Stomach Pain, Belching and Rib-Side Distension from Stress? Shu Gan He Wei Wan (Soothe the Liver and Harmonize the Stomach Pill) — Soothe the Liver, Resolve Stagnation, Harmonize the Stomach and Stop the Pain

Patient search terms: stomach pain from stress and anger / always belching and burping / rib-side distension and pain / what Chinese patent medicine for liver qi stagnation / Shu Gan He Wei Wan / bloating and stomach upset when emotions are bad

Corresponding medical names: liver qi stagnation (gan qi yu jie) · liver wood overacting on the spleen and stomach (gan mu heng ni ke pi tu) · liver-stomach disharmony (gan wei bu he) · rib-side distension and pain (liang xie zhang tong) · belching and hiccuping (ai qi) · irregular bowel movements

Today Doctor Luo Dalun talks about a Chinese patent medicine — Shu Gan He Wei Wan (Soothe the Liver and Harmonize the Stomach Pill). But before he gets to the medicine itself, he shares a surprising number that sets the whole scene.

Opening: eight out of ten people’s health problems are rooted in emotions

💬 Note from Doctor Luo: I often tell everyone that we need to soothe the liver and regulate the qi, and keep our emotions healthy. But because work pressure today is so heavy and the pace of life is so fast, many people end up with liver qi not flowing smoothly — liver qi stagnation. How common is this? Let me put it this way: of the people who come to me to have their health adjusted, I would say about 80 percent — or even more, 80 to 90 percent — their illness is connected to emotional imbalance and stress.

So that many people’s physical discomfort has its roots in the emotions. What can be done? Doctor Luo says, on one hand, you have to think things through — for example, listen to his talks on the Dao De Jing and take in the principles; on the other hand, find more activities:

💬 Note from Doctor Luo: For example, step out of your original environment — if the relationship with your mother-in-law at home is bad and the atmosphere is suffocating, can you move out? If work pressure is enormous, can you take a week off and travel? In any case, adjust yourself. First, take up some exercise — people who rarely exercise should go exercise, and you will be happy; play with people, play ball, and find joy through interaction. I always say, in life you must learn to seek out joy.

Chinese medicine has a trick too: the foot-soaking formula Shu Gan Jie Yu Tang

Beyond adjusting yourself, you can also ask a Chinese medicine practitioner for a prescription. Doctor Luo says his usual method for adjusting the emotions is a foot-soaking formula:

💬 Note from Doctor Luo: I often talk about my foot-soaking formula — Chai Hu Jia Long Gu Mu Li Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction) with modifications, for soaking the feet. Many people say that after soaking, their whole body feels relaxed and wonderful. The publisher gave it a name — Shu Gan Jie Yu Tang (Soothe the Liver and Resolve Stagnation Decoction) — for foot soaking.

What about ready-made patent medicines? There are actually many, many of them — people just don’t know, and it seems like everyone thinks only Xiao Yao Wan (Free and Easy Powder) is for this. Today Doctor Luo introduces more of them.

What does Shu Gan He Wei Wan treat? — Liver qi running sideways and bullying the stomach

What does this medicine adjust? Doctor Luo nails it in one sentence:

💬 Note from Doctor Luo: Liver qi stagnation — the liver qi is blocked and stagnant, so the liver qi runs sideways and invades the spleen-earth, affecting the spleen and stomach. Usually we talk about liver-spleen disharmony; this is liver-stomach disharmony — mainly the stomach suffering. What does this cause? Rib-side distension and pain, then belching and hiccuping, pain in the stomach, and irregular bowel movements — sometimes constipation, sometimes diarrhea. What is the root of all this? Bad emotions, liver qi stagnation.

So the main herbs in this formula are all qi-regulating ones, helping your qi mechanism flow smoothly, plus a little harmonizing and tonifying of the spleen and stomach. Once the liver qi is smoothed out, liver and spleen are in harmony again, and the other problems resolve themselves.

