Herb Formulas Notebook

San Wu Bei Ji Wan

Three Substance Pill Prepared for Emergencies

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Source: Essentials from the Golden Cabinet (c. 220)
Author: Zhang Ji / Zhong-Jing

Category: Formulas that Drain Downward

Pattern: Sudden onset of severe Cold Accumulation due to Cold Food Stagnation in the Stomach and Intestines

Key Symptoms: Sudden epigastric and abdominal pain and distention with pain so intense it feels as if "an awl is piercing the abdomen", rough uneven breathing, cyanotic complexion, no bowel movements
Secondary Symptoms: In severe cases there may be loss of consciousness with the mouth tightly closed. This is a life threatening condition and should be referred to hospital.

Tongue: Bluish-purple with a white coating
Pulse: Submerged and tight

Ba Dou 30g
Gan Jiang 30g
Da Huang 30g

In the UK Ba Dou is substituted with Wu Zhu Yu and generally used for less severe presentations but when Cold accumulation needs to be vigorously purged.

Preparation: Ground into powder and taken in 0.6 - 1.5g doses with rice water or warm, boiled water. Maybe be taken in powdered form or rolled into pills with honey. For patients unable to open their mouth it can administered through a nasogastric tube (not usually done in the UK).

Actions: Harshly purges Cold accumulation

Contraindications: Weak and pregnant patients, or in cases of acute abdominal pain due to Heat or Summerheat.

Several of the symptoms associated with this formula such as cyanotic complexion, bluish-purple tongue, lack of bowel movement and loss of consciousness are red flags that need to be urgently referred to hospital. Its inclusion is mainly for reference of when it was used historically and may still be in TCM hospitals in China. If used in the UK with Ba Dou substituted for Wu Zhu Yu it may still be a useful for if a less severe presentation is encountered where a strong purgative action for a Cold accumulation is encountered.

Research Links:
Science Direct
Google Scholar
Journal of Chinese Medicine
American Dragon

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.