Xuan Fu Dai Zhe Tang: A Classic TCM Formula for Digestive Relief
Hongji Medical- Feb 21
- 5 min read
Updated: May 7
Xuan Fu Dai Zhe Tang, documented in Zhang Zhongjing’s Treatise on Febrile Diseases and Miscellaneous Diseases from the Han Dynasty, is a cornerstone of traditional Chinese medicine (TCM). This formula is prescribed for conditions involving “a hard lump under the heart and belching” after sweating, vomiting, or diarrhea due to febrile diseases.
It targets stomach Qi deficiency, phlegm obstruction, and liver-stomach Qi reversal, offering relief by calming adverse Qi, resolving phlegm, and strengthening the stomach. Its gentle, effective approach makes it a trusted remedy for digestive and related disorders.
Formula Composition of Xuan Fu Dai Zhe Tang
Xuan Fu Dai Zhe Tang combines seven herbs, organized according to the TCM principle of “monarch, minister, assistant, and envoy”:
Monarch Herbs:
Xuan Fu Hua (Inula Flower): Warm in nature, it softens lumps, descends Qi, and stops belching by relieving fullness and promoting fluid movement.
Dai Zhe Shi (Hematite): Heavy and cold, it calms the liver, reduces adverse Qi, and clears phlegm when paired with Inula.
Minister Herb:
Sheng Jiang (Ginger): Warms the stomach, reduces nausea, disperses dampness, and balances hematite’s cold nature to protect digestion.
Assistant Herb:
Ban Xia (Pinellia): Pungent and warm, it resolves phlegm, relieves stagnation, and harmonizes the stomach to curb vomiting.
Envoy Herbs:
Ren Shen (Ginseng): Nourishes spleen and stomach Qi to address deficiency.
Zhi Gan Cao (Roasted Licorice): Harmonizes the formula and eases discomfort.
Da Zao (Jujube): Supports the spleen, boosts Qi, and enhances nourishment.
This synergistic blend descends adverse Qi, clears phlegm, and restores stomach function, alleviating symptoms like belching and fullness.
Pathogenesis: Understanding the Condition
Xuan Fu Dai Zhe Tang addresses a condition marked by “stomach Qi deficiency, phlegm obstruction, and liver-stomach Qi reversal.”
After treatments like sweating or purging for febrile diseases, the spleen and stomach weaken, leading to phlegm buildup and Qi stagnation in the middle burner. This causes:
A hard, lumpy sensation under the heart (epigastric region).
Frequent belching, nausea, or vomiting.
Pale tongue with a white, slippery coating and a stringy, weak pulse.
In TCM’s Five Elements theory, a weak stomach (Earth) allows the liver (Wood) to overact, causing Qi to rise abnormally and trigger belching or hiccups. The formula counters this by resolving phlegm, calming adverse Qi, and replenishing stomach Qi.
Therapeutic Effects of Xuan Fu Dai Zhe Tang
Xuan Fu Dai Zhe Tang excels in:
Descending Adverse Qi: Inula and hematite calm upward-rushing Qi, relieving belching, vomiting, and hiccups.
Resolving Phlegm: Pinellia and ginger clear phlegm to ease epigastric fullness and improve digestion.
Replenishing Qi: Ginseng, licorice, and jujube nourish the spleen and stomach, addressing deficiency.
Harmonizing the Stomach: The formula enhances digestive function, promoting food absorption and gut health.
These actions make it ideal for middle burner disorders involving phlegm, Qi stagnation, and stomach weakness.
Modern Applications
Modern research highlights the formula’s bioactive components:
Inula’s flavonoids reduce bronchial spasms and enhance intestinal motility, aiding digestion and asthma relief.
Hematite’s ferric oxide calms the liver and reduces adverse Qi.
Pinellia’s alkaloids suppress vomiting and cough.
Ginseng boosts heart function and vitality, while licorice and jujube support overall nourishment.
Xuan Fu Dai Zhe Tang is used for:
Digestive disorders like chronic gastritis, gastric ulcers, gastric neurosis, and bloating.
