【Naming】
(1) Yi Fang (Medical Formulas): This decoction warms and constructs the middle burner, hence the name Jian Zhong (Construct the Middle). (2) Shan Bu (Supplemented and Revised): It is named Xiao Jian Zhong (Minor Construct the Middle) because it subtly establishes the middle qi. Although the middle is deficient, the exterior is not yet harmonized, so a large tonification is not appropriate.
【Source】
Shang Han Lun (Treatise on Cold Damage)
【Ingredients】
Gui Zhi (Cinnamon Twig), Zhi Gan Cao (Prepared Licorice Root), Da Zao (Jujube), Bai Shao (White Peony Root), Sheng Jiang (Fresh Ginger), Yi Tang (Maltose)
(6)
【Category】
<Blood Tonifying>: Shao Yao (Peony Root)
<Spleen and Middle Qi Tonifying>: Yi Tang (Maltose), Gan Cao (Licorice Root), Da Zao (Jujube)
<Acre-Warm Exterior Releasing>: Gui Zhi (Cinnamon Twig), Sheng Jiang (Fresh Ginger)
【Formula Explanation】
Yi Fang: This formula is for the Foot Taiyin and Yangming meridians. Zhun Sheng (Guidelines) states: The spleen is located in the center of the four viscera, generating and nourishing the Ying (Nutritive) and Wei (Defensive) qi, and circulating fluids. If it is imbalanced, it loses its ability to nourish and circulate. This decoction warms and constructs the middle burner. (1) The spleen desires to be relaxed, and sweetness is used to relax it. Therefore, Yi Tang (Maltose) is the chief ingredient, and Gan Cao (Licorice Root) is the assistant. (2) Gui Zhi (Cinnamon Twig) is acrid and warm, dispersing and moistening. When the Ying and Wei qi are insufficient, it moistens and disperses. (3) Shao Yao (Peony Root) is sour and cold, astringing and draining. When the body fluids are not circulating, it astringes and moves them. Therefore, Gui Zhi and Shao Yao are used as assistants. (4) Sheng Jiang (Fresh Ginger) is acrid and warm, and Da Zao (Jujube) is sweet and warm. The stomach is the source of the Wei qi, and the spleen is the foundation of the Ying qi. The Zhen Jing (Acupuncture Classic) states: Ying qi emerges from the middle burner, and Wei qi ascends to the upper burner. Therefore, Wei qi is yang, and must be benefited by acridity; Ying qi is yin, and must be supplemented by sweetness. The combination of acrid and sweet strengthens the spleen and stomach and promotes the circulation of Ying and Wei qi. Therefore, ginger and jujube are used as envoy ingredients. Shan Bu: This formula is <a href='https://whatsintcm.com/dt_articles/Gui Zhi Tang/’>Gui Zhi Tang (Cinnamon Twig Decoction) with doubled Peony Root and added Maltose. It is named Xiao Jian Zhong, meaning it subtly constructs the middle qi. Although the middle is deficient, the exterior is not yet harmonized, so a large tonification is not appropriate. Therefore, <a href='https://whatsintcm.com/dt_articles/Gui Zhi Tang/’>Gui Zhi Tang is still used to harmonize the Ying and Wei qi, while doubled Peony Root and added Maltose regulate and construct the middle jiao, without sipping thin congee to induce sweating. Han Dian (Chinese Dictionary): This is a type of tonic. It can be used for those who are usually physically weak and easily fatigued, or those who are usually robust but are extremely fatigued due to overuse. There are two types of abdominal examinations: one with a thin abdominal wall, with the rectus abdominis muscles appearing tense on the abdominal surface; and one with a soft and weak abdomen, where intestinal peristalsis can be seen through the abdominal wall. In the latter case, it is difficult to distinguish from the syndrome of Da Jian Zhong Tang (Major Construct the Middle Decoction). Symptoms include fatigue and exhaustion as the main complaint, abdominal pain as the main complaint, or palpitations, night sweats, blood in the sputum, seminal emission, hot palms and soles, fatigue and pain in the limbs, dry mouth, and frequent urination. This formula is composed of <a href='https://whatsintcm.com/dt_articles/Gui Zhi Tang/’>Gui Zhi Tang with an increased amount of Peony Root and the addition of Maltose. Maltose and Da Zao (Jujube) have nourishing and strengthening effects. Gan Cao (Licorice Root) is added to relieve urgent symptoms, and Peony Root is added to enhance the analgesic effect. The combination of Gui Zhi (Cinnamon Twig) and Gan Cao (Licorice Root) can treat palpitations. Sheng Jiang (Fresh Ginger) strengthens the stomach and promotes the absorption of the medicine.
