Ang Li Zhong Tang ay galing sa Zhang Zhongjing's "Shanghan Lun," na binubuo ng Ren Shen, Gan Jiang, Bai Zhu, at Zhi Gan Cao. Sa reseta, ang Gan Jiang na may malamig na lasa ay ginagawang pangunahin, upang mainitan ang middle burner at alisin ang internal cold; ang Ren Shen ay nagpapalakas ng qi, tumutulong sa digestion at pagpapanumbok ng qi, bilang secondary ingredient, na nagpapalakas ng qi at spleen; ang Bai Zhu ay nagpapalakas ng spleen at alisin ang dampness, ang Zhi Gan Cao ay nagpapalakas ng qi at nagpapagaling ng earth element. Ang mga sangkap ay magkasama upang alisin ang cold sa middle burner, at balansehin ang deficiency sa middle burner, na nagpapataas ng clear yang at bumaba ng turbid yin, at nagpapabuti ng digestion at pagpapagaling ng middle burner, kaya tinawag itong "Li Zhong." Ginagamit ito para sa mga sakit dulot ng cold sa middle burner tulad ng yang deficiency bleeding, pediatric slow convulsion, chest oppression, post-illness excessive salivation, vomiting, diarrhea, at gastric pain. Kung titingin sa buong reseta, bagaman ito ay ginagamit para sa maraming sakit, ang tunay na layunin ay ang cold sa middle burner, kaya maaaring gamitin para sa iba't ibang sakit na may parehong ugat.
I. Pediatric Slow Convulsion
Si Dan, lalaki, 2 years 6 months old, first consultation on July 15, 2000. Ang nanay ay nagkuwento: Ang anak ay may diarrhea araw-araw sa loob ng 2 buwan, may 3-4 beses, may malinis na dumi na walang amoy, medium in quantity, parang egg-like, may undigested food residue, poor appetite, at minsan ay may seizures. Ang anak ay may pale face, malungkot na kalagayan, cold limbs, soft abdomen with slight bloating, pale tongue with thin white coating, deep pulse, at faint purple fingerprint that is close to the life line. Diagnosed bilang pediatric slow convulsion, with condition of spleen yang deficiency, treatment is to warm the middle burner, remove cold, and strengthen spleen yang. Prescription: Original Li Zhong Tang, decocted and taken once daily, advised to eat hot porridge after taking the medicine. After two days, the child showed significant improvement, diarrhea reduced to 1-2 times a day, seizures stopped, appetite improved. Continued with original prescription for three more doses, all symptoms disappeared. Note: "Xiao'er Yao Zheng Zhi Jue" says: "Pediatric slow convulsion is due to illness-related or vomiting/diarrhea, or medication damaging the spleen and stomach... this is a case of spleen deficiency causing wind without yang." This case was due to improper diet and feeding, damaging the spleen and stomach, leading to severe spleen yang deficiency, which caused diarrhea and seizures. Therefore, Li Zhong Tang was used to warm and strengthen spleen yang, so that when earth is strong, wood cannot overpower it, and all symptoms disappeared.
II. Body Weakness with Common Cold
Si Hu, babae, 52 years old, official. The patient has had recurrent colds for over five years. After catching cold, she took Shen Su Yin but saw no improvement, so she came to our hospital. She appeared thin, pale face, headache, nasal congestion, cold sensitivity, body aches, discomfort in the chest, occasional nausea, poor appetite, pale tongue, thin white coating, deep, slow, and weak pulse. Based on the combination of symptoms and pulse, the diagnosis is spleen and stomach deficiency with external cold invasion. Treatment is to warm the middle burner, strengthen the spleen, harmonize the nutritive essence, and relieve exterior symptoms. Prescribed Li Zhong Tang with addition of Gui Zhi 6g, Ge Gen 15g, Bai Shao 15g, and Zhi Gan Cao 5g. After three doses, all symptoms significantly improved, but still had bloating and poor appetite. Continued with original formula plus Zhi Ke 10g and Mu Xiang 6g, and recovered after three more doses. Note: "Shanghan Lun" Chapter 163 says: "In cases of Taiyang disease, if exterior symptoms are not resolved and repeated purging occurs, then there is concurrent heat and diarrhea, diarrhea continues, heart feels blocked, and both exterior and interior are unresolved—Gui Zhi Ren Shen Tang is indicated." Gui Zhi Ren Shen Tang is Li Zhong Tang with added Gui Zhi, originally intended for deficient cold diarrhea due to mistaken purging in Taiyang disease. Although this case did not involve mistaken purging, the person already has deficient yang and caught external cold, making it a case of both exterior and interior involvement, primarily interior. Thus, this formula was used to treat both exterior and interior, with reliable results.
