Disease Inquiry, Health Guidance, Classic Health Preservation, No Need to Seek Help When Sick
Li Zhong Tang (Regulating the Middle Decoction) is composed of equal parts of Ren Shen (Ginseng), Gan Jiang (Dried Ginger), Zhi Gan Cao (Honey-fried Licorice), and Bai Zhu (White Atractylodes). This formula uses Ren Shen, Bai Zhu, and Zhi Gan Cao to tonify the Spleen and Stomach, while Gan Jiang warms the middle and disperses cold, making it an excellent formula for warming and tonifying Spleen Yang.
According to the modifications in the “Lun” (Treatise), the following adjustments can be made:
If there is movement above the navel and Kidney Yang deficiency with water qi rising, remove Bai Zhu to alleviate stagnation and add Gui Zhi (Cinnamon Twig) to descend the counterflow;
If there is excessive vomiting due to qi counterflow, still remove Bai Zhu to alleviate qi stagnation and add Sheng Jiang (Fresh Ginger) to treat vomiting;
If there is severe diarrhea, it indicates that water and dampness are predominant and descending, thus Bai Zhu must still be used to assist the Spleen in overcoming dampness;
If there is palpitations in the heart area, it indicates water qi encroaching on the heart, add Fu Ling (Poria) to promote urination and resolve dampness;
If there is thirst and a desire for water, it indicates that the Spleen is unable to disperse fluids, leading to water retention, which is different from fluid damage causing thirst, hence increase Bai Zhu to strengthen the earth and control water, enhancing Spleen function;
If there is abdominal pain, it is due to internal deficiency causing pain, and the pain is relieved by pressure, thus increase Ren Shen to tonify the central qi;
If there is excessive cold in the interior, increase Gan Jiang to warm the middle and disperse cold;
If there is abdominal fullness due to Yang deficiency and cold stagnation, remove Bai Zhu to avoid excess tonification, and add Fu Zi (Aconite) for warmth to assist Yang and disperse stagnation.
The above eight modifications are reasonable for additions, but removals may not be appropriate and should be determined clinically. Later practitioners have created new formulas based on Zhang Zhongjing’s original formula, such as Xiang Sha Li Zhong, Ding Kou Li Zhong, Fu Gui Li Zhong, Wu Yu Li Zhong, and Jiao Mei Li Zhong, as well as Lian Li Tang and Zhi Zhong Tang, all of which are variations of Li Zhong Tang with unique effects and are commonly used in clinical practice.
Case Examples
Case 1: Liu, male, 57 years old, farmer. Consulted on April 23, 1964.
The patient is robust but has suffered from qi pain (possibly gastritis or gastric ulcer) since around the age of 30, for over 20 years, with repeated treatments yielding no effect. As he aged, he experienced pain every 2-3 days, with increasing severity. During pain episodes, he needed to lie prone, using his hands to cushion his abdomen for relief. Severe cases involved sour vomiting and belching, and eating flatbread would gradually alleviate the pain. There was a palpable mass in the abdomen that would appear and disappear, but after pain episodes, the distension was particularly severe. The abdomen was soft, the body was emaciated, the complexion was haggard, the pulse was thin and weak, the tongue was pale, and the coating was white and slippery. This condition was caused by deficiency cold, and treatment aimed to warm and tonify the Spleen and Stomach to restore balance.
Prescription: Xi Dang Shen (Western Ginseng) 15g, Tu Chao Bai Zhu (Stir-fried Atractylodes) 15g, Pao Gan Jiang (Processed Dried Ginger) 10g, Zhi Gan Cao (Honey-fried Licorice) 5g, Guang Mu Xiang (Aromatic Wood) 5g, Xi Sha Ren (Western Sand Ginger) 6g, Huang Lian (Coptis) stir-fried with Wu Zhu Yu (Evodia) 6g. Decoction with gentle heat, one dose daily.
After taking one dose, the pain slightly eased, and the abdominal mass seemed to dissipate. After the second dose, the pain stopped, appetite increased significantly, and especially notable was the improvement in spirit. After taking a total of 10 doses, the constitution recovered, allowing participation in general labor, and the chronic ailment was cured with one medicine, bringing great joy!