First herb: xiang fu — Li Dongyuan said it “treats all qi”

What herbs are in the formula? Doctor Luo goes through them one by one. The first is xiang fu (Cyperus, nutgrass rhizome):

💬 Note from Doctor Luo: Xiang fu is a herb frequently used to soothe the liver and regulate qi. Its flavor is acrid and slightly bitter, and it enters the liver, spleen and San Jiao channels. Its main actions are moving qi and resolving stagnation, regulating menstruation and stopping pain. Its qi-moving power is quite strong, and it is especially good at combing through liver stagnation — the state where liver qi is knotted and blocked. So for the chest, abdomen and rib-side distension and pain caused by liver qi stagnation, and for digestive problems, the effect is excellent. Li Dongyuan said that xiang fu treats all qi — all qi stagnation, all disordered qi movement, xiang fu can smooth it out for you. Li Dongyuan’s teacher Zhang Yuansu also said xiang fu is “quick qi” — it helps you regulate qi, smooth qi and get the qi flowing freely. So in my modified Chai Hu Jia Long Gu Mu Li Tang I often add xiang fu and yu jin too.

Bai shao: the liver must be “soothed,” not “suppressed”

The second herb is bai shao (white peony root). Why pair it in? Doctor Luo explains a very interesting principle:

💬 Note from Doctor Luo: When liver qi is not flowing smoothly, the liver qi easily flares into liver fire, easily runs sideways to invade the spleen-earth, dashes around in all directions and rushes upward — liver fire flaming upward, and so on. At this point we need to soothe it. With what? With bai shao. Bai shao’s nature is sour — its flavor is sour, and sourness can astringe — sour astringency — so bai shao is very strong at astringing yin and softening the liver. When we soothe the liver and regulate qi, we must always add some bai shao — you cannot suppress it, because the liver organ is very fierce and unbending; you cannot suppress it, you have to gradually soothe it and gently nourish it.

Fo shou: a southern fruit that was “snack food” for the Qing imperial palace

The third herb is fo shou — southern readers know it well, also called fo shou gan (Buddha’s hand, finger citron), a fruit very much like the citrus family:

💬 Note from Doctor Luo: Fo shou regulates qi and resolves phlegm. It enters the liver and stomach channels, with an acrid-bitter-sour-warm nature. It is especially good for qi stagnation and qi depression caused by heavy phlegm-dampness in the middle jiao, or qi stagnation from liver-spleen disharmony — especially for qi stagnation of the digestive system. When we treat stomach problems — for example, stomach pain from bad emotions and liver wood overacting on the spleen-earth, or qi stagnation — we often add fo shou, because its nature is gentle; it slowly dissolves the qi for you. For stomach pain from qi stagnation, chest and rib-side distension and pain, vomiting, belching, and that feeling of something stuck inside, the effect is excellent — and it also helps with hangovers. In the past, in the Guangdong area, fo shou was eaten as food, just like chen pi; it was made into all kinds of food products. During the Qing dynasty it was even presented as tribute to the imperial palace in Beijing, where the emperor ate it as a snack.

Mu xiang: of the three brothers xiang fu, fo shou and mu xiang, this one stands out for “stopping pain”

Next comes mu xiang (costus root). Friends ask: xiang fu, fo shou and mu xiang feel very similar — what’s the difference?

💬 Note from Doctor Luo: Mu xiang’s outstanding feature is stopping pain. Mu xiang is warm in nature and enters the lung, liver and spleen channels. Its power to move qi and stop pain and to regulate the qi mechanism is very strong — it can comb open the stagnant qi — and pain caused by qi stagnation, such as stomach pain and abdominal pain, disappears. Mu xiang is also quite good for the pain that comes with diarrhea and various intestinal disorders. It can also warm the middle and harmonize the stomach, because its nature is warm — when you have caught cold and cold qi is stagnating in the middle jiao causing pain, mu xiang works well too.

