Xianglian Lizhong Tang for Warming the Middle and Stopping Diarrhea
The "Chongding Tongsu Shanghan Lun" records a formula named "Xianglian Lizhong Tang." Its composition is: Guang Muxiang (Aucklandia) 8 fen (2.4g), Lu Dangshen (Codonopsis, stir-fried with rice) 2 qian (6g), Hei Pao Jiang (black blast-fried Ginger) 3 fen (0.9g), stir-fried Guang Chenpi (Tangerine Peel) 1 qian (3g), Xiao Huanglian (Coptis, stir-fried with vinegar) 6 fen (1.8g), Sheng Dongbaizhu (Atractylodes) 1.5 qian (4.5g), Qing Zhigancao (honey-fried Licorice) 5 fen (1.5g), Xiao Qingpi (Green Tangerine Peel) 6 fen (1.8g). Decoct in water; take twice daily, warm.
According to traditional TCM theory, this formula subdues the liver and supports the spleen, warms the middle and stops diarrhea. It is indicated for liver yang pressing downward while spleen yang is also declining: squelching diarrhea, borborygmus and abdominal pain, an urge to defecate without easy passage, or passage with tenesmus and qi sagging, with a wiry left pulse and a weak right pulse.
This formula is a modification of Liujunzi Tang (Codonopsis, Atractylodes, Poria, Licorice, Tangerine Peel, Pinellia). Its logic is close to that of the modern Chinese patent medicine compound berberine, and their indications are similar. The diseases it treats resemble the chronic conditions of modern medicine—acute and chronic enteritis, indigestion, ulcerative colitis, duodenal ulcer, and gastric ulcer. Some cancer patients may also develop these symptoms during or after radiotherapy, chemotherapy, or targeted therapy; all such patients may use this formula.
In this formula, Dangshen, Baizhu, and Gancao fortify the spleen and boost qi; Muxiang, Chenpi, and Qingpi move qi and stop pain; the berberine in Huanglian has broad-spectrum antibacterial action and a good antidiarrheal effect; Pao Jiang warms the middle and disperses cold, and also stops diarrhea and pain. Combined, they warm the middle and stop diarrhea.
Radiotherapy patients or those with ulcerative colitis may also have blood in the stool; such patients may add Cebotan (charred Platycladus), Xueyutan (charred human hair), Huaihua (Sophora Flower), and Diyu tan (charred Sanguisorba). Those with fifth-watch (early-morning) diarrhea may combine this formula with Sishen Wan. Severe abdominal pain may be treated by adding Baishao (White Peony); nausea and vomiting by adding Huoxiang (Agastache), Peilan (Eupatorium), Fabanxia (processed Pinellia), and Zhuru (Bamboo Shavings); acid regurgitation and heartburn by adding Wuzeigu (Cuttlebone) and Baiji (Bletilla); and frequent hiccups by adding Dingxiang (Clove) and Shidi (Persimmon Calyx).