What Constitutes the Li Zhong Wan Fang Ge Formula?

Li Zhong Wan (Pill for Regulating the Middle)

Li Zhong Wan possesses the effects of warming the middle, dispelling cold, tonifying qi, and strengthening the spleen. It exhibits remarkable therapeutic effects on conditions such as spleen-stomach deficiency cold, spontaneous diarrhea without thirst, vomiting with abdominal pain, anorexia, and cold-induced cholera. In ancient times, people recorded medicinal prescriptions in a unique way, often through the form of ballads. Therefore, the composition of the ballad for Li Zhong Wan refers to its constituent herbs, typically consisting of ginseng, dried ginger, atractylodes macrocephala, and licorice (honey-fried).

Composition of Li Zhong Wan

1. Composition: Ginseng, Dried Ginger, Atractylodes Macrocephala, Licorice (Honey-fried)

2. Ballad: "Li Zhong Gan Jiang Shen Shu Gan, Warms Middle Strengthens Spleen for Deficiency Cold; Middle Yang Deficiency Causes Pain, Vomiting, Diarrhea, Pills or Decoction Warms the Abdomen."

3. Functions: Warms the middle, dispels cold, tonifies qi, and strengthens the spleen.

Primary Indications of Li Zhong Wan

(1) Spleen-Stomach Deficiency Cold Syndrome: Continuous epigastric and abdominal pain relieved by warmth, vomiting, loose stools, epigastric distention with reduced appetite, aversion to cold with cold extremities, no thirst, pale tongue with white and moist fur, and deep, thin, or slow and weak pulses.

(2) Yang Deficiency with Blood Loss Syndrome: Hematemesis, hematochezia, epistaxis, or metrorrhagia with dark and thin blood.

(3) Chest obstruction caused by spleen-stomach deficiency cold, excessive saliva after illness, or slow convulsions in children.

Compatibility and Formulation of Li Zhong Wan

In this formula, dried ginger serves as the sovereign herb, with its strong pungent and hot nature warming the spleen-yang, dispelling cold pathogens, and supporting yang while restraining yin. Ginseng, as the minister herb, is sweet and warm in nature, tonifying qi and strengthening the spleen. Together, the sovereign and minister herbs warm the middle, dispel cold, and invigorate the spleen and qi. The spleen is prone to dampness when deficient, hence the use of atractylodes macrocephala, which is sweet, warm, bitter, and drying, as an assistant herb to strengthen the spleen and dry dampness. Licorice, used in equal amounts with other herbs, serves three purposes: firstly, it combines with ginseng and atractylodes macrocephala to assist in tonifying qi and strengthening the spleen; secondly, it alleviates acute pain; thirdly, it harmonizes the properties of the herbs, acting as both an assistant and a messenger herb. Overall, this formula combines warming and tonifying, with emphasis on warming, to warm the middle-yang, dispel cold pathogens, benefit the spleen-qi, and aid digestion, hence its name "Li Zhong" (Regulating the Middle).