What Shi Pi Yin is for
This is the formula for skin that has gone cold, pale and doughy with swelling, most often on the face, the ankles or the limbs. The tissue feels heavy and waterlogged rather than hot and red, and it pits under the finger. The formula warms the Yang that moves fluid, fortifies the Spleen and drains what has already gathered.
The surface picture is cold, waterlogged tissue. The face, ankles or limbs look puffy and pale, the swelling feels doughy and keeps a mark when pressed, and the skin is cool rather than warm. It is not red, not hot and not tender in the way an inflamed eruption would be; it simply holds fluid and looks heavy. The same picture often comes with a sense of cold and heaviness in the body, and a pale swollen tongue with a wet white coat confirms it.
Zhi Fu Zi warms the Kidney Yang that drives water metabolism and Gan Jiang warms the middle as the leading herb; Fu Ling, Bai Zhu and Da Fu Pi move the accumulated fluid out; Mu Gua relaxes the sinews and eases the heavy feeling; Hou Po, Mu Xiang and Cao Guo keep Qi moving so the middle can work; Gan Cao, Sheng Jiang and Da Zao support the middle. Warming, drying and moving run together, so the fluid is not pushed out while the source stays cold.
It is not for swelling that is hot and red with heat signs, which needs clearing rather than warming, and it is contraindicated in pregnancy because of Fu Zi. Because Fu Zi is a strong herb, the formula is used under supervision. New, one-sided or progressive swelling is not a pattern to treat at home and needs medical assessment first.
Actions
- Warms Yang and fortifies the Spleen
- Moves Qi and drains Dampness
- Reduces cold swelling
- Supports digestion and fluid transformation
Properties
- Taste and temperature: Predominantly pungent and bitter with a sweet note. Pungent and hot warm and move, bitter dries Dampness, sweet supports the middle.
- Organs: Spleen, Kidney, Stomach
- Channels: Spleen, Kidney, Stomach
The pattern behind it
The pattern is Spleen and Kidney Yang deficiency with Dampness and cold swelling. The weak Spleen cannot transform fluids and the cold Yang cannot move them, so they accumulate and the body feels cold and heavy. The formula warms, fortifies and drains, which is why it is used for cold swelling with poor digestion.
Composition
The herbs in Shi Pi Yin, with their role and dose.
| Role | Herb | Dose | Properties | Why it is there |
|---|---|---|---|---|
| Zhi Fu Zi | 3 to 9 g | Hot, Pungent, sweet | Warms the Kidney Yang that drives water metabolism; requires supervision. | |
| King | Gan Jiang | 3 to 6 g | Hot, Pungent | Warms the middle and dispels Cold, the central warming herb. |
| Fu Ling | 9 to 15 g | Neutral, Sweet, bland | Drains Dampness and supports the Spleen. | |
| Bai Zhu | 6 to 12 g | Warm, Bitter, sweet | Strengthens the Spleen and dries Dampness. | |
| Mu Gua | 6 to 9 g | Warm, Sour | Relaxes the sinews and transforms Dampness, easing the heavy feeling. | |
| Hou Po | 3 to 6 g | Warm, Bitter, pungent | Moves Qi and dries Dampness, relieving the abdominal fullness. | |
| Mu Xiang | 3 to 6 g | Warm, Pungent, bitter | Moves Qi and relieves distension, helping the middle to function. | |
| Da Fu Pi | 6 to 9 g | Slightly warm, Pungent | Moves Qi and drains fluid, addressing the swelling directly. | |
| Cao Guo | 3 to 6 g | Warm, Pungent | Dries Dampness and warms the middle, reducing the heavy damp feeling. | |
| Gan Cao | 3 to 6 g | Neutral, Sweet | Harmonises the formula and supports the middle. | |
| Sheng Jiang | 3 slices | Slightly warm, Pungent | Warms the middle and helps the formula digest. | |
| Da Zao | 3 to 5 dates | Warm, Sweet | Supports the middle and harmonises. |
Patterns it treats
Spleen and Kidney Yang Deficiency
Cold, pale, doughy swelling of the face, ankles or limbs, where the tissue looks waterlogged and feels heavy rather than hot and red. The puffiness keeps a mark when pressed and the surface stays cool.
How the formula is built
The formula warms and drains at once: Fu Zi and Gan Jiang restore the fire, Fu Ling, Bai Zhu and Da Fu Pi move the fluid out, and the aromatic group keeps the Qi moving so the middle can do its work. That is why it is used for cold swelling with stagnation rather than for simple fluid retention.
Skin conditions it is used for
Where this formula appears in the skin conditions of the library.
Preparation and use
Decocted in water and taken warm, in two divided doses, under professional supervision.
Modifications
- If the swelling is marked, the draining herbs are increased.
- If Cold dominates, the warming is increased carefully.
- If the Qi stagnation is prominent, the moving herbs are increased.
- If heat signs appear, the warming is reduced.
Timing
Taken warm in two divided doses.
Duration
One to four weeks for an acute episode, reassessed by a practitioner.
Diet while taking it
Warm food, reduced salt, no cold drinks.
Safety
Contraindications
Avoid in Yang-type oedema, where the swelling is hot and red with heat signs. Contraindicated in pregnancy. Requires supervision because of Fu Zi.
Interactions
Fu Zi can affect heart rhythm and interacts with cardiac medication. The draining herbs can add to diuretics.
Pregnancy
Contraindicated. The formula contains Fu Zi, which is prohibited in pregnancy.
Breastfeeding
Use only under professional guidance.
Children
Used only with professional supervision.
Before you use it
Recorded from the classical record and rewritten in this project's own words. Educational only: not a prescription, and new or progressive swelling needs medical assessment.
General safety references
General references for herbal hepatotoxicity and herb-drug interactions; they are not specific to this formula.
- Review article: Herbal hepatotoxicity - an update on traditional Chinese medicine preparations. Alimentary Pharmacology & Therapeutics, 2014. PMID: 24844799.
- Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs, 2009. PMID: 19719333.
- Warfarin and food, herbal or dietary supplement interactions: a systematic review. British Journal of Clinical Pharmacology, 2021. PMID: 32478963.
Origin and history
Ji Sheng Fang (济生方, Formulas to Aid the Living) by Yan Yonghe, Song dynasty, 1253.
Shi Pi Yin comes from Yan Yonghe's 13th century formulary, where it treated cold swelling caused by a Spleen too weak to transform fluids. Its name, fortify the Spleen, states the method: strengthen the source so the fluid stops accumulating rather than only draining what has already gathered.
Classical record
Yan Yonghe recorded the drink for cold swelling with Spleen deficiency, fortifying the Spleen and warming the Yang so the fluid could be transformed.
Ji Sheng Fang (济生方, Formulas to Aid the Living), Yan Yonghe, Song dynasty, 1253.
Evidence note
No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.
Common questions
How is it different from Zhen Wu Tang?
Zhen Wu Tang warms the Kidney and drains fluid. Shi Pi Yin also fortifies the Spleen and moves Qi, so it is used when the digestion is weak and the abdomen feels full.
Is it safe in pregnancy?
No. It contains Fu Zi, which is prohibited in pregnancy.
Can it help puffy skin?
Where the puffiness is cold and pale with poor appetite and loose stools, as part of a supervised treatment.
When should swelling be investigated?
New, one-sided or progressive swelling, breathlessness or reduced urine needs urgent medical assessment.