Classic Famous Formula
Da Jian Zhong Tang (Major Construct the Middle Decoction)
【Nature】 It is a warming interior medicine, which has the effects of warming the middle, tonifying deficiency, and descending counterflow to stop pain.
【Indications】 For symptoms of severe abdominal pain due to weak middle yang and excess cold yin. Symptoms include severe cold pain in the chest and abdomen, inability to eat due to vomiting, cold in the abdomen, skin rising with cold sensation, pain in the upper and lower body that cannot be touched, cold hands and feet, pale tongue, white slippery coating, and a deep, weak pulse.
【Functions】 Warms the middle, tonifies deficiency, descends counterflow, and stops pain.
【Dosage】 Take the three ingredients, add four liters of water, boil down to two liters, strain, and add rock candy (30 grams), simmer to obtain one and a half liters, and take warm. It can be consumed with two liters of porridge, and then continue to take as needed, preferably warm.
(Dr. Shen suggests using TCM formula granules for more convenience)
Two parts of Shu Jiao (Zanthoxylum) (to dispel sweat)
Four taels of Gan Jiang (Dried Ginger)
Two taels of Ren Shen (Ginseng)
From——”Jin Gui Yao Lue” by Zhang Zhongjing, Han Dynasty
Formula Explanation: This syndrome is often caused by weak middle yang and excess cold yin, treated primarily by warming the middle, tonifying deficiency, and descending counterflow to stop pain. Cold nature constricts, and with excess cold yin, yang loses warmth, hence the severe cold pain in the chest and abdomen, and the skin rises with cold sensation. The cold in the abdomen leads to disharmony and descent, causing vomiting and inability to eat. In the formula, Shu Jiao warms the spleen and stomach, assists the life fire, disperses cold, and stops pain, serving as the monarch herb. The spicy and warming Gan Jiang helps to warm the middle and disperse cold, enhancing the effect of Shu Jiao; rock candy warms and tonifies the middle deficiency, alleviates urgency and stops pain, complementing Shu Jiao’s pain-relieving function, serving as minister herbs. Ren Shen tonifies the spleen and benefits qi, working with rock candy to rebuild the middle organs, serving as an assistant herb.
Application: This formula is used for severe abdominal pain due to weak middle yang and excess cold yin, clinically applied to symptoms of severe cold pain in the chest, inability to eat due to vomiting, cold in the abdomen, cold hands and feet, pale tongue, white slippery coating, and a deep, weak pulse as key diagnostic points.
Adjustments: For cough, add Kuan Dong Hua (Tussilago); for coughing blood, add E Jiao (Donkey-hide Gelatin); for seminal emission, add Long Gu (Dragon Bone); for palpitations, add Fu Shen (Poria with fungus).
Contraindications: This formula has a strong spicy and warm nature, and should be used cautiously in those with a constitution of yin deficiency, and is also not suitable for those with cold stagnation and qi stagnation.
Additional Formula OneHuang Qi Jian Zhong Tang (Astragalus Construct the Middle Decoction) Composition: Gui Zhi (Cinnamon Twig), Gan Cao (Licorice), Da Zao (Jujube), Bai Shao (White Peony), Sheng Jiang (Fresh Ginger), Yi Tang (Rock Candy), Huang Qi (Astragalus). Dosage: Huang Qi 15g, Da Zao 10 pieces, Bai Shao 15g, Gui Zhi, Sheng Jiang, Gan Cao each 10g, Yi Tang 50g. Function: Warms the middle, tonifies qi, harmonizes the interior, alleviates urgency. Indications: Deficiency of both yin and yang qi and blood. Abdominal pain with urgency, preference for warmth and pressure, emaciation, pale complexion, palpitations, shortness of breath, spontaneous sweating, and night sweats. Source: “Jin Gui Yao Lue”
Additional Formula Two: Dang Gui Jian Zhong Tang (Angelica Construct the Middle Decoction) Composition: Dang Gui (Angelica), Gui Xin (Cinnamon Heart), Gan Cao (Licorice), Bai Shao (White Peony), Sheng Jiang (Fresh Ginger), Da Zao (Jujube). Dosage: Dang Gui 12g, Gui Xin 9g, Da Zao 12 pieces, Gan Cao 6g, Bai Shao 18g, Sheng Jiang 9g. Function: Warms and tonifies qi and blood, alleviates urgency and stops pain. Indications: Postpartum deficiency and weakness, persistent abdominal pain, or cramping pain in the lower abdomen radiating to the waist and back, inability to eat.
