Traditional Chinese Formulation with Poria: Support Digestion, Drain Damp

Traditional-Chinese-Formulation-with-Poria

One of the most commonly used ingredients in Chinese herbal formulas is the fungus known as Poria cocos in Latin, and also called China root, Indian bread, and just poria.  It is the primary herb in the “drain dampness” category.

To understand how poria “drains dampness,” we must first understand what dampness is in the context of Chinese medicine.  While dampness can be a healthy quality in certain tissues, when we are using poria to drain dampness it is to address conditions where there has been an accumulation of fluids in the body, what is sometimes referred to as “pathogenic water.”  Pathogenic water or pathogenic fluids are those which, while present in the tissues, are in excess of what is appropriate.  Furthermore, pathogenic fluids do not moisten the tissues.  This is very counter-intuitive because it can result in a patient who while clearly has excess fluids is also showing signs of dryness.  It is important to remember that draining pathogenic fluids does not cause dryness because the pathogenic fluids were not moistening the tissues to begin with.  Once the pathogenic fluids have been trained, the physiological fluids can come in and do the work of moistening.

Edema and Poria: Drain Pathogenic Dampness

The most obvious manifestation of accumulation of fluids in the body is edema.  Edema generally appears in the lower part of the body, often around the ankles, and produces tissue with a swollen appearance.  Pitting edema is a more severe form and can be seen when you press the swollen tissue with a finger or a thumb and the tissue does not bounce back to the proper shape and instead retains the pit left by the pressure.  Many people will first become aware that they are having some degree of edema when they notice lines left in their ankles and calves by socks that have become tight over the course of a day.  It is not uncommon for otherwise healthy people to develop edema after traveling if they had a long car ride or flight.  Long periods of sitting inhibit the body’s ability to properly metabolize fluids.

It is important to remember that edema is not fat.  Since edema is water it actually is far more dense than adipose tissue and weighs a lot more.  In our culture, we tend to assume that any person in a larger body or who is looking round, puffy or swollen must be having an excess of fat, but this is not always the case.  While a person can have both an excess of adipose tissue and have edema, it is important to separate the two.  This is why the lines from socks and the thumb-press test are so important.  Many people come to healthcare providers, including herbalists, seeking help in losing weight, and there are things we can do to help.  However, we must determine where their weight is coming from (adipose or water) and if the person has any edema at all, the edema must be resolved first.

A Quick Note on Terminology: Chinese medicinal formulas are commonly referred to as “herbal formulas” and the ingredients are usually referred to as “herbs,” though many of the ingredients are not, in fact, plants.  The traditional Chinese materia medica includes minerals, animal products, and, as in the case with poria, mushrooms and other funguses.  For the sake of ease, I will use the term “herb” and “herbal formula” in this broad sense of “any naturally derived ingredient used for healing.” I have found the other terms to be cumbersome and more confusing.

Treating Edema with Poria

Fortunately, edema is treatable, and poria is a great tool to address this very big concern.  Poria will not cause pathogenic dryness or dehydration of tissues, but it will cause temporary increase in urination.  This is because poria drains dampness by directing the pathogenic fluids out of the body through the urine.  Expect some increased urination and that the urine may be a little cloudy initially, but that neither the increased volume of urine nor the cloudiness should persist once the edema is resolved.

Poria Strengthens the Spleen, too.

Poria is often said to drain dampness and strengthen the Spleen.  The way I understand it poria drains dampness by strengthening the Spleen.  It is when the Spleen is functioning optimally that fluids are being metabolized correctly and not accumulating in tissues and thus causing harm.  For this reason, poria is understood as a tonifying or strengthening herb and can be given to patients who are deficient.  Caution is advised when working with a patient who has severe deficiency to the point of organ prolapse or similar.

Poria has a calming effect and can be helpful for palpitations and insomnia when either is caused by anxiety.  While I would not use it a single herb therapy for anxiety or insomnia, in combination with other calming herbs it can be very beneficial and is something to consider if poor digestion and fluid retention are also present.

Common Poria Formulas

The most common herbal combination with poria is cinnamon (specifically cinnamomi ramulus, but I really think any variety of cinnamon would get pretty good results.)  Taken together, these two herbs really strengthen the tonifying ability of the poria, help digestion, powerfully remove the pathogenic fluids, and can really clear up issues like diarrhea, cough, edema and an anxiety condition known as “running piglet syndrome.”  Running piglet is an adorable term to describe the feeling of intense, wiggly, squealing energy that can rise up from the abdomen, through the chest and into the throat.  It’s a sort of panic/anxiety feeling that rushes on quickly and can be quite overwhelming.  Poria and cinnamon taken together, especially as a tea, can be really soothing to this condition.

The herbal formula Gui Zhi Fu Ling Wan (Cinnamon Twig and Poria Pill) features cinnamon and poria, and was originally used for treating abdominal pain during pregnancy, but has since been expanded to treat any sort of lower abdominal pain with tenderness on palpation (so when you put pressure on the abdomen it hurts more). Other great poria-based formulas include: Wu Ling San (Five Ingredient Powder with Poria) which promotes urination, drains dampness and strengthens the Spleen; Fu Ling Gan Cao Tang (Poria and Licorice Decoction) a formula that focuses on a patient who is experiencing great thirst while also having edema; Zhu Ling Tang (Polyporus Decoction) which promotes urination while also clearing heat symptoms like fever and irritability; Wu Pi San (Five Peel Powder) which treats edema in the skin; and Fu Ling Wan (Poria pill) which is used for numbness in the hands and other areas of the upper body.  And, of course, poria is used in everyone’s favorite formula: Free and Easy Wanderer, the formula for anxiety, headache, menstrual issues, vertigo, and all the things caused by being too stressed out.

-In this context, I am referring the Spleen in the Chinese medicine sense of the term, ergo I have capitalized the word.  In Chinese medicine, the Spleen is the primary organ of digestion.  The Stomach is tasked with manually breaking down food, but the Spleen is what transforms food into Qi.  This does not map directly on to our Western biomedicine understanding of the spleen in which it is understood to be a large lymph node and thus primarily associated with immune function.

Custom Formulation with Poria

These days, I feel there is a growing acceptance of the use of medicinal mushrooms for a range of purposes.  Historically, Americans have been a little less excited about mushrooms than other cultures, and mushrooms do not play as large a role in our cuisine as it does in the cuisines of China, Japan and Europe, but that is changing.  Poria has a mild flavor (almost bland) and is thus more acceptable to patients.  When combined with stronger, better-tasting herbs like cinnamon, licorice root or ginger, the poria goes down easily.

When creating a custom formula, poria should only be used as the Chief Herb/Emperor herb if you are creating a formula that is focused on edema, or other issue of dampness, especially of damp heat.  As an assistant herb, though, poria can be a great addition to any formula that is designed to tonify or strengthen the function of the Spleen or the Lungs.  Pathological dampness can be present at a more subtle degree that does not cause obvious swelling while still being a problem.  Any two-week course of herbs that includes poria should alleviate lower grade dampness while supporting other beneficial effects.

Dosage for Poria

Poria is a safe and effective herb that can be consumed at fairly high doses without causing difficulty.  The general guideline is 9-15 grams per dose of the raw herb assuming 3 doses per day.  If using a concentrated form, use proportionally less.  If you are combining poria with cinnamon it makes both of them more effective so you can less of each and still get great results.

Cautions for Poria

It is possible for a patient to be allergic to poria, with the most common allergic reaction being skin rashes.  If you have any kind of rash after taking poria, or any other herb, have discontinue the herbs right away.  Overall, poria is a safe herb with a low risk of harmful effects.

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