HERB FORMULAS

ZHI SHI LI ZHONG WAN - 枳实李中丸 - IMMATURE BITTER ORANGE PILL TO REGULATE THE MIDDLE

English: Immature Bitter Orange Pill to Regulate the Middle
Also Known As:

HERBS AND ACTIONS

Pharmaceutical Latin
Pin Yin
Dosage
Actions
Fr. Aurantii Immaturus Zhi Shi 9-30g Breaks up Stagnant Qi, reduces accumulation, descends Qi, unblocks the bowels, removes Stagnant Food, transforms Phlegm, reduces distention and resolves hardenings.
With Bai Zhu, for distention in the epigastrium and abdomen due to Spleen and Stomach Deficiency with Food Stagnation.
Rz. Zingiberis Gan Jiang 9-60g Warms the Spleen and Stomach and eliminates interior Cold.
With Zhi Gan Cao, for vomiting and epigastric pain due to Spleen and Stomach Deficiency Cold.
With Bai Zhu, for diarrhea due to Spleen Deficiency.
With Bai Zhu and Ren Shen, for Spleen Yang Deficiency with a cold abdomen, vomiting and diarrhea.
With Fu Ling and Bai Zhu, for Cold-Dampness in the Lower Jiao leading to a sense of heaviness and Cold in the lower back.
Rx. Ginseng Ren Shen 15-60g Tonifies Spleen Qi and harmonizes the Middle Jiao.
 With Bai Zhu, tonifies the transformation and transportation functions of the Spleen.
(Rx. Codonopsis) (Dang Shen) (15-60g) (May substitute for Ren Shen.)
Dry-fried Rz. Atractylodis Macrocephalae Chao Bai Zhu 15-60g Strengthens the Spleen and dries Dampness.
With Ren Shen, tonifies the Spleen and Stomach.
With Ren Shen and Gan Jiang, for Middle Jiao Deficiency Cold with abdominal pain, distention, vomiting and diarrhea.
Poria Fu Ling 12-60g Promotes urination, leaches out Dampness, strengthens the Spleen and harmonizes the Middle Jiao.
With Ren Shen and Bai Zhu, for weak and deficient Spleen with fatigue, anorexia and loose stools.
Rx. Glycyrrhizae Preparata Zhi Gan Cao 6-60g Tonifies the Spleen and augments Qi, moderates and harmonizes the harsh properties of other herbs and guides the herbs to all twelve channels.
With Dang Shen, for anorexia, fatigue and loose stools due to Spleen Deficiency.
With Ren Shen, Fu Ling and Bai Zhu, strengthens the Spleen and augments Qi.

FORMULA ACTIONS

  • Tonifies the Spleen and Stomach
  • Tonifies Qi
  • Strengthens Yang
  • Resolves Dampness

SYNDROMES

  • Spleen and Stomach Deficiency Cold

CLINICAL MANIFESTATIONS

  • Mild constant epigastric pain; relieved by warmth and pressure
  • Anorexia
  • Abdominal pain and fullness after meals
  • Nausea
  • Vomiting
  • Loose, unformed stools
  • Excessive salivation
  • Cold limbs
  • Lassitude
  • Weakness
  • Sallow or pale, dull complexion
  • Maybe edema
  • Maybe scanty urination
  • Maybe clear, watery, copious vaginal discharge
  • T: Pale
  • C: White and greasy or Greasy-dirty
  • P: Deep, thready and forceless or Firm

TREATS

CONTRAINDICATIONS AND HERB/DRUG INTERACTIONS

CONTRAINDICATIONS
HERB/DRUG INTERACTIONS

NOTES

MODIFICATIONS

For severe Cold intolerance: For Dampness:
+ 6-12g Rx. Aconiti Lateralis Preparata Zhi Fu Zi + 9g Rz. Atractylodis Cang Zhu
For severe abdominal distention:
+ 3g Cx. Cinnamomi Rou Gui + 6-9g Rx. Aucklandiae Mu Xiang
For foggy-headedness or sleepiness: + 6-9g Fr. Amomi Sha Ren
+ 6-9g Rz. Acori Tatarinowii Shi Chang Pu    
   
+ 6-9g Rx. Polygalae Yuan Zhi