Da Jian Zhong Tang, Major Construct the Middle Decoction, is Chuan Jiao, Gan Jiang, Ren Shen and Yi Tang. The catalogue classes it among the formulas that warm the Middle and dispel Cold, and records it as warming and tonifying Middle Jiao Yang against severe Cold.

Herb

Amount

3 g

12 g

6 g

18 g

Actions and indications

Warms and tonifies Middle Jiao Yang and expels severe Cold

Yang deficiency of the Middle Jiao with Cold retained and rising upward; also Jue Yin Cold
Intense cold felt in the chest, epigastrium and abdomen
Cold limbs may be present
Tongue pale or dark purple, with a greasy white, slippery or moist coat; pulse tight, thin and tight, slow and wiry, or deep and thin, or hidden in severe cases

Directs rebellious Qi downward

Vomiting so severe that eating is impossible, or brought on by any attempt to eat or drink
Waves of movement or lumps under the abdominal skin that rise and subside, visible or palpable
Borborygmus or sounds of fluid in the abdomen may be present

Relieves pain

Violent cramping pain of the epigastrium and abdomen, so bad the abdomen cannot bear to be touched

Modern uses

Gastric ulcer
Duodenal ulcer
Gastric spasms
Chronic gastritis
Gastroenteritis
Indigestion
Nausea and vomiting
Chronic pancreatitis
Chronic cholecystitis
Cholelithiasis
Jaundice
Biliary ascariasis
Roundworm infestation
Urinary calculi
Peritonitis
Intestinal spasms
Intestinal colic
Intestinal flaccidity
Slow intestinal motility
Uncomplicated intestinal obstruction
Obstructive bowel disease
Postoperative ileus
Acute appendicitis
Hernia
Severe constipation
Constipation from morphine in cancer patients
Breast cancer, alongside chemotherapy
Cramping abdominal pain
Headache
Fatigue
Weakness

Modifications

Roundworms: + yi tang, + wu mei, + bing lang, + shi jun zi

To strengthen pain relief: + dan shen, + yan hu suo, + mu xiang

Numbness of the hands and feet: + gui zhi

Nausea and vomiting: + zhi ban xia, + sheng jiang

Cold hands and feet: + gui zhi, + xi xin

Constipation: + da huang, + mang xiao

Blood stasis: + san leng, + e zhu

Qi stagnation: + sha ren, + tan xiang

Chest and epigastrium very cold and painful: + zhi fu zi, + xi xin

Abdominal Cold and pain (combined with Li Zhong Tang)

Abdominal fullness and pain: + hou po, + xing ren

Nausea and vomiting with severe abdominal pain (combined with Ban Xia Xie Xin Tang)

Show all 13 modifications

Headache from Cold: + wu zhu yu

Cautions

contraindication Internal clumping or stagnation, or excess Heat

contraindication Damp-Heat

contraindication Yin deficiency or Blood deficiency

contraindication Signs of Heat such as a red tongue or thirst show it is the wrong treatment

caution Both Gan Jiang and Chuan Jiao are fiercely hot and acrid: taken too much or too long without a Cold, deficient picture they may harm the Yin fluids or add to Heat

caution Get medical assessment for sudden or severe abdominal pain: bowel obstruction, pancreatitis and gallbladder disease may be emergencies, and ulcers need medical care

Pinyin

da jian zhong tang

English Name

Major Construct the Middle Decoction

da jian zhong tang

About da jian zhong tang

Ingredients

Actions and indications

Warms and tonifies Middle Jiao Yang and expels severe Cold

Directs rebellious Qi downward

Relieves pain

Modern uses

Symptoms

Modifications

Cautions

Preparation

Names

Classification