Chapter Thirty-Two: Qi-Boosting and Phlegm-Clearing Drink, Dixian Pill, and Shenxianfu Guishui Formula
Regarding the etiology and treatment of obesity, the book *Shi Shi Mi Lu* states: "Obese people often have phlegm, which is due to qi deficiency. Deficiency prevents qi circulation, thus phlegm is generated. Therefore, treating phlegm cannot be limited to just treating the phlegm itself; one must replenish qi to simultaneously eliminate the phlegm. However, replenishing qi should not simply involve replenishing the spleen and stomach (earth element), but should also replenish the kidney's fire element (fire element). Fire generates earth, and earth generates qi. When qi is sufficient, phlegm naturally disappears. Treating phlegm without treating the phlegm itself is the way to treat phlegm." This formula not only replenishes the spleen and qi but also nourishes the kidneys and warms the kidney's life force; it not only replenishes the spleen and kidneys and promotes water metabolism but also eliminates phlegm, thus treating the symptoms. From a modern pharmacological perspective, this formula can stimulate the central nervous system, promote energy metabolism, and has functions such as suppressing appetite and promoting urination; therefore, it should also have some weight-loss function. This formula is suitable for obesity caused by spleen and kidney qi deficiency and internal obstruction of phlegm and dampness. From a Western medical perspective, it is most suitable for simple obesity of the edema type.
Those with damp-heat obstruction or kidney heat accumulation should avoid or use with caution.
3. Qi-tonifying and phlegm-reducing decoction
This prescription can be used by obese people.
Ginseng 3 qian, Atractylodes macrocephala 5 qian, Poria cocos 3 qian, Rehmannia glutinosa 1 liang, Cornus officinalis 4 qian, Cinnamomum cassia 1 qian, Amomum villosum 1 qian, Alpinia oxyphylla 1 qian, Pinellia ternata 1 qian, Citrus reticulata 5 fen, Massa fermentata 1 qian. Decocted
[Note] This formula originates from Chen Shiduo's *Shishi Milu* (Secret Records of the Stone Chamber) from the Qing Dynasty. The ginseng, atractylodes macrocephala, poria cocos, amomum villosum, and medicated leaven in the formula tonify the spleen, replenish qi, harmonize the stomach, and promote water metabolism. Rehmannia glutinosa and cornus officinalis nourish the liver and kidneys, replenish blood, and benefit essence. Cornus officinalis can suppress appetite and reduce weight; Rehmannia glutinosa, being rich and moistening, can cause "fullness in the middle jiao (abdominal distension) and impaired appetite." The above-mentioned medications achieve weight loss through three mechanisms: enhancing energy metabolism, promoting diuresis to reduce weight, and suppressing appetite to reduce intake. These are all commonly used weight-loss medications.
Alpinia oxyphylla warms the spleen and kidneys, and consolidates qi and essence. The *Ben Cao Qiu Zhen* states, "Alpinia oxyphylla has a pungent and hot nature, and its function is specifically to dry the spleen and warm the stomach. It astringes the rebellious qi of the spleen and kidneys, and restores their original state, hence it is also known as a tonic for the heart and life." The *Shi Shi Mi Lu* believes that "when the fire of the pericardium is sufficient, it can open the stomach to eliminate disease; when the fire of the gate of life is sufficient, it can strengthen the spleen to eliminate dampness." Once phlegm and dampness are eliminated, obesity will naturally subside. Cinnamon is also a tonic for the heart and life, with similar but stronger effects to Alpinia oxyphylla, enabling the body to reach a state of harmony between heaven and earth, and balance between water and fire. As the *Shi Shi Mi Lu* says, "Cinnamon, among tonics, promotes harmony between heaven and earth. Water returns to its proper channels, and phlegm accumulates." Tangerine peel and Pinellia ternata function to dry dampness and resolve phlegm; their use in this formula is intended to treat the symptoms of phlegm and dampness.
Regarding the functions of this formula, the original text states, "This formula treats qi deficiency while simultaneously replenishing kidney water and kidney fire. When kidney water is sufficient, the qi of the spleen and stomach naturally strengthens, and phlegm gradually dissipates. This formula can be used by obese individuals." Therefore, this formula is a dual-tonifying agent for the spleen and kidneys, replenishing both spleen qi and kidney water and fire; furthermore, it also has the effect of drying dampness and resolving phlegm. From a modern pharmacological perspective, this formula can stimulate the central nervous system, promote the decomposition and metabolism of substances, suppress appetite, reduce food intake, and promote diuresis and reduce swelling, making it a multifaceted weight-loss formula. This formula is used for obesity due to deficiency of both the spleen and kidneys. From a Western medical perspective, this formula is most suitable for simple obesity of the edema type.
Those with phlegm-heat obstruction or kidney heat accumulation should use it with caution or avoid it altogether.