Case 2: Qiu, female, 52 years old, retired worker. Consulted on April 5, 1993.
The patient has a weak constitution, and any slight dietary indiscretion leads to abdominal distension, bowel sounds, and diarrhea, ranging from 1-2 times daily to 5-6 times daily. The stools are loose or watery, with a feeling of heaviness in the anus. She feels fatigued, has a poor appetite, and experiences dizziness and tinnitus. Blood pressure is low, presenting an anemic complexion, with a weak pulse and a pale tongue with a white and moist coating.
Prescription: Dang Shen (Codonopsis) 15g, Bai Zhu (Atractylodes) 10g, Gan Jiang (Dried Ginger) 10g, Zhi Gan Cao (Honey-fried Licorice) 5g, Guang Mu Xiang (Aromatic Wood) 10g, Chuan Huang Lian (Coptis) 3g, Shen Qu (Fermented Wheat) 15g, Hou Po (Magnolia Bark) 10g. One dose daily, decocted and taken warm.
Second Consultation: April 10. After taking the previous prescription for 5 doses, diarrhea completely stopped, spirit improved, and appetite increased. The pulse was slow but strong, and the tongue was pale red and moist. The plan was to tonify the Spleen and Stomach while also regulating qi and blood, using a modified Gui Pi Tang (Restore the Spleen Decoction).
Prescription: Sheng Huang Qi (Fresh Astragalus) 20g, Dang Gui (Angelica) 10g, Dang Shen (Codonopsis) 15g, Bai Zhu (Atractylodes) 10g, Fu Ling (Poria) 15g, Fa Ban Xia (Pinellia) 10g, Chen Pi (Aged Tangerine Peel) 10g, Shan Yao (Chinese Yam) 15g, Guang Mu Xiang (Aromatic Wood) 5g, Zhi Gan Cao (Honey-fried Licorice) 5g, 3 slices of Sheng Jiang (Fresh Ginger), 3 dates. Instruct to take 10 doses, one dose daily, decocted and divided into two warm servings. Additionally, take one packet of Jian Pi Yi Qi Chong Ji (Spleen Tonifying and Qi Boosting Powder) every morning on an empty stomach (containing 15g of raw herbs).
After half a month of treatment, everything returned to normal, with increased food intake, and the decoction was stopped, only using the powder and Gui Pi Wan (Restore the Spleen Pill) for consolidation. Six months later, she returned for a follow-up, slightly overweight, in good spirits, able to manage household chores, and everything was as usual.
Note: Spleen deficiency diarrhea is a common clinical symptom. Due to insufficient Spleen and Stomach function, any slight dietary indiscretion can lead to diarrhea. The treatment should focus on tonifying the Spleen and stopping diarrhea. Li Zhong Tang is the first choice for warming and regulating the middle burner, and adding a small amount of Huang Lian (Coptis) for its bitter properties can strengthen the intestines, while the warmth of Gan Jiang provides a counteracting effect. When combined with Guang Mu Xiang, it effectively functions like Xiang Lian Wan (Aromatic and Bitter Pill) to regulate qi and stop diarrhea. Li Zhong Tang with Huang Lian is known as Lian Li Tang, which is an excellent formula for stopping diarrhea, exemplifying the clever use of slightly cooling herbs among the warming and hot herbs in the treatment of warm diseases.
The great way is extremely simple; it is the law of development of all things in the universe, the essence of Chinese culture, and the philosophy of Daoism. The so-called “true transmission is one sentence, false transmission is thousands of volumes of books.” “At the beginning of all things, the great way is extremely simple, evolving into complexity” comes from Laozi’s “Dao De Jing”. The great way is extremely simple, and it is emphasized not only by philosophical schools such as Daoism and Confucianism but also as a life principle.
