sDisclaimer For educational purposes only. Do not use as medical advice
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Research
Category: Warm Interior Cold ⌕
Subcategory: Warm the Middle and Dispel Cold Source: Shang Han Lun
Actions: Warm and tonify the middle Jiao,
moderates spasmodic abdominal pain [31]
Diagnosis
Tongue: pale, white coat Pulse: thin, wiry Other:
Patterns: Middle Jiao Deficiency Cold, Liver and Spleen Disharmony, Abdominal Pain Deficiency Cold
Indications: Middle Jiao Deficiency Cold (SP Yang deficiency cold) causing spasmodic abdominal pain [35] • Abdominal pain preferring warmth and pressure, pale tongue with white coating, thin wiry pulse [31]
Contraindications: Not for vomiting with middle Jiao excess[31]
Description
Name Variations: Xiao Jian Zhong Tang, 小建中汤, Minor Construct the Middle Decoction,
Herb List: Yi Tang(K, 30g) • Gui Zhi(M, 9g) • Bai Shao(M, 18g) • Sheng Jiang(A, 9g) • Da Zao(A, 12p) • Zhi Gan Cao(E, 6g)
Commentary: Xiao Jian Zhong Tang = Yi Tang + Gui Zhi Tang + 2X Bai Shao (9g Gui Zhi, 18g Bai Shao). Bai Shao is best for cramping, spasmodic abdominal pain and softening the Liver.
Related Formulas: – Huang Qi Jian Zhong Tang: Xiao Jian Zhong Tang + Huang Qi, warm and tonify middle Jiao qi, moderates spasmodic abdominal pain – Dang Gui Jian Zhong Tang • Xiao Jian Zhong Tang + Dang Gui. Warm and tonify qi blood, moderates spasmodic abdominal pain – Da Jian Zhong Tang: Yi Tang, Shu Jiao, Gan Jiang, Ren Shen. Warm and tonify middle Jiao, descend upward flowing cold, stop pain
NCCAOM: The 4 NCCAOM formulas for warming the Middle Jiao are Lǐ Zhōng Wán, Wú Zhū Yú Tāng, Xiǎo Jiàn Zhōng Tāng, and Dà Jiàn Zhōng Tāng. • Li Zhong Wan is for Spleen/Stomach deficiency cold with cold extremities, dull abdominal pain, poor appetite, loose stool. • Wu Zhu Yu Tang is for Deficiency Cold of the Stomach, Liver, and Kidney with vertex headaches, cold limbs, vomiting after eating food, intermediate gnawing hunger, or diarrhea. • Xiao Jian Zhong Tang is for deficiency cold due to Liver and Spleen disharmony leading to spasmodic abdominal pain and warmth makes it better. • Da Jian Zhong Tang is for Middle Burner Yang deficiency (root) + Vigorous Yin-cold (manifestation). For chronic gastritis, gastric ulcer, chronic cholecystitis, and duodenal ulcer.
Herbs
Cat/Dosage
Actions
Attributes
Yi Tang •
Malt Sugar • 饴糖Tonify Qi
Moisten lungs • Stop coughing • Tonify spleen Qi • Reduce spasms • Alleviate pain • Coat choking objectsAdd at very end of decoction
Atitussive
Gui Zhi •
Cinnamon Twig • 桂枝Release Exterior Wind Cold
Activate yang qi, warm yang, open channels, expel Wind Cold from muscle layer • warm Middle Jiao • regulate Wei Qi • improve circulation • relieve pain • thin mucus • treat chest BiPAIRS with Shao Yao and Fu Ling
diuretic, anticoagulant, vasodilation, diaphoretic, antipyretic, emmenagogue, antiparasitic, cardiotonic, antibiotic, hypoglycemic, analgesic, anti-inflammatory, antioxidant, sedative
Bai Shao •
White Root Peony • 白芍Tonify Blood
Tonify Liver blood - regulate menses • Tonify Liver Yin • Relief pain and spasms • Harmonize Ying and Wei QiDao Di: Zhe Jiang • AKA Shao Yao
analgesic • antibacterial • anti-inflammatory • hepatoprotective • immune system boost • sedative
Sheng Jiang •
Ginger (Raw) • 生姜 Release Exterior Wind Cold
Release exterior • Stops vomiting • Relieve Nausea • Stops cough • Reduce herb toxicity • Regulate central flow of Qi
Expectorant • Cough Suppressant • Digestive • Hypotensive • Antiplatelet • Stimulant • Analgesic • Anti-inflammatory • Antipyretic • Cholagogic • Antiemetic • Antimutagenic
Da Zao •
Jujube • 大枣 Tonify Qi
Tonify Spleen Qi • Calm the spirit • Harmonize other herb's properties • Nourish blood
antibaterial • antidepressant • anti-inflammatory • anodyne • antifungal • hepatoprotective • hypotensive • sedative
Zhi Gan Cao • Honey Fried Licorice • 炙甘草
Tonify Qi
Increase the effectiveness of Gan Cao, particularly with: Tonify middle • Tonify Heart and Spleen Qi • Harmonize other herbs Honey is a cardiotonic. Zhi Gan Cao is different from Gan Cao in that it nourishes the heart.
Hypoglycemic • Antiarrhythmic • Expectorant • Antidiarrheal • Antiulcer • Hepatoprotective • Antiulcer • Immunostimulant • Antitussive • Antiviral • Detox • Demulcent • Anti-inflammatory • Laxative • Emmenagogue • Antimicrobial • Spasmolytic
♠ King/Chief ♥ Minister/Deputy ♣ Assistant ♦ Envoy
Directions:
Caution
ALERT: Contraindications of each herb - use with caution under these conditions:
Yi Tang: Cloying • Excess damp heat • Phlegm heat cough• Heat • Pediatric food stagnation • Pediatric malnutrition • Fullness of middle jiao with vomiting
Gui Zhi: Pregnancy, Liver Wind, hyperactive Yang from Yin xu, Wind Heat, blood heat, heavy menses, measles, open skin sores
Bai Shao: Deficiency cold • Breast feeding • Pregnancy • Bleeding Disorder • Scheduled Surgery
Sheng Jiang: Lung heat • Dry cough • Phlegm heat • Full heat • Yin deficiency with heat • Vomiting from stomach heat • Gallstones • Exterior deficiency with unexplained sweating • Horse meat
Da Zao: Epigastric discomfort and bloating • Food stagnation • Damp excess • Damp Phlegm • Intestinal worms
Zhi Gan Cao:
Notes
Bibliography: [3], [8], [9], [14]
Information in this post came from many sources, including class notes, practitioners, websites, webinars, books, magazines, and editor's personal experience. While the original source often came from historical Chinese texts, variations may result from the numerous English translations. Always consult a doctor prior to using these drugs. The information here is strictly for educational purposes.
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