Dried ginger (Gan Jiang) Ginseng (Ren Shen) Atractylodes rhizomes (Bai Zhu) Liquorice (Gan Cao)

Li Zhong Wan

Chinese: 李中丸

Pinyin: Lǐ Zhōng Wán

Other names: Regulating the Centre Pill, Regulate the Middle Pill

Number of ingredients: 4 herbs

Formula category: Formulas that warm the middle and dispel Cold

Conditions for which it may be prescribed: DysenteryVaginitisPeptic ulcers and seven other conditions

  1. Warms the Middle Burner
  2. Strengthens the Spleen and Stomach

Contraindications: Not be used for externally-contracted disorders with fever or Yin Deficiency.

Source date: 220 AD

Source book: Discussion of Cold Damage

Li Zhong Wan is a 4-ingredient Chinese Medicine formula with Dried Ginger (Gan Jiang) as a principal ingredient.

Invented in 220 AD, it belongs to the category of formulas that warm the middle and dispel Cold. Its main actions are: 1) warms the Middle Burner and 2) strengthens the Spleen and Stomach.

In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.

In this case Li Zhong Wan is used by TCM practitioners to fight patterns like Kidney and Spleen Yang Deficiency or Greater Yin stage. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as gastroenteritis, peptic ulcers or irritable bowel syndrome for instance.

On this page, after a detailed description of each of the four ingredients in Li Zhong Wan, we review the patterns and conditions that Li Zhong Wan helps treat.

The four ingredients in Li Zhong Wan

Gan Jiang is a king ingredient in Li Zhong Wan. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Dried Ginger (Gan Jiang)

Part used: Dried rhizome

Nature: Hot

Taste(s): Pungent

Meridian affinity: StomachHeartKidneyLung

Category: Herbs that warm the Interior and/or expel Cold

Gan Jiang warms the Spleen and Stomach Yang and eliminates Interior Cold, the primary function of this formula.

Learn more about Dried Ginger (Gan Jiang)

Ren Shen is a deputy ingredient in Li Zhong Wan. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

2. Ginseng (Ren Shen)

Part used: Dried root

Nature: Warm

Taste(s): BitterSweet

Meridian affinity: SpleenHeartLung

Category: Tonic herbs for Qi Deficiency

Ren Shen strongly tonifies the source Qi. This reinforces the Yang and rectifies the ascending and descending functions of the Middle Burner.

Learn more about Ginseng (Ren Shen)

Bai Zhu is an assistant ingredient in Li Zhong Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

3. Atractylodes Rhizomes (Bai Zhu)

Part used: Dried rhizome

Nature: Warm

Taste(s): BitterSweet

Meridian affinity: SpleenStomach

Category: Tonic herbs for Qi Deficiency

Bai Zhu aids Ginseng in tonifying the Spleen and Stomach and also strengthens the Spleen and dries Dampness.

Learn more about Atractylodes Rhizomes (Bai Zhu)

Gan Cao is an envoy ingredient in Li Zhong Wan. This means that it directs the formula towards certain area of the body and/or harmonizes the actions of other ingredients.

4. Liquorice (Gan Cao)

Part used: Dried root and rhizome

Nature: Neutral

Taste(s): Sweet

Meridian affinity: SpleenStomachHeartLung

Category: Tonic herbs for Qi Deficiency

In general Gan Cao's main actions are as follows: "Tonifies the Basal Qi and nourishes the Spleen Qi. Clears Heat and dispels toxicity. Moistens the Lungsexpel phlegm and stop coughing. Relieves spasms and alleviates pain. Harmonizes and moderates the effects of other herbs."

In the context of Li Zhong Wan, it is used because it augments the Qi of the Middle Burner and harmonizes the actions of the other herbs in the formula.

Learn more about Liquorice (Gan Cao)

Conditions and patterns for which Li Zhong Wan may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Li Zhong Wan is used by TCM practitioners to treat two different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Gastroenteritis Peptic ulcers Irritable bowel syndrome Dysentery Ulcerative colitis Allergic rhinitis Prostatic hypertrophy Chronic bronchitis Vaginitis Pelvic inflammatory disease

Again it wouldn't be correct to say "Li Zhong Wan treats gastroenteritis" for instance. Rather, Li Zhong Wan is used to treat patterns that are sometimes the root cause behind gastroenteritis.

Now let's look at the two patterns commonly treated with Li Zhong Wan.

The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine

Kidney and Spleen Yang Deficiency

Li Zhong Wan is sometimes prescribed by TCM practitioners to treat Kidney and Spleen Yang Deficiency. This pattern leads to symptoms such as lower back pain, cold and weak knees, sensation of cold in the back and feeling of cold. Patients with Kidney and Spleen Yang Deficiency typically exhibit deep (Chen) or weak (Ruo) pulses.

The Spleen is the Organ that provides the material basis for our acquired constitution (Post-Heaven Essence), while the Kidneys provide the inherited constitution (Pre-Heaven Essence).

A Kidney Yang Deficiency contributes to a depletion of Spleen Yang and vice versa. This pattern results when... read more about Kidney and Spleen Yang Deficiency

'Yin' as a body pattern in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Yin in Chinese Medicine

Greater Yin stage

Pulse type(s): Deep (Chen), Slow (Chi), Weak (Ruo)

Symptoms: Vomiting Diarrhea No thirst Tiredness No appetite Feeling of cold Abdominal fullness

Li Zhong Wan is sometimes prescribed by TCM practitioners to treat Greater Yin stage. This pattern leads to symptoms such as no appetite, vomiting, abdominal fullness and feeling of cold. Patients with Greater Yin stage typically exhibit deep (Chen), slow (Chi) or weak (Ruo) pulses.

This is the pattern of the Greater Yin stage, the first Yin stage of the Six Stages theory

At this stage what's mainly affected is the Spleen Channel, often called "Lower Tai Yin".

In terms of symptoms patients typically experience classic signs of Spleen Yang Deficiency with Cold. Symptoms... read more about Greater Yin stage

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