da jian zhong tang

Name: da jian zhong tang
Creator: Bencao Index

Major Construct the Middle Decoction

About da jian zhong tang

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.

Ingredients

Herb	Amount
chuan jiao	3 g
gan jiang	12 g
ren shen	6 g
yi tang	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

Symptoms

Abdominal mass
Abdominal pain
Abdominal pulsation
Borborygmus
Cold abdomen
Cold limbs
Cold sensation
Epigastric pain
Foot pain
Headache
Pain aggravated by pressure
Poor appetite
Succussion splash
Visible peristalsis
Vomiting

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

Preparation

Two-stage decoction: first simmer Ren Shen, Gan Jiang and Chuan Jiao and strain, then stir Yi Tang into the hot liquid until it melts; Dang Shen is a common modern substitute for Ren Shen

Names

Pinyin	da jian zhong tang
English Name	Major Construct the Middle Decoction

Classification

Category: Warm the Middle and Dispel Cold

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