🌿 Folk Prescriptions

Lǐzhōng Tāng originates from Zhang Zhongjing’s *Treatise on Cold Damage Disorders*, composed of Ginseng (Rénshēn), Dried Ginger (Gānjiāng), White Atractylodes (Bái Zhú), and Fried Licorice (Zhì Gāncǎo). The formula uses pungent-hot dried ginger as the principal herb to warm the middle burner and expel interior cold. Ginseng, which greatly replenishes primordial qi and assists in transportation and transformation, serves as the secondary herb, tonifying qi and strengthening the spleen. White Atractylodes strengthens the spleen and dries dampness, while fried licorice tonifies qi, harmonizes the center, and supports earth (spleen). Together, these herbs eliminate cold in the middle burner and restore deficiency through sweet-warm properties. Clear yang ascends, turbid yin descends, and digestion functions properly—thus named “Lǐzhōng” (Regulate the Middle). It is commonly used for conditions caused by middle burner deficiency-cold, such as yang deficiency bleeding, pediatric chronic convulsions (slow fright), chest obstruction (Xīnbì), post-illness excessive salivation, vomiting, diarrhea, and gastric pain. Overall, despite treating various conditions, the underlying essence remains middle burner deficiency-cold, enabling the principle of treating different diseases with the same method.
I. Pediatric Chronic Convulsion (Slow Fright)
Dan Mou, male, 2 years 6 months old, first visit on July 15, 2000. His mother reported: for the past two months, he has had 3–4 episodes of diarrhea daily, with watery, odorless stools of moderate volume resembling egg whites, containing undigested food residues, poor appetite, and occasional convulsions. Examination revealed pale complexion, lethargy, cold limbs, slightly distended soft abdomen, pale tongue with thin white coating, deep pulse, faint purple finger markings approaching the life gate. Diagnosis: pediatric chronic convulsion, syndrome attributed to spleen yang deficiency. Treatment: original Lǐzhōng Tāng formula, decocted and taken once daily, with instructions to consume warm porridge afterward. Two days later, follow-up: significant improvement in mental state, diarrhea reduced to 1–2 times daily, convulsions ceased, appetite improved. Continued original formula for three more doses, all symptoms resolved. Explanation: *Direct Guidelines for Pediatric Medication* states: “Pediatric chronic convulsion results from post-illness or vomiting/diarrhea, or from medicinal injury to the spleen and stomach... This is a case of spleen deficiency generating wind without yang.” This case resulted from irregular diet and improper feeding, damaging the spleen and stomach, leading to severe spleen yang deficiency and subsequent diarrhea and convulsions. Thus, Lǐzhōng Tāng was used to warm and invigorate spleen yang, ensuring the earth (spleen) becomes strong so wood (liver) cannot overact—thereby eliminating all symptoms.
II. Constitutional Susceptibility to Common Cold
Hu Mou, female, 52 years old, cadre. She has suffered recurrent colds for over five years. After catching a chill, she took Shen Su Yin (Ginseng and Perilla Decoction) with no noticeable effect, so she sought treatment at our hospital. Examination revealed a thin physique, pale complexion, headache, nasal congestion, aversion to cold and wind, body aches, discomfort in the chest, occasional nausea, poor appetite, pale tongue, thin white coating, deep, slow, and weak pulse. Based on pulse and symptom analysis, the diagnosis was spleen-stomach deficiency with external cold invasion. Treatment: warm the middle, strengthen the spleen, harmonize the nutritive and defensive qi, and resolve exterior symptoms. Prescription: Lǐzhōng Tāng with added 6g Cinnamon Twig (Guìzhī), 15g Kudzu Root (Gé Gēn), 15g White Peony Root (Bái Sháo), and 5g Fried Licorice (Zhì Gāncǎo). After three doses, all symptoms significantly improved, but abdominal distension and poor appetite persisted. The original formula was then augmented with 10g Fructus Aurantii (Zhǐ Qiào) and 6g Costus Root (Mù Xiāng), and three more doses led to complete recovery. Explanation: *Treatise on Cold Damage Disorders*, Section 163, states: “In solar disease, if exterior symptoms persist and repeated purgatives are administered, leading to persistent diarrhea with fever, heart distress, and unresolved exterior and interior conditions, Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction) is indicated.” Gui Zhi Ren Shen Tang is Lǐzhōng Tāng with added cinnamon twig, originally designed for cold-deficiency diarrhea due to mistaken purgation in solar disease. Although this case did not involve mistaken purgation, the patient has inherent yang deficiency and contracted external cold—still a combined exterior-interior pattern, primarily interior. Thus, this formula was used to treat both exterior and interior simultaneously, proving highly effective.
