A pediatric-oriented "open the spleen, harmonize the center, resolve food stagnation" formula from the Ming dynasty, one of the most commonly suggested TCM tonics for children with weak digestion.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Compiled in the Ming dynasty text "Introduction to Medicine" (《医学入门》) as a gentle pediatric spleen tonic. In Japan, Keihi-tō (啓脾湯) is sold by Tsumura as the standard pediatric OTC for "weak digestion, poor appetite, pale child, prone to diarrhea". In Korea it appears as Gyebi-hwan (계비환) in the Kyungdong hanbang line. The formula's structure is the Four Gentlemen base (ginseng, atractylodes, poria, licorice) plus spleen-strengthening and food-moving herbs.
From the source text
This page is cultural documentation, not medical advice.
From the source text · 《医学入门》卷八·小儿门·启脾丸条
Classical text
据《医学入门》：启脾丸，治小儿脾胃虚弱，饮食不进。人参、白术、茯苓、山药、莲子、山楂、神曲、麦芽、泽泻、甘草。
Modern Chinese rendering
本方用于"小儿脾胃虚弱、饮食不进"系列证候：脾胃运化不足所致的食欲不振、面色萎黄、形体消瘦、大便偏溏、神疲乏力、易反复外感。方以四君子汤（人参、白术、茯苓、甘草）补气健脾为君；山药、莲子助健脾止泻；山楂、神曲、麦芽消食化积以"开胃进食"；泽泻渗湿以助脾运。整体上，是明代"健脾 + 消食"思路下"儿科脾虚"代表方，临床用于"小儿脾胃虚弱、疳积初起"证候。
Editorial translation
This formula is used for "pediatric spleen-stomach weakness with poor food intake" patterns: insufficient spleen-stomach transport and transformation causing poor appetite, sallow complexion, thin body, loose stools, fatigue, and susceptibility to recurrent external infections. The Qǐ Pí Wán uses the Sì Jūn Zǐ Tāng (Four Gentlemen Decoction: Rén Shēn, Bái Zhú, Fú Líng, Gān Cǎo) to tonify qi and fortify the spleen as sovereign; Shān Yào and Lián Zǐ assist in fortifying the spleen and stopping diarrhea; Shān Zhā, Shén Qū, and Mài Yá digest food accumulation to "open the stomach and promote eating"; Zé Xiè drains dampness to assist spleen transport. It is, in short, the Ming-dynasty representative formula for the "pediatric spleen-deficiency" pattern of the "fortify spleen + digest food" register.
In tradition
In TCM tradition, associated with "spleen deficiency with food stagnation" patterns in children (and sometimes adults): poor appetite, abdominal distension after eating, thin or loose stools, fatigue, a sallow complexion, and a tendency to pick at food rather than eat properly. It is the formula of choice for the "skinny, pale, doesn't eat well" child, and is also commonly suggested for adults recovering from prolonged illness.
Formula composition
Monarch4
- Ginseng (Rén Shēn / 人参)
- White atractylodes (Bái Zhú / 白术)
- Poria (Fú Líng / 茯苓)
- Licorice root (Gān Cǎo / 甘草)
Minister5
- Chinese yam (Shān Yào / 山药)
- Lotus seed (Lián Zǐ / 莲子)
- Hawthorn fruit (Shān Zhā / 山楂)
- Massa fermentata (Shén Qū / 神曲)
- Barley sprout, sprouted (Mài Yá / 麦芽)
Assistant1
- Tangerine peel (Chén Pí / 陈皮)
Envoy1
- Alisma rhizome (Zé Xiè / 泽泻)
International availability
Taiwan & Hong Kong
- 順天堂OTC啟脾丸Qi Pi Wan
Cautions & context
- A relatively safe pediatric formula, but not appropriate for active fever or acute infection.
- Considered inappropriate for what TCM describes as "yin deficiency with fire" patterns.
- Persistent or worsening digestive symptoms, blood in the stool, or failure to thrive requires pediatric medical evaluation before any herbal remedy is considered.
- Long-term daily use should be monitored by a qualified pediatric practitioner.
Related formulas
Other formulas from this text· "Introduction to Medicine"
Other formulas by this contributor· Li Chan
Related concerns
Concern · digestion
Digestion
Upper-abdominal heaviness, bloating, sour reflux, loose stools, traveler's stomach, and the aftermath of a meal that was richer, spicier, or larger than usual.
Editorial note
Compiled from "Introduction to Medicine" (1575).
Last reviewed: July 18, 2026
Three layers of evidence
Classical source
≈ 500 years · "Introduction to Medicine" (1575)
Pharmacopoeia indication
"Fortify the spleen and harmonize the stomach. Used for spleen-stomach weakness: poor digestion, abdominal distension, and loose stools."
Modern research status
As of 2026-07-18, a PubMed search using the formula name and the Latin / Korean / Japanese transliterations together with "systematic review" and "meta-analysis" did not identify a dedicated systematic review for this formula. Any clinical evidence that does exist is fragmented across small individual trials or covered in broad herbal-medicine umbrella reviews, which do not allow a per-formula evidence assessment; the absence of a dedicated SR is itself the relevant editorial fact here.
References
References reviewed on July 18, 2026 · PubMed search on 2026-07-18
- 01ClassicalLǐ Chán (李梴), 《医学入门》 (Yīxué Rùmén / Introduction to Medicine), late Ming dynasty, compiled 1575 (Wanli 3rd year), the "pediatric section" (卷八·小儿门), the entry for Qǐ Pí Wán (启脾丸), a representative pediatric "fortify-spleen + digest-food" formula of the late-Ming "weak digestion in children" register; editorial adaptation, pending scholarly verification of exact chapter / verse wording against the 1575 first-edition.
- 02TextbookDuān Fùjīn (段富津) et al. (eds.), 《方剂学》 (Fāngjìxué / Science of Formulas), 2nd edition, Shanghai Scientific and Technical Publishers, 2011, the standard modern university-level formula textbook in mainland China, with Qǐ Pí Wán discussed in the "tonifying formulas" (补益剂) chapter as a representative pediatric "spleen-tonification + digestion" formula, the canonical entry for the "pediatric spleen-deficiency with food-stagnation" register.
- 03TextbookTsumura (ツムラ), Keihi-tō (啓脾湯, TJ-43) prescription documentation, Japan's leading Kampo manufacturer, the standard Japanese Kampo "pediatric spleen-opening" formula derived from the late-Ming 《医学入门》 line, sold in Japanese pediatric clinics and pharmacies for "weak digestion, poor appetite, pale child, prone to diarrhea" presentations; mirrored in Korean hanbang as 계비환 (Gyebi-hwan) in Kyungdong (경동) product line.
- 04PharmacopoeiaPharmacopoeia Commission of the PRC, 《中华人民共和国药典》 2020 edition, vol. 1 (Zhōnghuá Rénmín Gònghéguó Yàodiǎn, Pharmacopoeia of the People's Republic of China, 2020 ed., vol. 1), China Medical Science Press, 2020, the official national monograph for Qǐ Pí Wán (丸 / 浓缩丸), "functional indication" reads "fortify the spleen and harmonize the stomach, used for spleen-stomach weakness: poor digestion, abdominal distension, and loose stools".