The great way is extremely simple, the great way is formless, the great way is formless; this is a high state of naturalness, returning to simplicity. In this state of tranquility, selflessness, and unity with nature, one does not seek to cultivate skills, and the power naturally increases; one does not seek to treat diseases, and the body and mind naturally adjust; one does not seek functions, and the functions naturally manifest; one does not seek the small and large circulations, and the hundred meridians naturally flow smoothly. The deepest truths are the simplest and most ordinary truths. Transforming the most complex into the simplest is the highest wisdom. The greatest people appear noble simply because they are simple.
The great way is extremely simple, and life is also simple. Enlightenment, when profound, becomes simple; when simple, it becomes profound. From seeing mountains as mountains to seeing mountains as mountains, the realms are different. From simplicity to complexity, and then from complexity to simplicity, is sublimation. The meaning of life lies in simplicity. When a person cultivates to a certain extent, they will become indifferent to some matters and become simple. You can understand others, but others may not necessarily understand you. In fact, it is not about understanding but about recognition.
Refined in heart, simple in form. Questioning the soul is the ultimate question of humanity. Simplicity is not only a form of beauty but also a capability and a realm. Seeing through without revealing is a high realm; seeing vaguely, the heart is transparent; transparency is not transparency, knowing the unknown, intentionally not seeing through is true clarity; knowing that worldly matters cannot be seen through is clarity. The clarity after clarity, understanding after misunderstanding, and being confused is a true realm.
“The great way is extremely simple” is the wisdom of being human. To do things, one must simplify complex matters, which requires wisdom. Returning complicated matters to simplicity requires wisdom, ability, and determination. Wise people appreciate the great way is extremely simple; therefore, one should not chase after fame and profit; one should not be burdened by reputation and wealth. Indifference clarifies one’s aspirations, tranquility leads to far-reaching goals. We should live simply and work diligently, using wisdom to simplify the difficult.
For the sake of fame and profit, one should cast aside honor and disgrace, pure as the innocent virgin of childhood, simple as the fertile soil cultivated by ancestors. Only those with a calm heart can see the leisurely scene of “the setting sun shining on the village, the cattle and sheep returning home in the narrow alley” and hear the heavenly sounds of “the lotus breeze sending autumn air, the bamboo dew dripping clear sounds” and feel the emptiness of “the empty mountain with no one in sight, only the sound of human voices.” Tao Yuanming was such a person, so he could compose the verse “Picking chrysanthemums by the eastern fence, I leisurely see the southern mountain”; Ouyang Xiu was also such a person, so he could still write the “Record of the Drunken Old Man’s Pavilion” with ease during his exile.
The great way is extremely simple, and life is also simple. Simplicity is not material poverty but spiritual freedom; simplicity is not the emptiness of life but the purity of the soul. The great way is extremely simple, and the highest principles are often the most straightforward. People should learn to live simply, simply act, and let go of selfish thoughts and desires, transcending the cage of self-will, truly forgetting one’s thoughts and consciousness, entering a state of selflessness and forgetting things.
The complexities of life arise from confusion. To resist temptation with “benevolence” and to resolve confusion with “wisdom”. Not being confused is the mark of life transitioning from complexity to simplicity. With the weak waters of three thousand, I only take a ladle to drink; in the myriad forms of life, one must remain steadfast. Rejoice to forget worries, and simplicity preserves truth; this is the “great way is extremely simple” of life.
There is a story about the great way being extremely simple and having a peaceful heart: A traveler asked an old Daoist, “What did you do before you attained the Dao?” The old Daoist replied, “Chopping wood, carrying water, and cooking.” The traveler asked, “And after attaining the Dao?” The old Daoist replied, “Chopping wood, carrying water, and cooking.” The traveler asked again, “What does it mean to attain the Dao?” The old Daoist replied, “Before attaining the Dao, when chopping wood, I thought about carrying water; when carrying water, I thought about cooking; after attaining the Dao, chopping wood is just chopping wood, carrying water is just carrying water, cooking is just cooking.” The dialogue between the old Daoist and the traveler enlightens us that many profound truths are contained in extremely simple thoughts.