4. Di Xian Wan (地仙丸)
It treats wind-related ailments, replenishes vital energy, invigorates blood circulation, strengthens muscles and bones, moisturizes the skin, improves hearing and vision, prolongs life, preserves youthful appearance, and prolonged use leads to a lighter body.
Astragalus membranaceus, chopped and stir-fried; Arisaema heterophyllum, processed; Notopterygium incisum, root removed; Clematis chinensis, stir-fried; Pheretima aspergillum, soil removed; Drynaria fortunei, stir-fried; Saposhnikovia divaricata, forked removed; Phaseolus angularis, picked; Cibotium barometz, hair removed; Tribulus terrestris, stir-fried; Lindera strychnifolia, wood removed; Aconitum carmichaelii, processed; Aconitum carmichaelii, processed, skin and navel removed; Dioscorea hypoglauca; each half an ounce. Achyranthes bidentata, soaked in wine, sliced and roasted, one ounce. Momordica cochinchinensis, shelled, three fen.
Grind into a fine powder, mix with wine-cooked flour paste to form pills the size of a paulownia seed. Take twenty pills each time, on an empty stomach with salt water, tea, or wine. This medicine is suitable for men suffering from chronic coldness, weakness of vital energy, and pain in the hands and feet.
[Note] This formula originates from Fang Xian's *Qixiao Liangfang* (奇效良方) of the Ming Dynasty. Astragalus membranaceus (Huangqi) in the formula tonifies the middle energizer, replenishes qi, promotes diuresis, and reduces swelling; it is also a commonly used weight-loss drug throughout history, and current clinical reports indicate it has good weight-loss effects. Arisaema heterophyllum (Tiannanxing) dries dampness, resolves phlegm, dispels wind, calms the nerves, reduces swelling, and dissipates nodules. Notopterygium incisum (Qianghuo) disperses wind-cold, dispels wind, and eliminates dampness. Saposhnikovia divaricata (Fangfeng) disperses wind-cold, eliminates dampness, and relieves pain; it is also a commonly used weight-loss drug in ancient times. For example, the *Shennong Bencao Jing* (神农本草经) states that "long-term use lightens the body." Regarding the principle of Saposhnikovia divaricata's weight-loss effect, the *Bencao Jing Shu* (本草经疏) says: "How can a dispersing medicine be taken for a long time? Its claim of lightening the body is merely the removal of dampness." The use of Notopterygium incisum in this formula likely reflects this principle.
Red beans are known for their diuretic and dampness-removing properties, as well as their ability to promote blood circulation and drain pus. They have been a commonly used weight-loss remedy throughout history. For example, the *Shixing Bencao* (Food and Herbal Materia Medica) states that they "shrink qi, promote wind, strengthen tendons and bones, and reduce muscle mass; prolonged consumption leads to weight loss." The *Yibu Quanlu* (Complete Records of Medical Prescriptions) also records that "red beans can make people thin; prolonged consumption leads to dark, thin, and dry skin; those who are overweight can also consume them." The *Shennong Bencao Jing Jizhu* (Collected Annotations on Shennong's Materia Medica) also says that "red beans expel body fluids and promote urination; prolonged consumption leads to dryness." Regarding the principle behind red beans' weight-loss effect, the *Bencao Gangmu* (Compendium of Materia Medica) states that "prolonged consumption leads to excessive downward movement, causing the loss of body fluids, thus resulting in muscle loss and a heavy body." The use of *Bixie* (Dioscorea hypoglauca) here to dispel wind and dampness may serve the same purpose as red beans.
*Drynaria fortunei* tonifies the kidneys and strengthens bones, invigorates blood and stops bleeding. *Cibotium barometz* and *Achyranthes bidentata* tonify the liver and kidneys, strengthen tendons and bones. *Aconitum carmichaelii* restores yang and tonifies fire, dispels cold and dampness. *Fennel seeds* (also known as fennel) warm the kidneys, dispel cold, harmonize the stomach and regulate qi. *Lindera strychnifolia* regulates qi, relieves stagnation, dispels cold and relieves pain. *Tribulus terrestris* dispels wind and improves eyesight, dispels dampness and breaks up blood stasis, reduces swelling and dissipates nodules. Studies have shown that *Tribulus terrestris* has diuretic and antihypertensive effects, and recently it has been found to suppress appetite and contain psychoactive substances. *Aconitum carmichaelii* dispels wind and phlegm, and expels cold and dampness. *Momordica cochinchinensis* seeds are the mature seeds of *Momordica cochinchinensis*, a perennial herbaceous vine of the Cucurbitaceae family. They contain sterols, oleanolic acid, *Momordica cochinchinensis* acid, saponins composed of gossypol saponins, α-keto acids, and trichosanthes acid. They also contain abundant oils, proteins, and trehalose. *Momordica cochinchinensis* seeds are bitter and slightly sweet, warm in nature and toxic, and function to reduce swelling and dissipate nodules. *Earthworm* clears heat, calms the nerves, unblocks the meridians and detoxifies.
