TCM Prescriptions for Warming the Interior

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Minor Decoction for Strengthening the Middle energizer
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Source: Shanghan Lun (Treatise on Exogenous Febrile Diseases).

Ingredients:
No.1  Shaoyao (Radix Paeoniae) 18 g (parched with wine)
No.2  Guizhi (Ramulus Cinnamomi) 9 g
No.3  Zhigancao (Radix Glycyrrhizae Praeparatae) 6 g
No.4  Shengjiang (Rhizoma Zingiberis Recens) 9 g
No.5  Dazao (Fructus Ziziphi Jujubae) 12 pcs
No.6  Yitang (Saccharum Granorum) 30 g (melted by heat)
 
Administration:
Decoct the above drugs in water for oral application.

Actions:
Warming the middle-energizer to restore qi, relieving spasm and pain, and coordinating yin and yang.

Clinical Application:
This recipe is used to treat interior contraction due to consumption, marked by epigastric and abdominal pain relieved by warming and pressing, pale tongue with whitish fur, thready-taut and slow pulse; or palpitation, restlessness, or soreness of the limbs, feverish sensation in the hands and feet, dryness of the mouth and throat. It is applicable to chronic gastritis, gastroduodenal ulcer, neurosism, functional fever and others with the above symptoms attributable to deficiency-cold syndrome of the spleen and stomach. Baishaoyao, (Radix Paeoniae Alba) is often used clinically as Ingredient No. 1.

In case of deficiency of qi in the middle-energizer manifesting lassitude and lack of strength, add Huangqi (Radix Astragali seu Hedysari) to invigorate qi and the spleen, namely Huangqi Jianzhong Tang. In case of deficiency of ying blood manifesting sallow complexion, add Danggui (Radix Angelicae Sinensis) to nourish the blood and restore qi, namely Danggui Jianzhong Tang.

Elucidation:
The syndrome results from pathogenic factors in the liver subjugating the spleen due to deficiency-cold in the middle-energizer and disharmony between Yin and yang. It should be treated by warming the middle-energizer to restore qi, relieving spasm and pain, and regulating yin and yang. The last ingredient is used as monarch drug not only to warm the middle-energizer and restore qi but also to relieve spasm and pain. Ingredient No. 2 bears the function of warming yang and dispelling cold, and No. 1 nourishing yin and the liver. Both act as minister drug and help the monarch drug carry out its function, and regulate yingqi and weiqi as well as yin and yang.

Ingredient No. 3 is of sweet and warm nature with the effect of replenishing qi. It can warm the middle-energizer when used together with No. 6 and No. 2 of pungent and sweet nature and relieve spasm and pain when combined with No. 1 of sour and sweet nature. Ingredients No. 4 and No. 5 have respectively the function of warming the stomach and reinforcing the spleen, and serve as adjuvant drug. Their combination is to promote the middle-energizer qi to regulate yingqi and weiqi, and promote the production and transformation of qi and blood. Ingredient No. 3 is meant to mediate the effects of other ingredients and acts as, guiding drug.

Cautions:
This recipe is sweet in flavor and apt to generate dampness in the middle-energizer, thus is contraindicated for patients with deficiency cold syndrome in the middle-energizer concomitant with flatulence and greasy fur.



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