Dingyu Lizhong Tang for Warming the Middle, Harmonizing the Stomach, and Stopping Vomiting

Dingyu Lizhong Tang (Clove-Evodia Center-Regulating Decoction) comes from the Yizong Jinjian (Golden Mirror of the Medical Tradition). It consists of clove (Dingxiang) 2 qian (6 g), evodia (Wuzhuyu) 1 qian (3 g), Codonopsis (Dangshen) 5 qian (15 g), fried Atractylodes (Chao Baizhu) 3 qian (10 g), dried ginger (Ganjiang) 2 qian (6 g), and honey-fried licorice (Zhi Gancao) 2 qian (6 g), decocted in water for oral use.

This formula has the actions of warming the middle and harmonizing the stomach, and downbearing counterflow and stopping vomiting. It is indicated for vomiting due to deficiency-cold in the middle jiao, presenting with vomiting long after eating, or morning eating and evening vomiting, evening eating and morning vomiting; vomiting of clear, thin phlegm-water or undigested milk and food residue; accompanied by poor appetite, pale complexion, spiritlessness and fatigue, cold limbs, abdominal pain and loose stools, a pale tongue with white coating, a slow, retarded, forceless pulse, and a faint fingerprint.

It is now commonly used for peptic ulcer, reflux esophagitis, chronic gastritis, pancreatitis, and cholecystitis presenting the pattern of deficiency-cold in the middle jiao and stomach-qi failing to harmonize.

If the patient's yang deficiency is severe, with pronounced vomiting of clear water and cold limbs, add prepared aconite (Fuzi), galangal (Gaoliangjiang), and cinnamon (Rougui) to warm yang and dispel cold; if the patient has loose, watery stools, this formula may be combined with Sishen Wan, adding nutmeg (Roudoukou), malaytea scurfpea (Buguzhi), and schisandra (Wuweizi); for spleen deficiency with qi weakness, add astragalus (Huangqi), ginseng (Renshen), Chinese yam (Huaishanyao), and white hyacinth bean (Baibiandou) to boost qi and fortify the spleen; for pronounced interior dampness with watery stools, add hyacinth bean (Biandou), Poria (Fuling), Coix seed (Yiyiren), and plantain seed (Cheqianzi) to fortify the spleen, seep dampness, and stop diarrhea. For peptic ulcer with vomiting, acid regurgitation, and reflux, add cuttlebone (Wuzeize), bletilla (Baiji), clam shell (Walengzi), persimmon calyx (Shidi), inula flower (Xuanfuhua), and ochre (Daizheshi).

This formula can also be used for cancer patients who, constitutionally having a cold-deficient stomach, develop incessant vomiting after chemotherapy. Generally such patients are also Helicobacter pylori positive and have long-standing chronic diseases such as gastritis, reflux esophagitis, and cholecystitis. Certain antitumor Chinese medicinals, such as toad venom (Chansu), can also cause such reactions; when symptoms appear, patients may also use this formula to relieve them.