Li Zhong Wan理中丸
Regulate the Middle Pill
Ingredients4 herbs
Indications
Spleen and Stomach cold-deficiency: the yang of the middle burner is too weak to transform food or hold fluid in place. The distinguishing detail is direction — the pain, the appetite and the stool all improve with warmth and worsen with cold or raw food.
Clinical Manifestations
- Chronic loose stools containing undigested food
- Dull epigastric or abdominal pain relieved by warmth and pressure
- Vomiting of clear thin fluid with a poor appetite
- Copious clear saliva after a long illness
- Cold hands and feet with no thirst
Health Categories
Modern Applications
Common adjustments
- Palpitations — add Fu Ling 茯苓, following the classical text's own modification
- Frequent vomiting — reduce or omit Bai Zhu 白术 and add Sheng Jiang 生姜
- Abdominal fullness with the cold reaching Kidney yang — add Fu Zi — the formula becomes Fu Zi Li Zhong Wan 附子理中丸
- Chronic bleeding from a cold Spleen failing to hold blood — use Pao Jiang 炮姜 in place of Gan Jiang
- Sinking qi with prolapse or long-standing diarrhea — combine with the qi-raising strategy — add Huang Qi 黄芪, Sheng Ma 升麻
Contraindications
Not for diarrhea or epigastric pain of damp-heat or Stomach fire — burning malodorous stools, thirst, a yellow greasy coating — where warming feeds the heat. Also unsuitable in yin deficiency with heat signs, and in the acute stage of a dysenteric illness, which needs a different strategy.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Generally compatible where the cold-deficiency pattern is clear — none of the four herbs is restricted in pregnancy — but it should be prescribed and reviewed by a practitioner rather than self-selected.
Related Formulas
References
Source Shang Han Lun 《伤寒论》 · Eastern Han
「霍乱，头痛发热，身疼痛，热多欲饮水者，五苓散主之；寒多不用水者，理中丸主之。」
- Classical source (public domain), cited in the source-quote section.
2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
3. 《方剂学》（全国中医药行业高等教育规划教材）— pattern analysis cross-checked.
Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.