Herb Formulas Notebook

Xiao Jian Zhong Tang

Minor Construct the Middle Decoction

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Source: Discussion of Cold Damage (c. 220)
Author: Zhang Ji / Zhong-Jing

Category: Formulas that Warm Interior Cold

Pattern: Middle Jiao deficient and Cold due to consumptive illness, Chong Mai counterflow due to Cold Damage.

Key Symptoms: Spasmodic abdominal pain (often focused in either the epigastrium or around the umbilicus) that improves with heat or pressure, lustreless complexion, reduced appetite
Secondary Symptoms: Low grade fever, spontaneous sweating, night sweats, palpitations, irritability, aversion to cold, cold extremities with soreness and nonspecific discomfort, alternating diarrhoea and constipation, dry mouth and throat, increased urination, bedwetting in children

Tongue: Normal or pale, thin white coating
Pulse: Thin, wiry and moderate, or large and deficient
Abdomen: Distended but with weak muscle tone, visible peristaltic movements, hypertonicity of rectus abdominis, pencil line of tension above and below the umbilicus

Yi Tang 30g
Gui Zhi 9g
Bai Shao 18g
Zhi Gan Cao 6g
Sheng Jiang 9g
Da Zao 4pcs

Preparation: Decoction.

Actions: Warms and tonifies the middle Jiao, moderates spasmodic abdominal pain

Contraindications: Heat from Yin deficiency, abdominal distension from excess patterns

Extraordinary Vessel attributions come from Li Shi-Zhen's (1577-8) Exposition on the Eight Extraordinary Vessels (Qi Jing Ba Mai Kao), trans. Chace & Shima (2009). It should be preceded by Fang Feng Bai Zhu Mu Li Tang or Gan Cao Gan Jiang Tang.

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Journal of Chinese Medicine
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Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.