The great way is extremely simple, and life is easy and simple. A thousand people have a thousand ways of living and paths in life. After walking through the years and life, there are many feelings in the heart. Let go of everything, and be free; let go in the present, and be free in the present. Many problems in life do not need to be held in the heart, and many burdens in life do not need to be shouldered. Only by letting go of a thought can one feel the joy of simple living and the exhilaration of the soul soaring. To change some things, one must first find oneself. We all have potential energy, which is easily covered by habits, confused by time, and worn down by inertia. We should remember what should be remembered, forget what should be forgotten, change what can be changed, and accept what cannot be changed. We should face the past with the least regret, the present with the least waste, and the future with the most dreams.
The way of heaven and earth is simple and easy. Life is short; do not think too complicated about everything, live simply. Once the curtain of this grand play of life is raised, no matter how nervous you are, you must perform until the end. The greatest challenge in the process of growth is that some paths can only be walked in silence. Happy work and simple living are the keys to a happy life. One must understand to be content and happy. All sorrow and pain, all things that cannot be given up, are merely transitions in life. Once you jump over them, you can become more wonderful.
The best life is a simple life: a cup of tea, a table, a quiet place, plain days, and a mind free of distractions. However, a simple life requires great effort to enjoy life without worries. Overall, life is perfect; it is the mindset that is imperfect. Those who do not understand appreciation will turn everything into flaws with their criticism. Live simply, act naturally, grasp the measure, and accept reality calmly; do things simply, do not provoke trouble, do not create issues, do not fear problems, do not regret, do not complain, and do not begrudge what you have done.
Life is a long struggle; some people smile at the beginning, while others win in the end. Try to smile, try to look back, relax yourself, do not force, do not be weak, do not be restless. Live simply, follow your heart, follow your nature, and be the best version of yourself. Be content, smile, and remain calm. Even if it is bitter and tiring, as long as you persist in moving forward, your own scenery will eventually appear.
Whether life is easy or not depends on how you live. The situation depends on the mindset; when the mindset changes, the situation will also change. The more you demand from life, the more tense and complicated you will become, and life will become more difficult. Conversely, the less you demand from life, the easier it is to be satisfied and happy. The bright moon and mountains have no permanent owner; when you are free, you are the master. The great way is extremely simple; live in the present, and being content can bring lasting happiness.
Understanding enters the tranquil realm of no worries; a heart like the moon shines alone, fully revealing the state of a calm heart. A calm heart naturally brings composure and ease, holding the heart like water and smiling at life, further revealing the charm of a calm heart. In life, simplicity is the truest, silence is the most beautiful. The most enduring in life is not prosperity but simplicity, not noise but tranquility. Maintain a childlike heart; when unhappy, openly share troubles with friends; when happy, laugh freely. Perhaps all worries will flow away in the sharing, and all tension will be released in laughter.
There is always a story in life that is hard to tell, gradually composing a melody in the heart. People are like this; what they cannot obtain they will always yearn for, and what they have lost will be felt as precious. The so-called gains and losses, emotions and fates, scenery and way stations, all gradually fade in the dust of time. Although it is difficult to let go of some things, what does not belong to you will eventually drift away.
A person’s life is destined to experience much. On the road of the mundane world, there are bright laughs, tears of grievance, naive persistence, confident successes, and awakening failures. Every experience is precious. The richness of life comes from the compassion of the heart, and the beauty of life comes from having a peaceful heart. A simple life brings ease and joy, and simple thoughts bring peace and tranquility. Because of simplicity, one can deeply understand the lightness of life; because of simplicity, one can perceive the tranquility of the soul.
Spleen and Stomach Yang Deficiency Diarrhea: In urgent cases, stop the diarrhea. After the diarrhea stops, one should tonify the Spleen and Stomach. Liu Jun Zi Tang (Six Gentlemen Decoction) is a tonifying agent that can be used for consolidation, followed by Gui Pi Wan for completion, which is beneficial for regulating and tonifying qi and blood.
The above is for reference only; please consult a physician for guidance.
Reviewed by: Pharmacist Lu
Edited by: San Qi Xiao Mei
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