Herb Formulas Notebook

Da Jian Zhong Tang

Major Construct the Middle Decoction


Author: Zhang Zhong-Jing, 張仲景

Year: c. 220

Source: Essentials from the Golden Cabinet (Jin Gui Yao Lue, 金匱要略)


Category: Formulas that Warm Interior Cold

Pattern: Middle Jiao Yang deficiency with internal Cold

Key Symptoms: Excruciating epigastric and abdominal pain, strong sensation of cold in the epigastrium, vomiting to the point of being unable to eat
Secondary Symptoms: Borborygmus

Tongue: White, slippery coating
Pulse: Thin and tight, or slow and wiry, or in severe cases hidden
Abdomen: Cannot tolerate being touched


Ingredients

Hua Jiao 3-9g
Gan Jiang 12g
Ren Shen 6g
Yi Tang 18-30g


Preparation: Decoction.


Actions: Warms and tonifies middle Jiao deficiency, directs rebellious Qi downwards, alleviates pain

Contraindications: Internal clumping, Damp-Heat, Yin and Blood deficiency



Notes:
One liang is taken as 3g in modern sources but in Eastern Han times it was equivalent to 13.875g. This means that the dosages in classical formulae could have been more than 4x what is given today making them far higher than recommended safe dosages today but prompts consideration of what an effective dose may be (He, 2013).



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Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.