五皮饮

Converted to 5:1 granules:

48 g raw herbs ÷ 5 = 9.6 g granules.

Granule dose: Take dissolved in warm water in 2 doses, morning and evening, about 5 g per dose.

5. Cautions and clinical notes

• Contraindications:
  1. This formula is used for patterns of skin water edema due to Spleen deficiency with abundant dampness. It is not suitable for use alone in edema caused by Kidney yang deficiency or by wind-water exterior patterns.
  2. The water-disinhibiting force of this formula is relatively mild; severe edema requires combination with other formulas.
• Clinical modifications: This formula is a base formula for skin water edema and often requires modification in clinical use. If swelling is more severe above the waist accompanied by wind evil, Fang Feng (siler root) and Qiang Huo (notopterygium rhizome) may be added to disperse wind and dispel dampness. If swelling is more severe below the waist with scanty urination, this formula is often combined with Wu Ling San (Five Poria Powder) to enhance its water-disinhibiting effect.
• Modern applications: Mainly used for edema of nephritis, cardiogenic edema, edema of pregnancy, and ascites of liver cirrhosis where the pattern is identified as Spleen deficiency with abundant dampness and water overflowing into the skin.
• Duration of use: This formula is a dispersing (evil-expelling) formula; use should stop once the condition resolves. After the edema subsides, treatment should shift to a Spleen-strengthening formula to consolidate the effect and prevent recurrence.