【Source】

“San Yin” (1174), “Zheng Zhi Zhun Sheng Fang” (1607), Vol. 2.

【Composition】

Fuzi (Aconite Root), Gan Jiang (Dried Ginger), Bai Zhu (White Atractylodes Rhizome), Ren Shen (Ginseng), Gan Cao (Licorice Root). (5)

【Classification】

<Tonify Qi>: Ren Shen; <Tonify Spleen and Middle Jiao>: Gan Cao, Bai Zhu; <Warm Interior>: Fuzi, Gan Jiang.

【Analysis】

(1) Lizhong Tang (Bai Zhu, Ren Shen, Gan Cao, Gan Jiang) + Fuzi. (2) Sini Tang (Gan Cao, Gan Jiang, Fuzi) + Bai Zhu, Ren Shen. (3) <a href='https://whatsintcm.com/dt_articles/四逆加人參湯/’>Sini Jia Renshen Tang (Gan Cao, Gan Jiang, Fuzi, Ren Shen) + Bai Zhu. <Warm Interior>: Fuzi; <Tonify Qi>: Ren Shen; <Tonify Spleen and Middle Jiao>: Bai Zhu.

【Mnemonic】

Lizhong Tang (Family, people, stir-fried ginger = Bai Zhu, Ren Shen, Gan Cao, Gan Jiang) + Fuzi.

【Functions】

Warms the middle and dispels cold, tonifies deficiency and restores yang, benefits qi and strengthens the spleen.

【Indications】

Spleen and stomach deficiency cold, undigested food, abdominal pain with poor appetite, cold limbs, borborygmus with abdominal pain, cholera with muscle cramps, body cold with slight sweating, vomiting and diarrhea, and all syndromes of deep cold and chronic cold.

【Pharmacology】

It can enhance the cold resistance of mice, has a significant analgesic effect on acetic acid-induced abdominal pain in mice, and can significantly antagonize the effects of adrenaline and acetylcholine on isolated rabbit intestines.

【Clinical Applications】

Gastroenteritis, gastric atony, gastroptosis, indigestion, dysentery, abdominal pain.

【Formula Rationale】

“Yi Fang Kao”: Ren Shen, Gan Cao, and Bai Zhu, with their sweet and warm nature, tonify deficiency; Gan Jiang and Fuzi, with their pungent and hot nature, restore yang.

“Shan Bu”: Ren Shen, Bai Zhu, and Zhi Cao (prepared Gan Cao) nourish the Middle Jiao. Gan Jiang is pungent to warm the middle. It must be used with the flame of a furnace to elevate qi and yang. Thus, food enters the yin, qi grows in the yang, ascending to the “Hua Gai” (upper chest) and descending to the “Zhou Du” (lower abdomen). All five zang and six fu organs receive qi, which is the entirety of Lizhong. If water cold mutually prevails, then both spleen and stomach require warming. Adding Fuzi warms the “Ming Men” (kidney gate) and strengthens the mother earth, thus warming it. Bai Zhu tonifies the spleen; when combined with Ren Shen, it obstructs qi. Therefore, for those with moving qi below the umbilicus, excessive vomiting, and abdominal fullness, remove Bai Zhu. Add Gui Zhi (Cinnamon Twig) to attack pathogenic evil in the kidney, add Sheng Jiang (Fresh Ginger) to stop vomiting, and add Fuzi to resolve yin. For those with excessive diarrhea, strengthen dampness resolution. Return to using Bai Zhu to dry dampness. For thirst with a desire to drink, add Bai Zhu to transform fluids and generate them. For palpitations in the epigastrium, it indicates water accumulation; add Fu Ling (Poria) to guide water. For abdominal pain, double the dose of Ren Shen for deficiency pain. For cold, add Gan Jiang for severe cold.

【Modification】

(1) For severe food stagnation, add Zhi Shi (Immature Bitter Orange) and Bing Lang (Areca Seed) to enhance the action of resolving food stagnation and promoting digestion.

(2) For food accumulation transforming into heat, evidenced by a yellow tongue coating and rapid pulse, add Huang Qin (Scutellaria Baicalensis Root) and Huang Lian (Coptis Chinensis Rhizome) to clear heat.

(3) For constipation, remove Fu Ling and add Da Huang (Rhubarb) to purge and relieve constipation.

(4) For concurrent spleen deficiency, add Bai Zhu to strengthen the spleen. This becomes “Da An Wan” from “Dan Xi Xin Fa,” which is indicated for food stagnation with spleen deficiency or food stagnation in children.