【Functions】
Warms the middle and tonifies deficiency, nourishes the righteous and expels evil, harmonizes the interior and alleviates spasms.
【Indications】
Deficiency and cold in the middle qi, disharmony of the Ying and Wei, imbalance of yin and yang, stomachache due to deficiency and cold in the spleen and stomach, relieved by warmth and pressure, or deficiency and heat, or palpitations and irritability. Yi Fang: (1) Palpitations and irritability due to deficiency of middle qi two or three days after cold damage. (2) Treats abdominal pain with a choppy pulse in the yang channels and a wiry pulse in the yin channels due to cold damage (Shang Han Lun, Taiyang section). (3) Commonly treats deficiency and palpitations, epistaxis, abdominal pain with urgency, nocturnal emission, pain in the extremities, hot palms and soles, dry throat and mouth, and deficiency jaundice (Jin Gui Yao Lue, Deficiency Disorders). Shan Bu: For unreleased exterior in cold damage, or palpitations and irritability, or abdominal pain with urgency, and a choppy pulse in the yang channels and a wiry pulse in the yin channels.
【Applications】
Gastric and duodenal ulcers, gastrointestinal dysfunction with symptoms of stomach deficiency and cold, gastritis, various acute and chronic pain, deficiency, and weak constitution. This formula has a wide range of applications, especially in infants and young children. It can be used to improve the constitution of weak children, treat bedwetting, frequent urination in children, diarrhea in children, night terrors, colds, measles, and pneumonia in children.
【Contraindications】
(1) Jian Zhong Tang is used because of its sweetness. (2) Avoid Hai Zao (Sargassum), Chinese cabbage, and raw scallions. (3) It must be used when urination is normal and there is no damp-heat.
【Mnemonic】
(1) Little Pai Jian Zhong, Teacher drinks <a href='https://whatsintcm.com/dt_articles/Gui Zhi Tang/’>Gui Zhi Tang (Gui’s wife, three assistants) plus Yi Tang. (2) Aunt Gui uses sugar to fry ginger and dates (Gui Shao Yi Tang Gan Cao Jiang Zao).
【Modifications】
(1) If qi deficiency is severe, or there is spontaneous sweating due to qi deficiency and fever occurs frequently, add Dang Shen (Codonopsis) and Huang Qi (Astragalus) to tonify the qi. (2) If Ying blood deficiency is severe, or there is bleeding, add Dang Gui (Angelica Sinensis), Shu Di (Prepared Rehmannia), and E Jiao (Donkey-hide gelatin) to tonify the blood and stop bleeding. (3) If abdominal pain is severe, add Wu Ling Zhi (Trogopterus Dung) to relieve spasms and stop pain. (4) Adding Huang Qi (Astragalus) to this formula makes <a href='https://whatsintcm.com/dt_articles/Huang Qi Jian Zhong Tang/’>Huang Qi Jian Zhong Tang (Astragalus Construct the Middle Decoction), which mainly treats deficiency with internal urgency and all types of deficiencies. (5) Adding Dang Gui (Angelica Sinensis) to this formula makes <a href='https://whatsintcm.com/dt_articles/Dang Gui Jian Zhong Tang/’>Dang Gui Jian Zhong Tang (Angelica Sinensis Construct the Middle Decoction), which mainly treats postpartum deficiency and weakness, persistent abdominal pain, shortness of breath, or abdominal cramps, pain radiating to the back, and inability to eat. (6) Adding Dang Gui (Angelica Sinensis), Huang Qi (Astragalus), Gao Liang Jiang (Galangal), and calcined tile makes Gui Qi Jian Zhong Tang, which mainly treats duodenal ulcers. (7) If there is qi stagnation, add Mu Xiang (Aucklandia) and Bing Lang (Betel Nut) to move qi and relieve stagnation. (8) If there is food stagnation, add Shan Zha (Hawthorn Fruit) and Shen Qu (Medicated Leaven) to digest food and resolve stagnation. (9) If there is vomiting, use more Sheng Jiang (Fresh Ginger) to stop vomiting. (10) If there is acid reflux, remove Yi Tang (Maltose) and add stir-fried Bai Zhu (White Atractylodes Rhizome) and Wu Zei Gu (Cuttlebone) to strengthen the spleen and neutralize acid. (11) If damp-heat is more prominent, add Yin Chen (Artemisia scoparia), Pu Gong Ying (Dandelion), and Cang Zhu (Atractylodes Rhizome) to remove damp-heat.
【Pharmacology】
Anti-experimental gastric ulcer, antispasmodic, analgesic effects.