FU ZI LI ZHONG WAN (Jia Wei) (BP070)Dangshen & Ginger Complex

Indication

This formula is from the ‘Formulary of the Tai Ping Welfare Dispensary Bureau’ (tai ping hui min he ji ju fang) (1151 CE), a compilation of popular and effective formulas that were used in the public dispensaries of the Song dynastic period. It is a variant on Li Zhong Wan (Formula to Regulate the Middle [Jiao]) from the ‘Treatise on Cold-induced Diseases’ (shang han lun), by Zhang Zhong-jing (circa 150 – 219 C.E.), which was originally used for disorders characterised by acute onset vomiting with diarrhoea (huo luan) due to Cold; for Greater Yin (tai yin) syndrome; as well as Cold in the chest during recovery from a chronic illness with spitting of fluids.

Over the centuries the clinical uses of this formula have been expanded to include a broad range of disorders characterised by deficiency-Cold of the Spleen and Stomach, as listed above. Thus the key clinical features for the application of this formula centre on Spleen & Stomach Qi deficiency together with signs of Yang deficiency. When the Spleen Yang is deficient the ascending movement of the Spleen Qi fails to send the clear Yang Qi upwards. This leads to watery diarrhoea; failure of the Stomach functions leads to nausea or vomiting (i.e. the turbid Yin is not sent downwards).

The presence of Cold in the middle Jiao retards the circulation of the Qi and Blood leading to stagnation, manifesting clinically with epigastric or abdominal pain that is aggravated by the application of cold but alleviated by warmth and pressure (i.e. massage). In addition there are systemic signs of Cold, i.e. cold extremities.

The addition of Aconite root (fu zi) enhances the original formula’s interior Warming and Cold dispelling actions. Due to restrictions on the use of this ingredient by the Australian Therapeutic Goods Administration (TGA), Myristica seed (rou dou kou) and Tetradium fruit (wu zhu yu) are used together in this formula to substitute for the desired effects.

The synergistic actions of the ingredients are as follows:

Codonopsis root (dang shen), Atractylodes rhizome (bai zhu), Glycyrrhiza root (gan cao): tonify the Spleen Qi.

Zingiber rhizome (gan jiang), Myristica seed (rou dou kou), Tetradium fruit (wu zhu yu): warm the middle Jiao and dispel Cold.

Myristica seed (rou dou kou): warms the middle Jiao, moves the Qi and alleviates pain; astringes the intestines and relieves diarrhoea.

Tetradium fruit (wu zhu yu): warms the middle Jiao, moves the Qi and alleviates pain; redirects the Stomach Qi downwards and alleviates vomiting; warms the Spleen, expels Cold-Damp and relieves diarrhoea.

Glycyrrhiza root (gan cao): harmonises the formula and protects the body from the Drying action of the Interior Warming herbs.

Signs & Symptoms:

Dysentery, chronic

Duodenal ulcer

Functional uterine bleeding

Gastric ulcer

Gastroenteritis, acute and chronic

Gastroptosis

Irritable bowel syndrome

Colitis, ulcerative

Crohn’s disease

Ulcer, aphthous (mouth)

Herpes, oral

Cold sores

Bronchitis, chronic

Dysfunctional uterine bleeding

Diarrhea or loose stools, chronic

Nausea or vomiting

Poor appetite

Hypothyroidism

Digestion, poor

Malabsorption syndrome

Gastritis

Combinations –

Diarrhoea, chronic or early morning:

BA JI YIN YANG WAN

ZHUANG YANG YI JING WAN

YOU GUI WAN

Diarrhoea, chronic or IBS:

CHAI HU SHU GAN WAN

fluid retention:

WU LING SAN

Kidney Yang deficiency:

FU GUI BA WEI WAN

REHMANNIA EIGHT VITALITY Formula

Thyroid hypofunction:

YOU GUI WAN

TCM Syndromes: Spleen-Stomach deficiency-Cold (middle Jiao Yang deficiency), Cold stagnation of the middle Jiao.

TCM Actions: Warm-tonifies the middle Jiao (i.e. Spleen & Stomach), dispels Cold (from the middle Jiao).