Non-digestive conditions such as Meniere’s vertigo, neurotic hiccups, and diaphragmatic spasms, where phlegm and Qi stagnation are present.
Its antiemetic, antitussive, and tonic effects make it a versatile remedy in modern TCM.
Precautions for Use
When using Xuan Fu Dai Zhe Tang, consider the following:
Hematite Dosage: Hematite’s cold, heavy nature may strain weak stomachs; use smaller doses (typically 9–15 grams) for sensitive patients.
Syndrome Differentiation: Ensure the condition matches stomach deficiency with phlegm and Qi reversal (e.g., epigastric hardness, slippery tongue coating). Misuse may reduce efficacy.
Yang Deficiency: For patients with Yang deficiency, pre-treat with warming formulas like Sini Tang or Lizhong Wan before using this prescription.
Medical Supervision: Consult a TCM practitioner to tailor the formula and monitor for side effects, especially in chronic cases.
Chinese Name | 旋覆代赭湯 |
Phonetic | Xuan Fu Dai Zhe Tang |
English Name | Inula and Hematite Decoction |
Classification | Qi-regulating formulas |
Source | 《Treatise on Cold Damage》Shang Han Lun《傷寒論》 |
Combination | Inulae Flos (Xuan Fu Hua) 3 liang (9g), Ginseng Radix et Rhizoma (Ren Shen) 2 liang (6g), Zingiberis Rhizoma Recens (Sheng Jiang) 5 liang (15g), Haematitum (Dai Zhe Shi) 1 liang (6g), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gan Cao) 3 liang (9g), Pinelliae Rhizoma (Ban Xia) 5 sheng (9g), Jujubae Fructus (Da Zao) 4 pieces |
Method | Decoct the medicinals in 1 dou water down to 6 sheng, strain the residues and boil, once again, down to 2 sheng. Take 1 sheng, warm (ed), 3 times a day. (Modern use: Prepare it as a decoction.) |
Action | Directs counterflow downward, dissolves phlegm, boosts qi, and harmonizes the stomach. |
Indication | Xuan Fu Dai Zhe Tang is indicated for weak stomach qi with internal obstruction of phlegm-turbidity. The symptoms are pi below the heart, belching, or vomiting with saliva. The tongue is pale with a white, glossy coating. The pulse is wiry and weak. |
Pathogenesis | This pattern is the result of unresolved wind-cold constrained within taiyang that has transformed into heat. It then transmits to yangming, spreads further to shaoyang, and eventually affects all three yang channels. Aversion to cold, absence of sweat, and headache are due to unresolved wind-cold constrained in the taiyang. The pathogen, after penetrating into the interior, heats up and attacks the yangming and shaoyang. It causes eye pain, nose dryness, orbit pain, dry throat, and impaired hearing. These symptoms are related to how the two channels transverse: Yangming originates from both sides of the nose, goes up to the root of nose, passes through the orbits, and travels down. Shaoyang winds its way behind the ears, enters, comes out in front of them, passes through the cheeks and reaches the infra-orbital area. In addition, the superficial and slightly surging pulse is evidence of the exterior pathogen and excessive interior heat. The appropriate treatment is to release the flesh with acrid-cool medicinals and clear interior heat. |
Application | 1. Essential pattern differentiation Xuan Fu Dai Zhe Tang is commonly indicated for the pattern characterized by middle jiao deficiency, phlegm blockage, and qi counterflow. This clinical pattern is marked by pi below the heart, belching, vomiting, hiccups, white, glossy coating, wiry, weak pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders, when the patient shows signs of a middle jiao deficiency with phlegm blockage and qi counterflow pattern: gastric neurosis, gastric dilatation, chronic gastritis, gastric ulcers, duodenal ulcers, Helicobacter incomplete obstruction, neurological hiccups, and diaphragm spasms. 3. Cautions and contraindications Dai zhe shi has a cold nature and tends to descend. Its heavy property can block the stomach. Small dosage should be applied for patients who have stomach deficiency. |
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. |
