Fu Ling Wan茯苓丸

Poria Pill to Guide Out Phlegm

Dispelling Phlegm 祛痰剂Dry Damp and Transform Phlegm 燥湿化痰

Ingredients4 herbs

HerbDosageRoleWhat it does in this formula

茯Fu Ling茯苓Poria30g臣 DeputyDrains the damp that keeps regenerating phlegm, so the treatment holds 枳Zhi Ke枳壳麸炒，去瓤Aurantii Fructus15g佐 AssistantOpens the qi of the chest and epigastrium so the loosened phlegm has a way out 半Zhi Ban Xia半夏Pinelliae Rhizoma preparatum60g君 ChiefThe largest herb in the formula — dries damp and breaks up the phlegm that has congealed in the channels

风Feng Hua Xiao (Mang Xiao)风化朴硝Natrii Sulfas0.3g佐 AssistantSoftens hardened phlegm and leads it downward; kept small on purpose, as this is a purgative mineral

Indications

Dries damp and transforms phlegmMoves qi in the chest and epigastriumSoftens congealed phlegm and guides it downward

Damp-phlegm lodged in the middle burner that has spilled into the channels. The phlegm is the cause and the arm is only where it shows; treating the shoulder locally does nothing, which is why the pattern is so often mistaken for wind-damp bi or for blood deficiency.

Clinical Manifestations

Aching or drawing pain in both upper arms with no joint findings
Arm that cannot be raised overhead
Pain that migrates from one arm to the other
Fullness below the sternum with copious clear sputum
Puffy hands with a greasy tongue coating

TongueWhite and greasy coating

PulseDeep and thin, or wiry and slippery

Health Categories

Respiratory HealthBone & Joint Health

Modern Applications

Frozen shoulder Shoulder and upper arm pain Periarthritis of the shoulder Myofascial pain Chronic bronchitis with sputum

Common adjustments

Pain marked and long-standing — channel-reaching herbs are added to carry the formula into the shoulder, e.g. Jiang Huang 姜黄 or Bai Jie Zi 白芥子
Spleen qi weak, appetite poor — Bai Zhu 白术 and Chen Pi 陈皮 are added so the middle burner stops generating phlegm
Stools already loose — the is reduced or omitted — the softening action is not worth a purge in someone whose bowel is already open
Cold signs prominent, sputum thin and clear — Gan Jiang 干姜 is added to warm the middle

Contraindications

Not for arm and shoulder pain from blood deficiency, from wind-damp bi, or from a structural lesion such as a torn tendon — the pattern must actually be phlegm, with the middle-burner and tongue signs to match. Unsuitable where stools are loose or the Spleen is cold and weak, because of the mirabilite. Stop once the arm frees up: this is a short-course formula, not something to take for months.

For licensed practitioners’ reference only — not a self-treatment guide.

Pregnancy

Avoid in pregnancy. The formula contains Mang Xiao, a saline purgative that stimulates the bowel and is traditionally withheld in pregnancy, and Ban Xia, which is used during pregnancy only where a practitioner judges it necessary and then in processed form. Shoulder and arm pain in pregnancy is managed with a different approach.

References

Source 《是斋百一选方》，录自《全生指迷方》 · Southern Song

Classical source (public domain) — 《是斋百一选方》, Southern Song, citing 《全生指迷方》.
2. 《方剂学》（全国中医药行业高等教育规划教材）— 祛痰剂·燥湿化痰, pattern and composition cross-checked.
3. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
4. Chinese Pharmacopoeia monographs on 半夏 (processed forms, 3–9 g) and 芒硝.

Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.