Da Jian Zhong Tang: Herbal Warmth for Digestive Pain Relief
Hongji Medical- Jan 30
- 4 min read
Da Jian Zhong Tang, or Major Middle-Strengthening Decoction, is a revered formula from Zhang Zhongjing’s Treatise on Febrile Diseases and Miscellaneous Diseases in the Han Dynasty. Crafted by the “Medical Saint” to treat severe abdominal pain due to cold and deficiency, this blend of four ingredients warms the middle, replenishes qi, and relieves pain.
Known in traditional Chinese medicine (TCM) for soothing chest and abdominal discomfort, it remains a powerful remedy for modern digestive disorders, backed by research and cherished in places like Japan.
What’s in Da Jian Zhong Tang?
Da Jian Zhong Tang combines four ingredients, structured by the TCM principle of monarch, minister, assistant, and envoy, to warm the body and ease pain. The ingredients and their roles are:
Monarch Herb
Sichuan Pepper (Hua Jiao): Pungent and hot, Sichuan pepper warms the middle, dispels cold, and relieves pain, targeting abdominal coldness.
Minister Herb
Dried Ginger (Gan Jiang): Pungent and hot, dried ginger warms the stomach, stops vomiting, and enhances Sichuan pepper’s warming effects.
Assistant Herbs
Ginseng (Ren Shen): Sweet and warm, ginseng boosts spleen qi, replenishes energy, and tempers the formula’s heat to prevent dryness.
Malt Sugar (Yi Tang): Sweet and warm, malt sugar nourishes deficiency, relieves urgency, and supports ginseng’s qi-tonifying action.
Preparation
Decoct the herbs and sugar in water and drink warm as a tea, with dosages adjusted based on the patient’s condition, typically for short-term use in acute cases.
How It Works
Da Jian Zhong Tang targets middle jiao deficiency-cold, a TCM condition where spleen and stomach yang qi are weak, allowing excessive yin-cold to cause pain and dysfunction. The formula works by:
Warming the Middle: Sichuan pepper and dried ginger dispel cold, restoring spleen and stomach function.
Replenishing Qi: Ginseng and malt sugar boost energy and nourish deficiency, supporting yang.
Relieving Pain: The warming herbs unblock qi stagnation, easing abdominal and chest pain.
Harmonizing the Stomach: Ginger and sugar reduce nausea and improve appetite.
This aligns with Zhang Zhongjing’s principle of “warming the middle to eliminate yin-cold” and “tonifying to build yang,” restoring digestive warmth and vitality.
What Does It Treat?
Da Jian Zhong Tang is used for middle jiao deficiency-cold with excess yin-cold, with symptoms including:
Severe chest or abdominal pain (cold, stabbing sensation)
Nausea, vomiting, or poor appetite
Cold abdomen with gurgling sounds
Greasy white tongue coating or stiff tongue
Tight or stringy pulse
Other pains (headache, menstrual pain, testicular pain, intercostal or groin pain)
Additional symptoms: diarrhea, constipation, sweating, weight loss, frequent urination
These reflect a cold, weakened digestive system, often triggered by poor diet, stress, or chronic illness.
Pathogenesis in TCM
In TCM, the spleen and stomach (middle jiao) govern digestion and qi production. When spleen yang is deficient, cold accumulates, impairing digestion and causing:
Pain and Stagnation: Yin-cold blocks qi and blood, leading to severe abdominal or chest pain.
Digestive Issues: Weak spleen yang causes nausea, poor appetite, or diarrhea with undigested food.
Systemic Effects: Cold disrupts other organs, contributing to fatigue, cold limbs, or urinary issues.
Da Jian Zhong Tang warms the spleen, dispels cold, and restores yang, addressing these root causes and their widespread effects.
Modern Applications
Modern research highlights Da Jian Zhong Tang’s anti-inflammatory, analgesic, and gut-regulating effects, driven by compounds in Sichuan pepper (local anesthetic), ginger (digestive aid), and ginseng (immune booster). Clinical uses include:
Digestive Disorders: Treats inflammatory bowel diseases (e.g., Crohn’s), intestinal adhesions, constipation, and pancreatitis by reducing inflammation and spasms.
Abdominal Conditions: Relieves intestinal hernia, gastric dilatation, appendicitis, and peritonitis by warming and unblocking the gut.
Other Conditions: Manages kidney stones, biliary ascariasis, and postoperative intestinal obstruction by improving qi flow.
Mental Health: Combined with ketamine, it shows promise in treating depression by modulating gut-brain pathways.
Its popularity in Japan stems from studies showing efficacy in inflammatory bowel diseases, often used as a medicinal diet.
Causes of Spleen Yang Deficiency
Spleen yang deficiency, the root of Da Jian Zhong Tang’s indications, arises from:
Diet: Overeating cold, greasy, or sweet foods that burden digestion.
Emotions: Excessive worry or stress weakening spleen function.
Lifestyle: Overwork, poor rest, or post-illness weakness.
Congenital Factors: Innate spleen deficiency from prenatal conditions.
Environment: Cold, damp weather exacerbating internal cold.
Improving Spleen Yang Deficiency
To support spleen yang alongside Da Jian Zhong Tang:
Herbal Support: Use warming formulas like Fu Zi Li Zhong Tang for chronic cases.
Diet: Eat warm foods like lamb hotpot in winter to boost yang.
Lifestyle: Maintain regular sleep, avoid overexertion, and gently massage spleen/stomach meridians.
Precautions
Contraindications: Avoid in cases of excess heat, damp-heat (yellow tongue coating), or yin-blood deficiency (dryness, red tongue).
Dietary Restrictions: Avoid cold, raw foods during treatment to support warming effects.
Side Effects: Overuse of warming herbs may cause dryness; monitor dosage and duration.
Professional Guidance: Consult a TCM practitioner due to the formula’s potency, especially for complex conditions.
Conclusion
Da Jian Zhong Tang is a masterful Chinese herbal formula that warms the middle, replenishes deficiency, and relieves pain. With Sichuan pepper, dried ginger, ginseng, and malt sugar, it soothes severe abdominal pain, nausea, and cold-related symptoms caused by spleen yang deficiency.
Widely used in modern TCM for digestive disorders and even depression, its benefits are backed by research showing anti-inflammatory and gut-regulating effects. Under professional guidance, Da Jian Zhong Tang offers natural warmth and relief, embodying Zhang Zhongjing’s ancient wisdom for today’s health challenges.