Additional Formula Three: Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) Composition: Yi Tang (Rock Candy), Gui Zhi (Cinnamon Twig), Bai Shao (White Peony), Gan Cao (Licorice), Da Zao (Jujube), Sheng Jiang (Fresh Ginger). Function: Warms the middle, tonifies deficiency, harmonizes the interior, alleviates urgency. Indications: Middle jiao deficiency cold, liver and spleen disharmony. Abdominal cramping pain, preference for warmth and pressure, fatigue, weakness, palpitations, restlessness, pale complexion; may also have limb soreness, hot hands and feet, dry throat, and dry mouth. Pale tongue with white coating, thin and wiry pulse.
Distinguishing Between Adjusted Formulas: All four formulas belong to warming the middle and tonifying deficiency. Xiao Jian Zhong Tang uses more Bai Shao, beneficial for yang deficiency while also having insufficient yin. Huang Qi Jian Zhong Tang is Xiao Jian Zhong Tang with added Huang Qi, enhancing the tonifying qi and constructing the middle. Dang Gui Jian Zhong Tang emphasizes harmonizing blood and stopping pain. Da Jian Zhong Tang has a much stronger effect of tonifying deficiency and dispersing cold compared to Xiao Jian Zhong Tang, and also has the function of descending counterflow and stopping vomiting, used for abdominal pain and vomiting due to weak middle yang and excess cold yin.
Important Literature Summary:1、“Jin Gui Yao Lue Shi Yi”: “The Ben Cao Jing states that Shu Jiao is the master of evil qi, warms the middle, expels cold pain, and descends qi. Severe cold is indeed evil qi. Severe cold pain in the chest and abdomen, vomiting and inability to eat, should be treated by warming the middle. Cold qi rising causes skin to rise with cold sensation, and if there are head and feet, it should also descend qi, hence Shu Jiao is essential. If the middle does not receive warmth, pain and obstruction do not necessarily require descending qi, thus Shu Jiao is not suitable. Gan Jiang is also a warming middle herb; this syndrome is due to deep cold and stubborn cold in the middle, which moves upward, hence Shu Jiao is used with Gan Jiang to calm and suppress it to achieve balance. Some say Fu Zi (Aconite) drives away cold and stops pain, why not use it? It is because there is yang within yin, and reality within emptiness; why? Vomiting is a real symptom with fire, and inability to eat indicates great injury to the middle qi, thus Fu Zi cannot be used to attack. It is better to use Ren Shen and Yi Tang to replenish the deficiency. The formula name Da Jian Zhong Tang is indeed appropriate.”2、“Yi Fang Ji Jie”: “This is a medicine for the foot Taiyin and Yangming; Shu Jiao is spicy and warm, enters the lungs to disperse cold, enters the spleen to warm the stomach, and enters the kidneys to supplement fire; Gan Jiang is spicy and warm, opens the heart, assists yang, expels cold, and disperses counterflow; Ren Shen is sweet and warm, greatly tonifies the qi of the spleen and lungs; Yi Tang is sweet and can tonify the earth, harmonizing the middle. The essence of a person is based on the middle qi; using spicy, hot, and sweet medicines warms and strengthens the internal organs, expelling the yin of the lower jiao while restoring the yang of the upper jiao.”3、“Yi Fang Lun”: “Without Ren Shen, one cannot greatly tonify the heart and spleen; without Jiang and Jiao, one cannot greatly expel cold qi, hence it is called Da Jian Zhong. Moreover, Yi Tang’s sweetness can mitigate the spiciness and dryness of Jiang and Jiao. Only a sage in medicine can discern this.”
Contraindications
This formula has a strong spicy and warm nature, and should be used cautiously in those with a constitution of yin deficiency, and is also not suitable for those with cold stagnation and qi stagnation.
【Special Reminder】TCM formula granules are prescription medications and should only be prepared, purchased, and used under the guidance of a physician. Patients are advised to use them under the guidance of a doctor.