This formula not only invigorates Qi and warms Yang, but also dries dampness and resolves phlegm, while simultaneously dispelling wind and promoting blood circulation. Ancient people believed that obesity was often caused by internal stagnation of phlegm and dampness, which in turn was often due to Qi deficiency and impaired Yang transformation. This formula warms and invigorates Yang, while also resolving phlegm and eliminating dampness, treating both the root cause and the symptoms, thus naturally curing obesity. Although this formula is for weight loss, many of its ingredients are kidney-warming and Yang-tonifying. Traditional Chinese medicine believes that the kidneys are the source of life, the gate of life, and the essence manifests in the ears and eyes. Therefore, this formula can also promote longevity and improve hearing and vision. Furthermore, this formula dispels wind and dampness, and promotes blood circulation, thus it can also treat various ailments such as pain in the hands and feet.
This formula contains mostly warming and drying ingredients, so it should be avoided by those with yin deficiency and internal heat, kidney excess and heat accumulation, or phlegm-heat obstruction.
5. A recipe for immortals to drink cassia water to make their bodies light and healthy.
Three ounces of cinnamon bark, pounded and ground into powder; three liters of scallion broth.
Take the right side of the mixture, put it in a green bamboo tube, and steam it on a steamer for three days and three nights. After it cools down, take it out and take half a box each time, mixed with wine. Take it three times a day. If you take it for a long time, you will be able to walk on water and become an immortal.
[Note] This formula comes from *Taiping Shenghui Fang*, compiled by Wang Huaiyin and others during the Song Dynasty. The main ingredient, onion sap, also known as onion juice, is the juice extracted from the stem or whole plant of the perennial herbaceous plant *Allium chinense* (Liliaceae family). It is pungent and warm in nature. *Mingyi Bielu* states that it "treats hematuria and, when drunk, counteracts the poisoning of Veratrum nigrum and cinnamon." *Compendium of Materia Medica* states that it can "disperse blood stasis, stop nosebleeds, and relieve pain. It treats headaches, deafness, hemorrhoids, and detoxifies various poisons." It also says, "Onion juice is onion sap, with the same effects as onion whites. Ancient formulas often used onion sap pills, also for its ability to disperse wind-heat in the upper burner." Regarding the function of onion whites, *Yongyao Xinfa* says it can "unblock yang qi and disperse wind-evil." *Bencao Jing Shu* says, "Onion, pungent, can disperse, can relieve muscle tension, and can unblock yang qi in the upper and lower parts of the body." Therefore, onion sap should have the functions of releasing exterior pathogens, unblocking yang, dispersing blood stasis, and detoxifying. Studies have shown that onion snot contains volatile oils, the main component of which is allicin, as well as diallyl sulfide. Onion snot also contains vitamin C, vitamins B₁ and B₂, niacin, fatty oils, and mucilage. The main component of the mucilage is carbohydrates. Pharmacological studies have shown that onion snot has an excitatory effect on the central nervous system and also possesses lipid-lowering, anti-tumor, antibacterial, antifungal, and antitrichomonal effects. Ancient people believed that dispersing medicines often deplete bodily fluids, thus also having a weight-loss effect. For example, the *Ben Cao Jing Shu* states, "Dispersing medicines cannot be taken for a long time; their claim of lightening the body is merely due to the removal of dampness." From a modern pharmacological perspective, central nervous system stimulants and lipid-lowering drugs often have a weight-loss effect.
Cinnamon bark is obtained by scraping off the cork from cinnamon bark. Its effects are similar to cinnamon bark, including tonifying heart yang, warming the spleen and stomach, dispelling cold accumulation, and promoting blood circulation. This formula is mainly used as a heart-warming and life-tonifying medicine. Ancient people believed that sufficient heart and kidney fire could dispel phlegm and dampness. As stated in *Shi Shi Mi Lu* (Secret Records of the Stone Chamber): "Sufficient pericardial fire can open the stomach to dispel phlegm, and sufficient kidney fire can strengthen the spleen to dispel dampness." Because cinnamon bark can tonify both the heart and kidneys, it has the function of harmonizing the heart and kidneys. Ancient people believed that "when heaven and earth are in harmony, water naturally returns to its proper channels; where does phlegm accumulate? This is the treatment method for obese people."
This prescription can promote the flow of Yang energy, dispel blood stasis, and promote water metabolism, making it suitable for obesity caused by deficiency of both heart and kidney Yang. From a modern pharmacological perspective, using this prescription for weight loss also has some merit.
All the herbs in this formula are pungent and warm in nature, so it should be avoided by those with yin deficiency and internal heat or kidney excess and heat accumulation.