III. Excessive Salivation
Qin Mou, female, 42 years old, farmer, first visit on June 2, 1999. She reported excessive clear saliva following surgery for peptic ulcer bleeding, lasting three years, accompanied by poor appetite and fatigue. Previous treatment with both TCM and Western medicine yielded little effect, prompting her to seek care at our hospital. Examination revealed sallow complexion, lethargy, cold limbs, slightly distended soft abdomen, pale white tongue with thin white coating, deep, fine, and weak pulse. Clearly, this was spleen qi deficiency with cold. Treatment: warm the middle, tonify spleen qi, and consolidate fluid retention to stop salivation. Formula: Lǐzhōng Tāng with added 6g Prepared Aconite Root (Fùzǐ, pre-boiled for 40 minutes), 9g Alpinia Oxyphylla Seed (Yìzhì Rén), and 6g Cyperus Rotundus (Wū Yào). After three doses, excessive salivation ceased, appetite improved, and spirits lifted. Continuing the original formula for seven more doses, all symptoms disappeared, appetite normalized, and the patient was cured. Follow-up for one year showed no recurrence. Explanation: The spleen governs phlegm and saliva, while the kidney governs saliva. Spleen deficiency-cold fails to control fluid, causing upward overflow and excessive salivation. This case treated both spleen and kidney: Lǐzhōng Tāng warmed spleen yang, while prepared aconite, Alpinia Oxyphylla seed, and Cyperus Rotundus warmed the kidney and consolidated fluid to stop salivation. This strengthened spleen and kidney yang, enhanced water metabolism, and prevented fluid overflow—achieving therapeutic success.
IV. Chest Obstruction (Xīnbì)
Tan Mou, female, 50 years old, visited on March 5, 1998. She complained of chest pain, chest tightness, palpitations, occurring 3–5 times daily, accompanied by shortness of breath and sweating, exacerbated by exertion. Symptoms relieved after taking Xīoxīntōng (Nitroglycerin) and resting. The patient was obese, pale-faced, cold limbs, fatigued, poor appetite, and often experienced chest pain radiating to the back, occasionally palpitations. Western coronary angiography confirmed “coronary heart disease.” Tongue coating was white and greasy, pulse deep and slow. Diagnosis: spleen-stomach deficiency-cold with insufficient chest yang. Treatment: strengthen the spleen and stomach, invigorate chest yang, and unblock blood vessels. Prescription: Lǐzhōng Tāng with added 6g Cinnamon Twig (Guìzhī), 10g Fructus Aurantii (Zhǐ Shí), 30g Trichosanthes Fruit (Quán Guālóu), 15g Allium Tuber (Xiè Bái), and 6g Pinellia Rhizome (Bàn Xià). After one week of continuous use, chest pain disappeared, and other symptoms improved. Explanation: *Legal Principles of Medicine* states: “All chest obstruction stems from yang deficiency, allowing yin to invade.” The patient’s obesity reflects pre-existing yang deficiency, with inadequate chest yang and cold invading the upper position, obstructing qi movement and causing chest obstruction. This case targeted the root cause: using Lǐzhōng Tāng to warm and strengthen the spleen and stomach, nurturing yang; adding cinnamon twig, Trichosanthes fruit, and Allium tuber to warm and open the chest, broaden the chest, and regulate qi—treating both root and branch, hence achieving excellent results.
V. Recurrent Aphthous Stomatitis
Shi Mou, female, 38 years old, first visit on June 5, 1999. She had suffered recurrent oral ulcers for five years, triggered by fatigue. Diagnosed with recurrent aphthous stomatitis by Western medicine. Previous treatments with TCM and Western drugs, plus topical application of Xilile San (Xilile Powder), yielded unsatisfactory results. Examination revealed ulcers of varying sizes on the inner lips, sides and tip of the tongue—some as large as a mung bean, others as small as a grain of rice—sunken surfaces, gray-white in color, surrounded by slightly raised pale red margins. The patient had a sallow complexion, fatigue, poor appetite, abdominal distension, pale swollen tongue with obvious tooth marks, thin white coating, and deep fine pulse. Diagnosis: spleen-kidney yang deficiency with cold-dampness rising. Treatment: warm yang, tonify qi, strengthen the spleen, and resolve dampness. Prescription: Lǐzhōng Tāng with added 6g Prepared Aconite Root (Fùzǐ), 15g Bamboo Leaf (Zhú Yè), and 10g White Peony Root (Bái Sháo). After three doses, the patient felt improved abdominal distension and increased appetite, with oral ulcers improving. The formula was then enhanced with Cinnamon Twig to strengthen yang and dispel cold, continued for three more doses, resulting in complete healing of oral ulcers and marked improvement in systemic symptoms. She was advised to take Fu Zi Li Zhong Wan (Prepared Aconite and Lǐzhōng Pill) for one month to consolidate gains. One-year follow-up showed no recurrence. Explanation: Due to prolonged spleen dysfunction, internal cold-dampness generated, with damp-toxicity rising upward. Spleen deficiency affects the kidney, leading to spleen-kidney yang deficiency and floating of deficient yang, resulting in recurrent oral ulcers. Zhu Danxi said: “Oral ulcers failing to heal with cooling herbs indicate central earth deficiency and inability to eat, with fire rising uncontrollably. Use Lǐzhōng Tāng.” Li Shizhen also noted: “For oral ulcers persisting despite long-term use of cooling herbs, reverse treatment with Lǐzhōng Tāng plus prepared aconite and cinnamon twig is appropriate.” This formula uses prepared aconite to warm and supplement spleen and kidney, guiding fire back to its source; the entire formula tonifies qi and warms yang, strengthens the spleen, disperses cold, and detoxifies, thus subduing rising cold-dampness and healing oral ulcers.