Li zhong Tang: A Warming Remedy for Spleen and Stomach Health
Hongji Medical- Feb 3
- 7 min read
Li Zhong Decoction, also known as Li Zhong Wan or Li Zhong Tang, is a classic Chinese herbal remedy from the Treatise on Cold Damage. This warming formula strengthens the spleen and stomach, dispels cold, and boosts energy (qi).
Made with ginseng, dried ginger, roasted licorice, and white atractylodes, it’s a go-to for digestive issues caused by a weak, cold digestive system. This article breaks down its ingredients, benefits, modern uses, and dietary tips to support its effects.
Ingredients and Preparation of Li zhong Tang
Ingredients
The formula includes equal parts (90 g each) of:
Ginseng
Dried ginger
Roasted licorice
White atractylodes
Preparation
Grind the herbs into a fine powder, mix with honey, and shape into 9-gram pills. Take one pill 2–3 times daily with warm water. Alternatively, boil the herbs in water to make a decoction, adjusting the dose as needed.
Benefits and Uses
Benefits
Warms the spleen and stomach, dispelling internal cold.
Boosts qi and strengthens digestion.
Uses
This remedy targets spleen and stomach deficiency-cold, where the digestive system becomes weak and cold, causing:
Dull stomach pain, eased by warmth or pressure
Vomiting, loose stools, or bloating
Loss of appetite
Feeling very cold, with cold hands and feet
Pale tongue with a white, moist coating
Slow, weak pulse
It also helps with spleen yang deficiency blood loss, where weak spleen energy leads to bleeding issues like dark, thin blood in stools, vomiting, nosebleeds, or heavy menstrual flow.
Additionally, it can relieve chest discomfort from spleen weakness, such as bloating, gas, chest tightness, increased saliva, or chronic shock in children.
How Li zhong Tang Works
In Chinese medicine, the spleen and stomach are key to digestion, turning food into energy and nutrients. When they’re weak and cold (due to low yang qi), digestion falters, causing bloating, diarrhea, or pain.
Cold stagnates in the body, leading to chills and discomfort. Center-Regulating Pill warms the system, restores spleen and stomach function, and clears these symptoms.
Key Ingredients and Their Roles
Ginseng: Boosts spleen and stomach qi, warms the digestive system, and supports digestion and energy.
Dried ginger: Warms the stomach, dispels cold, and improves circulation to ease pain, chills, and digestive issues.
White atractylodes: Strengthens the spleen, boosts qi, reduces dampness, and protects digestion.
Roasted licorice: Harmonizes the formula, softens the herbs’ effects, and supports spleen qi.
Together, these herbs warm the body, strengthen digestion, and fight off cold pathogens.
Modern Applications
In modern medicine, Li zhong Tang is widely used for digestive issues like:
Acute or chronic gastroenteritis
Stomach or duodenal ulcers
Gastric spasms or prolapse
Chronic colitis
It also shows promise for other conditions, including:
Frozen shoulder
Chronic renal failure
Heart conditions like pericarditis or arrhythmias
Rheumatoid arthritis
Diabetes complications
By warming the spleen and stomach and boosting qi, it helps relieve symptoms across multiple systems, making it a versatile remedy.
Dietary Support
Li zhong Tang with warming foods can enhance its effects. Try these:
Ginger and Date Tea
Ingredients: 3 ginger slices, 5 red dates, water.
Method: Boil ginger and dates in water, then simmer for 10 minutes. Strain and drink.
Benefits: Warms the stomach, dispels cold, and boosts qi.
Yam Porridge
Ingredients: 100 g yam, 50 g rice, water.
Method: Peel and chop yam, rinse rice, and cook with water into porridge.
Benefits: Strengthens the spleen and supports digestion.
Red Date and Longan Soup
Ingredients: 10 red dates, 10 g longan pulp, water.
Method: Boil dates and longan, simmer for 20 minutes, strain, and drink.
Benefits: Boosts qi, blood, and spleen health.
Precautions
Not for: People with damp-heat in the stomach (e.g., burning sensations) or spleen/stomach yin deficiency (e.g., dry mouth, thirst).
Avoid: Raw or cold foods during treatment, as they worsen cold symptoms.
Stop use: If fever from an external infection occurs, as this formula is for internal cold.
Conclusion
Li zhong Tang is a powerful yet gentle remedy for spleen and stomach weakness and cold. By warming the digestive system and boosting energy, it relieves symptoms like stomach pain, bloating, and fatigue. Its modern applications span digestive disorders and beyond, supported by simple dietary additions like ginger tea or yam porridge. Use it carefully, avoiding contraindicated conditions, to safely restore balance and vitality.