Yu jin: when qi is stagnant for a long time, blood stasis follows — so you also need to “dissolve the blood”

This formula also includes yu jin (turmeric root tuber). Doctor Luo says xiang fu and yu jin are regulars in his prescriptions:

💬 Note from Doctor Luo: Yu jin also regulates qi. It enters the heart, lung and liver channels, and its nature is cool; its main use is moving qi and resolving stagnation. But it differs from the herbs I mentioned before — yu jin leans somewhat into the blood aspect. What does that mean? Qi stagnation and qi blockage cause blood to accumulate; when blood gathers together, it can lead to bleeding — various kinds of bleeding, including vomiting blood. Yu jin can regulate qi, and it can also dissolve this accumulation of blood — once it is dissolved, the blood no longer bleeds randomly, so yu jin has the function of treating blood problems. We often say “xiang fu, yu jin”: one leans to qi, one leans to blood, each with its own emphasis, but both soothe the liver and regulate qi. Why pair yu jin in? You have to understand that the body is a whole — when your emotions are bad and liver qi is stagnant, do you think it’s only the qi that is stagnant? Does the blood also get blocked? Of course it does! At that point, if you only regulate the qi, sometimes the effect is not ideal. If you also dissolve and break open the blood, once qi and blood both flow freely, the stasis resolves. Especially for friends whose qi stagnation has reached a certain degree — not just a few days, but several months or years — can there really be no blood stasis? There will be. That’s why when I soothe the liver and regulate qi I often add some yu jin.

Bai zhu: when you see liver disease, know it will transmit to the spleen — strengthen the spleen first

Why is bai zhu (Atractylodes macrocephala) also included? This is wisdom handed down from the ancestors:

💬 Note from Doctor Luo: In liver-spleen disharmony and liver-stomach disharmony, the liver qi is not flowing smoothly and runs sideways to invade the spleen-earth — so the spleen and stomach must be weak. If the spleen and stomach were strong, they could in turn restrain the liver qi. But now your spleen and stomach are weak, and the sideways-running liver qi is affecting them instead. What to do? The ancestors’ saying is: when you see liver disease, know it will transmit to the spleen, so strengthen the spleen first — first build up the spleen enough, and that can counteract the problem. So while soothing the liver and resolving stagnation, pair in bai zhu. I often say “bai shao with bai zhu” — that’s the meaning: on one side soften the liver, on one side soothe the liver, and at the same time fill up the spleen. This breaks up the pattern of liver-spleen and liver-stomach disharmony.

Chen pi, chai hu, huo xiang: regulating qi, soothing the liver, reviving the spleen — each with its own job

The formula also contains chen pi (aged tangerine peel), chai hu (bupleurum) and huo xiang (patchouli). Doctor Luo unpacks each one:

💬 Note from Doctor Luo: Chen pi also regulates qi; it disperses cold and stops cough, opens the lung qi, harmonizes the middle and resolves phlegm-dampness. Generally when we tonify the spleen, we use some bai zhu and dang shen, paired with chen pi to regulate the qi — this way the spleen is easier to tonify, tonify without stagnation. Li Dongyuan even treated chen pi as a spleen-tonifying herb, a herb for tonifying the middle and boosting the qi. Chai hu everyone knows — what is it for? Soothing the liver and regulating qi, soothing the liver directly, because liver qi not flowing smoothly is the main cause of the illness. Then why add huo xiang? Huo xiang can dispel dampness; it is a wind herb, and wind herbs can dry dampness and can rouse the qi of the spleen and stomach — the spleen and stomach have been restrained and suppressed by the sideways-running liver qi, and after qi stagnation, phlegm-dampness, that kind of pathogenic qi, stays inside the spleen and stomach. At that point you need to wake the spleen and rouse it, and transform the dampness away, and then the spleen and stomach revive. So adding some huo xiang can rouse the spleen-stomach qi, generate yang qi and transform dampness.

Lai fu zi and bing lang: when the bowels open, the qi stagnation lightens

Then the formula adds lai fu zi (radish seed) and bing lang (areca seed). Doctor Luo says there is a reason for this:

💬 Note from Doctor Luo: When liver qi is not flowing smoothly and runs sideways to invade the spleen-earth, causing dysfunction of the spleen and stomach, very often it is qi stagnation — and qi stagnation easily leads to constipation. Sometimes the bowels do move but not smoothly; sometimes there is diarrhea, but inside there is still accumulation, and the diarrhea smells strong. At that point, lai fu zi resolves phlegm and unblocks the bowels, and bing lang removes dampness, resolves phlegm and opens the intestines. When the intestines are open — think about it: when qi stagnation is blocked inside, the more it blocks, the worse it gets; once the intestines are open, the qi stagnation cannot get severe. So this formula works even better for the kind of irregular, constipation-tending bowels caused by bad emotions. Of course, irregular bowels also include diarrhea — but not the dysentery kind; it’s the kind where the person is often emotional, leaks out a little, and normally has a weak spleen and stomach. For that, this medicine is also fine.