III. Excessive Saliva
Si Qin, babae, 42 years old, farmer, first visit on June 2, 1999. She complained of vomiting large amounts of clear phlegm and saliva after surgery for gastric ulcer bleeding, along with poor appetite and fatigue for three years. Despite treatment with traditional and Western medicine, the effect was minimal, so she sought help at our hospital. Examination revealed a pale, dull complexion, lethargic appearance, cold limbs, soft abdomen with slight bloating, pale white tongue with thin white coating, and deep fine weak pulse. This clearly indicates spleen qi deficiency and cold, so treatment should be to warm the middle burner, strengthen the spleen, boost qi, and control saliva. Formula: Li Zhong Tang with addition of Fu Zi (pre-boiled for 40 minutes) 6g, Yi Zhi Ren 9g, and Wu Yao 6g. After three doses, vomiting of clear phlegm and saliva stopped, appetite improved, and mental state improved. Continued with original formula for seven more doses, all symptoms disappeared, appetite normalized, and the patient was cured. Follow-up one year later showed no recurrence. Note: The spleen governs phlegm and saliva, while the kidney governs saliva. Spleen deficiency and cold lead to inability to control fluids, causing them to overflow into the mouth and result in excessive saliva. In this case, both spleen and kidney were treated. Li Zhong Tang warms the spleen yang, while Fu Zi, Yi Zhi Ren, and Wu Yao warm the kidney and control saliva, thus strengthening the yang of spleen and kidney, improving water metabolism, and preventing fluid from overflowing into the mouth, resulting in cure.
IV. Chest Obstruction
Si Tan, babae, 50 years old, visited on March 5, 1998. She reported chest pain, chest tightness, palpitations, occurring 3-5 times daily, accompanied by shortness of breath and sweating during episodes, worsened by exertion, relieved by nitroglycerin and lying down. The patient is obese, pale face, cold limbs, fatigued, poor appetite, frequent chest pain radiating to the back, occasional palpitations. Diagnosed with coronary artery disease via coronary angiography. Tongue coating is greasy white, pulse is deep and slow. Diagnosis: Spleen and stomach deficiency cold, with lack of chest yang. Treatment: Strengthen spleen and stomach, invigorate chest yang, and promote blood circulation. Prescription: Li Zhong Tang with addition of Gui Zhi 6g, Zhi Shi 10g, Quan Kua Lou 30g, Xie Bai 15g, and Ban Xia 6g. After one week of continuous use, chest pain disappeared, other symptoms improved. Note: "Yimen Falü" says: "Chest obstruction is always due to yang deficiency, allowing yin to invade." The patient is obese with inherent yang deficiency, leading to poor chest yang movement, allowing cold to invade the yang position, obstructing qi flow and causing chest obstruction. This case focused on treating the root cause, using Li Zhong Tang to warm and strengthen the spleen, nourishing yang; using Gui Xin, Kuai Lou, and Xie Bai to warm and open the chest, regulate qi, treating both root and branch, hence achieving good results.
V. Recurrent Aphthous Stomatitis
Si Shi, babae, 38 years old, first visit on June 5, 1999. She has had recurrent oral ulcers for five years, often triggered by fatigue. Diagnosed with recurrent aphthous stomatitis by Western medicine. Tried various traditional and Western medicines, including topical application of Xilai San, but with poor results. Examination revealed ulcers of varying sizes on inner lips, sides and tip of tongue, ranging from the size of a soybean to a grain of rice, with sunken surfaces, gray-white in color, surrounded by slightly raised pale red areas. Pale yellow complexion, fatigue, poor appetite, bloating, pale swollen tongue with prominent tooth marks, thin white coating, deep fine pulse. Diagnosis: Spleen and kidney yang deficiency, cold-dampness rising upward. Treatment: Warm yang, boost qi, strengthen spleen, and resolve dampness. Prescription: Li Zhong Tang with addition of Fu Zi 6g, Zhu Ye 15g, and Bai Shao 10g. After three doses, the patient felt bloating improved, appetite increased, and oral ulcers improved. Added Gui Zhi to enhance warming and dispelling cold, continued for three more doses, oral ulcers healed, and overall symptoms significantly improved. Advised to take Fu Zi Li Zhong Wan for one month to consolidate the effect. Follow-up for one year showed no recurrence. Note: Due to long-term spleen dysfunction, internal cold-dampness arises; spleen deficiency affects the kidney, leading to spleen-kidney yang deficiency, with deficient yang floating upward, causing recurrent oral ulcers. Zhu Danxi said: "Oral ulcers that do not improve with cooling medicines are due to deficiency of earth in the middle burner, unable to eat properly, with fire rising uncontrollably. Use Li Zhong Tang." Li Shizhen also said: "For oral ulcers that persist despite long-term use of cooling medicines, treat with Li Zhong Tang plus Fu Zi, combined with cinnamon." This formula uses processed Fu Zi to warm and supplement spleen and kidney, guiding fire back to its source; the entire formula boosts yang, warms, strengthens spleen, disperses cold, and detoxifies, thus subduing the rising cold-dampness and healing the ulcers.
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