Chinese Name | 理中丸 |
Phonetic | Li Zhong Wan |
English Name | Center-Regulating Pill |
Classification | Warming interior formulas |
Source | 《Treatise on Cold Damage》Shang Han Lun《傷寒論》 |
Combination | Ginseng Radix et Rhizoma (Ren Shen) 3 liang (90g), Zingiberis Rhizoma (Gan Jiang) 3 liang (90g), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gan Cao) 3 liang (90g), Atractylodis Macrocephalae Rhizoma (Bai Zhu) 3 liang (90g) |
Method | As a pill: pound and sift these four medicinals, mix with honey to make pills as big as an egg yolk (9g). To take, break up and mix a pill with boiled water and drink when it is still warm. Take three or four doses during the day, and two at night. If the stomach is not warm after taking the pill, increase the dosage up to three or four pills. It should be noted that the therapeutic effect of the pills is weaker than that of a decoction. As a decoction: cut the four medicinals into pieces. Add to eight sheng of water and boil down until three sheng of water remains. Take the warm decoction three times a day. Eat one sheng of hot porridge a little while after drinking the decoction. If the body feels hot at this point, the clothes should be kept on. (Modern use: grind these four medicinals into fine powder, mix with honey to make pills about 9g, take one pill each time with warm water, two or three times a day. Or use as decoction, adjust the medicinal dosages according to their original proportions.) |
Action | Warms the center and dispels cold, boosts qi and supplements the spleen. |
Indication | This formula is indicated for: 1. Deficiency-cold of the spleen and stomach. The symptoms include chronic stomachache which can be reduced by warmth and pressure, vomiting, loose stool, distention and fullness of the stomach, poor appetite, fear of cold, cold limbs, a pale tongue with a white coating, and a deep, thin pulse or deep, slow and feeble pulse. 2. Blood loss due to spleen yang deficiency. The symptoms are bloody stool, spitting of blood, nose bleeding, and menstrual flooding and spotting with pale and thin blood. 3. Chest bi syndrome due to deficiency-cold of the spleen and stomach. Besides the obstruction of qi in the chest, other symptoms include stuffiness and fullness in the chest and stomach, qi counter-flowing to the chest, profuse saliva after the illness, or chronic infantile convulsions. |
Pathogenesis | This formula is indicated for patterns caused by deficiency-cold of the spleen and stomach. Insufficiency of center yang produces cold, yang deficiency fails to warm, and cold has the property of coagulation and stagnation so there is a fear of cold, cold limbs, and occasional abdominal pain reduced by pressure and warmth. The spleen governs transportation and transformation and controls the ascent of the clear, while the stomach governs receiving food and the descent of the turbid. However in patterns of deficiency-cold of the spleen and stomach the ascending and descending function is damaged, so there is distention and fullness of the stomach, poor appetite, vomiting, and loose stool. All manifestations such as the pale tongue with a white, watery coating, lack of thirst, and a deep, thin or deep, slow and feeble pulse refers to deficiency-cold. The treatment is to warm the center in order to dispel cold, boost qi, and fortify the spleen. |
Application | 1. Essential pattern differentiation This is a basic formula for deficiency-cold of the spleen and stomach, also known as deficiency-cold of the middle jiao. This clinical pattern is marked by chronic continuous abdominal pain or stomachache, vomiting, diarrhea, fear of cold and cold limbs, pale tongue with white coating, thin, deep pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of deficiency-cold of the spleen and stomach: acute or chronic gastritis, gastric and duodenal ulcers, stomach cramps, gastroptosis, gastric dilatation, and chronic colitis. 3. Cautions and contraindications This formula is prohibited for syndromes of damp-heat accumulation in the middle jiao, or spleen-stomach yin deficiency. |
Additonal formulae | 1. Fu Zi Li Zhong Wan (Aconite Center-Regulating Pill 附子理中丸) [Source]《Beneficial Formulas from the Taiping Imperial Pharmacy》Tai Ping Hui Min He Ji Ju Fang《太平惠民和劑局方》 [Ingredients] Li Zhong Wan add fu zi (processed), 3 liang (90g) [Preparation and Administration] Grind the above medicinals into a fine powder, and mix with honey to make pills. One liang makes ten pills. [Actions] Warms yang and dispels cold, boosts qi, and fortifies the spleen. [Applicable Patterns] Severe deficiency-cold of the spleen and stomach, or syndrome of spleen-kidney yang deficiency, or cholera, vomiting, diarrhea, cramp and spasm. 2. Gui Zhi Ren Shen Tang (Cinnamon Twig and Ginseng Decoction 桂枝人參湯) [Source]《Treatise on Cold Damage》Shang Han Lun《傷寒論》 [Ingredients] Li Zhong Wan add gui zhi 4 liang (12g) [Preparation and Administration] Among all the five medicinals, add nine sheng of water, decoct four of them of five sheng, add gui zhi and decoct again till three sheng left, remove the remainder, take one sheng of warm decoction, twice in the day time and once at night. [Actions] Warms yang and fortifies the spleen, releases the exterior, and dissipates cold. [Applicable Patterns] Deficiency-cold of the spleen and stomach, attacked by wind-cold, aversion to cold with fever, headache, general pain, abdominal pain, diarrhea, loose stool, no thirst, a pale tongue, and a white and watery coating, floating and weak pulse. |
Remark | Ginseng (Panax ginseng) is listed in the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) Appendix II. Its trade is allowed but subject to licensing controls. |
