Ban Xia Xie Xin Tang — Pinellia Decoction to Drain the Epigastrium

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Conditions treated
5. Cautions

Overview

Ban Xia Xie Xin Tang — Pinellia Decoction to Drain the Epigastrium — is one of the most important formulas from Zhang Zhongjing’s Shang Han Lun for harmonising the Stomach and intestines when both Hot and Cold pathological factors are simultaneously present. It is the principal formula for the pattern known as “Stomach Qi disharmony with mixed Hot-Cold obstruction” — a pattern characterised by symptoms that appear contradictory (simultaneous heat and cold signs) and which commonly underlies modern conditions such as IBS, functional dyspepsia and gastro-oesophageal reflux. The formula’s elegant design uses bitter, cold herbs to drain Heat and pungent, warm herbs to disperse Cold, creating a harmonising effect on the Stomach and intestines.

TCM pattern

Prescribed for Stomach Qi disharmony with Hot-Cold obstruction in the Middle Jiao, characterised by: a sensation of fullness and stuffiness in the epigastrium (without pain), nausea and vomiting, borborygmus (intestinal gurbling) and loose stools or diarrhoea, a greasy yellow or white tongue coating, and a wiry pulse. The epigastric fullness is the defining symptom — not pain, but a sense of obstruction and discomfort. This pattern can arise from improper treatment of Cold conditions that drives the pathogen inward, or from a constitutional mixed Hot-Cold constitution.

Key herbs

1. Ban Xia (Pinellia ternata rhizome, processed) — the principal herb; dries Dampness, descends Rebellious Qi, stops nausea and disperses the Cold component of the obstruction
2. Huang Lian (Coptis chinensis rhizome) — the most bitter Cold herb in TCM; clears Heat and drains the Hot component; particularly targets Stomach Heat
3. Huang Qin (Scutellaria baicalensis root) — clears Heat and dries Dampness; works with Huang Lian to address the Heat component
4. Gan Jiang (dried Zingiber officinale rhizome) — warms the Middle Jiao and disperses Cold; works with Ban Xia to address the Cold component
5. Ren Shen (Panax ginseng root) — tonifies Spleen Qi to support the harmonising action and prevent the formula from damaging the Middle Jiao
6. Da Zao (Ziziphus jujuba fruit) — nourishes Blood and Spleen Qi; harmonises the formula
7. Zhi Gan Cao (honey-fried Glycyrrhiza root) — tonifies Qi and harmonises all herbs

Conditions treated

1. IBS with mixed Hot-Cold pattern — the most clinically important modern application; particularly where simultaneous diarrhoea and heat sensations coexist with cold pain
2. Acid reflux and gastro-oesophageal reflux disease (GORD) from Stomach Qi disharmony
3. Functional dyspepsia and epigastric fullness after meals
4. Nausea and vomiting from Stomach Qi disharmony with mixed Hot-Cold pattern
5. Crohn’s disease and ulcerative colitis with Hot-Cold mixed pattern
6. Chronic gastritis and Helicobacter pylori infection with Stomach Heat and Cold mixed pattern

Cautions

Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). Online herbal consultations are available. See the prices page for costs.