Jian Pi Wan (Spleen-Fortifying Pill) jiàn pí wán · 健脾丸

Safety. Jian Pi Wan is recorded in Zhengzhi Zhunsheng, Wang Kentang's early-seventeenth-century compendium. Its thirteen herbs read more usefully in four layers than as a list. The first layer is the base: bai zhu, ren shen, fu ling and gan cao, the four herbs of the classical spleen-supplementing combination. The second is the group that disperses: shan zha, shen qu and mai ya, traditionally paired with three kinds of accumulation — meat, fermented and starchy foods, and grain. The third moves qi: chen pi, sha ren and mu xiang, included on the classical argument that accumulation clears more readily once movement is restored. The fourth is the binders and the clearer: shan yao and rou dou kou to bind, huang lian to clear the heat classical writers expected where food sits too long. Two things deserve to be said plainly. First, the name is itself a claim about priority: this is a formula that supplements more than it disperses, and the classical commentaries frame it for accumulation in a person whose digestion is already weak, not for a single heavy meal in a robust person. Second, the name is not unique. Several distinct formulas in the literature are called jian pi wan, and the later patent preparation ren shen jian pi wan is a different composition. This entry describes the Zhengzhi Zhunsheng version and does not adjudicate between them. A modern reader should know what indigestion can be. Persistent upper abdominal discomfort with unintentional weight loss, difficulty swallowing, vomiting that does not settle, black stools or anaemia, or indigestion beginning after the age of fifty warrants endoscopic assessment rather than self-management. Helicobacter pylori infection, coeliac disease, pancreatic insufficiency, gastroparesis and several common medicines all present this way, and pulse and tongue examination cannot separate them. Safety. This is a compound formula containing gan cao, and prolonged daily intake of licorice is associated with pseudoaldosteronism — sodium and water retention, potassium loss and raised blood pressure. Huang lian contains berberine, which inhibits several drug-metabolising enzymes and transporters and displaces bilirubin, and is therefore unsuitable in jaundiced newborns and in G6PD deficiency. Mu xiang must be the correct aucklandia root: the similarly named qing mu xiang is an Aristolochia species containing aristolochic acid and is prohibited, while true Saussurea costus is listed under CITES. Mai ya is barley malt and shen qu is a fermented mass prepared with wheat bran, so both are gluten sources. Rou dou kou is nutmeg, which is neurotoxic in large amounts; culinary exposure and daily medicinal intake are not the same arithmetic. Shan zha has cardiovascular activity whose benefit here has not been established. The evidence on ren shen and warfarin is genuinely mixed, and this library reports it as mixed rather than choosing a side. Several herbs in this formula are traditionally listed as cautioned in pregnancy. This library does not claim the formula improves appetite or treats indigestion.