Herb Formulas Notebook

Wu Mei Wan

Mume Pill


Author: Zhang Zhong-Jing, 張仲景

Year: c. 220

Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)


Category: Formulas that Expel Parasites

Pattern: Jueyin patterns: inversion due to Roundworms; Cold in the Zang Organs; Heat in the Stomach and/or Liver with Cold in the Intestines.

Key Symptoms: Treats 3 separate patterns:
1. Unquenchable thirst (Xiao Ke ), Qi rushing upwards towards the Heart, pain and heat in the Stomach, hunger with no desire to eat and eating induces vomiting of worms while downward purging results in unceasing diarrhoea with cold extremities
2. Intermittent attacks of abdominal pain, a stifling sensation with irritability and warmth in the chest and epigastrium, vomiting after eating, cold hands and feet
3. Chronic diarrhoea with discharge of small amounts of pus, abdominal pain that responds favourably to pressure or warmth, borborygmus

Tongue: Red body, white coat
Pulse: Frail
Abdomen: Tight in lower abdomen that responds favourably to pressure


Ingredients

Wu Mei 24-30g (300 pieces)
Hua Jiao 1.5-3g (4 liang)
Xi Xin 1.5-3g (6 liang)
Huang Lian 9-12g (16 liang)
Huang Bai 6-9g (6 liang)
Gan Jiang 6-9g (10 liang)
Zhi Fu Zi 3-6g (4 liang)
Gui Zhi 3-6g (6 liang)
Ren Shen 6-9g (6 liang)
Dang Gui 3-9g (4 liang)

Subsitutions:
In the UK Xi Xin and Fu Zi have to be substituted. Standard suggestions for them do not seem to fit very well and are often already in the formula (e.g. Gan Jiang and Gui Zhi).

For Xi Xin, Zi Su Ye may suffice for its warm acridity and actions on vomiting, fullness the Middle Jiao, releasing the exterior and being one of the chief herbs for Gu Parasites. If Gu is suspected then Bai Zhi and Bo He could also be added.

For Fu Zi the Gan Jiang and Gui Zhi can be used at their maximum dosages and some other warming herbs for abdominal pain like Ding Xiang, Xiao Hui Xiang, Gao Liang Jiang or Mu Xiang to warm and move the Middle. Yi Zhi Ren and Rou Dou Kou are other considerations if there is excessive diarrhoea and discharge and astringing the bowel is desired. Wu Zhu Yu is also a possibility if vomiting is a main concern, as this addition introduces Zuo Jin Wan to the formula, while also being a Jueyin herb and stopping diarrhoea.


Preparation: Originally the dosages in parentheses were used. Wu Mei is steeped in vinegar, pitted, mashed and cooked with rice until the rice is done. The remaining ingredients are ground into a powder and mixed with the Wu Mei paste, then formed into small pills with honey. Take 10 pills 3x a day before meals.

At present Wu Mei is soaked in a 50/50 vinegar water mixture, pitted, mashed and mixed with the other ingredients, dried, ground into powder and formed into pills with honey. 9g are taken with warm water 1-3 times per day on an empty stomach.

Can also be taken as a decoction using the dosages above. Wu Mei can be soaked in vinegar before decocting.


Actions: Warms the Yin organs, drains Heat, calms roundworms, drains the Liver, calms the Stomach

Contraindications: Explosive diarrhoea, Damp-Heat dysenteric disorders



Notes:
Liu Lihong (2019: 590-4, Classical Chinese Medicine) contemplates the construction of this formula. He suggests that the warming herbs, which appear to be directed at all different divisions, are shepherded towards Jueyin by the sour Wu Mei acting as chief herb, to enable the latent Yang to burst forth from Yin, allowing winter to become spring. Huang Lian and Huang Bai then act to clear Heat from the stagnant Yang.

For a video on how it is traditionally made, see https://youtu.be/sWwtXRVMFlo?si=3TViTGpXkzx-LZCt.



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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.