Wu yao and honey-fried gan cao: dispersing cold, stopping pain, harmonizing all the herbs

Finally there are wu yao (lindera root) and honey-fried gan cao (licorice):

💬 Note from Doctor Luo: When we speak of wu yao we often say “Tiantai wu yao” — the best is produced in Tiantai, Zhejiang. Wu yao is warm in nature; its functions are smoothing the qi and opening stagnation, dispersing cold and stopping pain. It works well for all kinds of distending pain from qi stagnation — stomach pain, abdominal pain, even hernia caused by cold patterns. We often use wu yao in treating hernia. Finally, honey-fried gan cao is added to harmonize all the other herbs.

Don’t be limited by the name: stomach pain is only the consequence — soothing the liver is the root

After walking through the whole formula, Doctor Luo emphasizes one key tip for using it — never be limited by the name of the medicine:

💬 Note from Doctor Luo: You can see that in this formula, the qi-regulating herbs — xiang fu, fo shou, mu xiang, yu jin, chen pi, plus lai fu zi, bing lang, wu yao — gather together every qi-regulating and pain-stopping herb, plus a little spleen-tonifying herbs. The logic is very clear and very simple, and the power to soothe the liver and regulate qi is quite strong. I think it’s a pity this medicine just sits on the pharmacy counter; many people don’t know what it’s really for, as if it’s only used when stomach pain strikes. But in fact, stomach pain and various abdominal pains are only one consequence, one symptom, of liver qi not flowing smoothly. There are also many people with liver qi stagnation and emotional depression who don’t have obvious stomach pain — they have stomach fullness and blockage, all kinds of discomfort, emotional depression, and various reactions all over the body: joints that feel like they can’t straighten out, a racing heart at times, dizziness when walking. These various disorders of the body are all caused by liver qi stagnation. As long as you have liver qi stagnation, and the stagnation is causing all kinds of discomfort, try taking one or two pills — it will dissolve the qi, and you will feel very comfortable. This is a little formula for releasing liver qi stagnation.

Three reminders: pregnant women follow a doctor’s advice, stop once it works, and don’t forget life adjustments

At the end, Doctor Luo gives three reminders:

💬 Note from Doctor Luo: Note — pregnant women must use this only under a doctor’s guidance, don’t take it casually, because this formula has quite a few qi-moving herbs. In daily life, if you judge that your discomfort really is related to your emotions — high emotional stress, a somewhat qi-stagnant state causing all sorts of physical discomfort — you can try taking a little. This formula is very mild; once it works, a few pills are enough. Don’t overdo it, and there’s no need to take it for years. After you feel relief, use other methods — sing, dance, exercise more, leave your surroundings and travel — and adjust yourself on every front. That will certainly help.

This is the opening of Doctor Luo’s series on liver-soothing Chinese patent medicines — next he will introduce more:

💬 Note from Doctor Luo: After I’ve talked about these formulas with everyone for a while, you’ll discover that Chinese medicine actually has this many liver-soothing herbs. Once you understand the herbs little by little, it will benefit you later — when you stand in front of the pharmacy counter, you’ll look at a box and know what the fo shou is for, and why both xiang fu and yu jin are in there. Next I’ll introduce several more, so that when you choose at the pharmacy, you’ll know how we select and what to use. That will help everyone.

Compiled from Doctor Luo Dalun’s lecture. Shu Gan He Wei Wan is a common ready-made medicine at Chinese pharmacies. Its core approach is soothing the liver and resolving stagnation, harmonizing the stomach and stopping pain — suitable for rib-side distension and pain, stomach pain, belching, and irregular bowel movements caused by liver qi stagnation and liver-stomach disharmony. When your emotions are good, your body will be good too.