Li Zhong Wan (Regulate the Middle Pill)
- Warming the Middle Jiao
- Gan Jiang
- Ren Shen
- Bai Zhu
- Zhi Gan Cao
- Gan Jiang is pungent and hot. Warms the MJ and eliminates interior cold.
- Ren Shen is sweet and warm. Strongly tonifies the MJ Qi thereby recovering Yang.
- Bai Zhu is sweet, bitter, warm and dry. Tonifies Sp Qi, dries dampness to strengthen transformation and transportation.
- Zhi Gan Cao Tonifies Spleen Qi, harmonizes other ingredients.
Function: Warms the MJ, eliminates cold, tonifies the Qi, strengthens Spleen
Indications: MJ deficient cold syndrome
Symptoms:
- Diarrhea, no thirst, vomiting, epigastric and abdominal pain that is relieved by warmth and pressure, aversion to cold, cold limbs, and loss of appetite
- There may also be bleeding, or chronic childhood convulsion, or spitting copious saliva post disease, or chest Bi syndrome, etc.. due to MJ deficient cold.
Tongue: Pale tongue with white coating
Pulse: Deep and thready
Clinical Applications:
- This is the warm tonic formula used for Sp and St deficient cold causing the disorder of transportation and transformation of nutrients.
- The key symptoms are vomiting, diarrhea, epigastric and abdominal cold pain, cold limbs, aversion to cold, loss of appetite, pale tongue with white coating, deep and slow or deep and thready pulse.
- For bleeding cases due to Yang deficiency marked by nosebleed, or vomiting with blood, or passage of bloody stools, pale complexion, SOB, fatigue, thready pulse or deficient and large pulse, omit Gan Jiang, and replace with Pao Jiang, Huang Qi, Dang Gui, and E Jiao.
- For severe deficient cold, add Fu Zi (Fu Zi Li Zhong Wan) and Rou Gui (Fu Gui Li Zhong Wan).
- For severe vomiting or hiccup, add Ding Xiang and Bai Dou Kou (Ding Kou Li Zhong Wan).
- For cases with phlegm accumulation, add Ban Xia and Fu Ling (Li Zhong Hua Tan Wan).
- For cases with exterior wind-cold, add Gui Zhi (Gui Zhi Ren Shen Tang).
- For cases with Qi stagnation, add Qing Pi and Chen Pi (Zhi Zhong Tang).
- For cases with Qi stagnation and water retention, addZhi Shi and Fu Ling (Zhi Shi Li Zhong Wan).
- For cases with a mixture of cold and heat marked by diarrhea with acid regurgitation, add Huang Lian (Lian Li Tang)
- Currently used for acute chronic gastroenteritis, peptic ulcer, gastroptosis, dilation of stomach, and chronic colitis due to Spleen and Stomach deficient cold.
Cautions and Contraindications: It should not be used for cases with fever due to external evil or Yin deficiency.