soon a workshop on TCM recipes is scheduled). As you can see, in the classics there are several such pairs of recipes with almost the same name, often very similar in mechanism of action. And in practice it is sometimes important to know accurate information on their purpose. One such pair is Wu Pi San and Wu Pi Yin. What are their differences and similarities?

As is known, the recipe for Wu pi san was invented in ancient times. We can find a description of this recipe from the famous classic Hua Tuo in the treatise Zhong Zang Jing, 220 (“Precious Classics”). The recipe consists of five ingredients. Sheng jiang pi – 9, sang bai pi – 9, chen pi – 6-9, da fu pi – 6-9, fu ling pi – 9.

The name Wu Pi San literally translates as “powder of five skins”. And the essence of the recipe lies in the presentation of the TCM about tropism and the similarity of everything in nature, that is, “the skin has the tropism to the skin.” Referring to the group that removes dampness and dispels swelling, this recipe expels water that has accumulated under the skin. Edema occurs against the background of a weak spleen, when its function as a “water source” is impaired. There are many recipes for the expulsion of edema. The indications for using Wu Pi San are water retention and skin pastos, when the relief lines of the body and limbs are smoothed, the contours of the figure loses its shape like wax. Even against the background of thinness, the whole body flabbiness is observed. The face is usually pale, pasty, slightly yellowish. These symptoms are accompanied by severe weakness, fatigue, exhaustion. At the same time we can see general edema, fluid retention in the body. Many other symptoms of deficiency of the spleen are present. The condition of emptiness is rather heavy. For example, such a syndrome often appears after chemotherapy at the treatment of tumors; in case of toxicosis of pregnant women, when the spleen was initially very weak; after severe mental fatigue.

The main ingredient (jun yao) is fu ling pi, as it removes swelling, removes dampness and strengthens the spleen. Fu ling has the ability to remove water from top to bottom, “wipe out” dampness, while carefully preserving qi. Sang bai pi has tropism to the lungs, removes both phlegm and dampness. According the theory of TCM the lungs are the “son” of the spleen. Therefore, normalizing the lungs, sang bai pi indirectly improves the exchange of water in the body, contributing to its excretion. Da fu pi, in addition to diuretic properties, still has the property of “loosening the chest.” That is, da fu pi removes the rigidity of the chest, which appears due to the accumulation of water. Chen pi moves qi in the middle Jiao, helps normalize spleen function, removes phlegm, removes swelling. Sheng jiang pi, sharp and warm in nature, removes water through diaphoretic action, “opens” the lungs, soothes the stomach, relieves nausea. The whole recipe is very soft, safe and has a narrow specificity in its action. In mild cases, it can be used in case of pasty face, swelling around the eyes against the background of various exhaustion, especially mental fatigue. In practice, this recipe is often used as part of the general medical course, as a separate unit in the general scheme. For example, if the body is affected by external dampness and wind (which happens quite often), add fang feng and qiang huo. Wu pi san goes well with recipes that bring out dampness from internal cavities when it is necessary, as well as with means that gently strengthen the spleen and move qi.

The recipe Wu Pi Yin is very similar in its action.

Di gu pi – 9, wu jia pi – 9, da fu pi – 9, fu ling pi – 9, sheng jiang pi – 9 (+ sang bai pi-3, chen pi – 3).

This recipe was included in “Tai Ping Hui Min He Ji Ju Fang” (“Recipes for the benefit of the civilian population”), the first state recipe guide in China (and probably all over the world), created in 1107 by Chen Shi Leng . This recipe is also mentioned in the “Ma Ke Huo Ren Quan Shu” edition (“Saving the lives of children with a rash”), dated 1748 and posted by Xie Yu Qiong. A distinctive feature is the addition of two ingredients – Di gu pi and Wu jia pi. Thise are also the skins. Both ingredients have a diuretic effect, so the main vector of the recipe does not change. But wu jia pi strengthens bones and ligaments against the background of a weak kidney and liver, and di gu pi has the property of treating fever “xu re” during prolonged exhaustion, hormonal imbalance, deficiency of yin, blood, normal fluids. Doses of sang bai pi and chen pi in this recipe are significantly reduced, or these ingredients are completely excluded from the recipe. Thus, the recipe Wu pi yin is also used for subcutaneous edema on the background of a weak spleen, but when there is still pain in the body, swelling is more in the joints, weakness of the ligaments and muscles. This recipe is more suitable for patients who have not only exhausted the spleen, but also have a lack of kidney and liver blood, especially against the background of hormonal disorders, after prolonged debilitating diseases, with a strong weather dependence with a tendency to retain fluids in the skin. The recipe Wu pi yin can be taken for a long time or several courses, since Wu jia pi has the property to strengthen the ligaments and bones, strengthen the heart muscle. By nature, it is warm, but in the recipe there is di gu pi, which prevents the occurrence of empty heat (“xu re”) and compensates for the warm properties of wu jia pi. I would be glad if this information will be useful for you!