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The *Neijing* (Inner Canon) states: The liver qi arises on the left, the lung qi is stored on the right, the heart is located superiorly, and the kidney is situated inferiorly. The four viscera occupy these four positions: left, right, superior, and inferior. The spleen belongs to Earth, corresponds to the Center, resides among the four viscera, is termed the "Middle State" (Zhongzhou), governs the Middle Jiao, generates Ying (Nutrient) Qi and Wei (Defensive) Qi, and circulates Jin-Ye (Body Fluids). If there is any dysfunction, Ying and Wei Qi will lose their source of generation, and Body Fluids will lose their pathway of circulation. Therefore, this decoction must be used to warm and establish the function of the central viscera; hence it is named Jianzhong Tang (Middle-Establishing Decoction).

Jiaoyi (Maltose) has a sweet flavor and warm nature; Gancao (Licorice Root) has a sweet flavor and neutral nature. The spleen desires relaxation; in cases of urgency, one should eat sweet substances to relax it. To build the spleen, one must primarily use sweet herbs. Thus, Jiaoyi is used as the Jun (Sovereign) herb, and Gancao as the Chen (Minister) herb. Guizhi (Cinnamon Twig) is acrid and hot. Acridness disperses and moistens. When Ying and Wei Qi are insufficient, they are treated by moistening and dispersing. Shaoyao (Peony Root) has a sour flavor and slightly cold nature. Sourness astringes and drains. When Body Fluids fail to reach their destination, they are treated by astringing and promoting their movement. Therefore, Guizhi and Shaoyao are used as Zuo (Assistant) herbs. Shengjiang (Fresh Ginger) has an acrid and warm flavor; Dazao (Jujube Fruit) has a sweet and warm flavor. The Stomach is the source of Wei Qi, and the Spleen is the root of Ying Qi. The *Huangdi Zhenjing* (Yellow Emperor’s Classic of Acupuncture) states: "Ying Qi emerges from the Middle Jiao, and Wei Qi emerges from the Upper Jiao." This is correct. Wei Qi is Yang; when Yang is insufficient, tonification must utilize acrid substances. Ying Qi is Yin; when Yin is insufficient, tonification must utilize sweet substances. When acrid and sweet flavors combine, the Spleen and Stomach become robust, and Ying and Wei Qi flow freely. Therefore, Shengjiang and Dazao are used as Shi (Envoy) herbs.

Some argue: Guizhi Tang (Cinnamon Twig Decoction) releases the exterior, yet contains a small amount of Shaoyao; Jianzhong Tang warms the interior, yet contains a large amount of Shaoyao. They do not understand the principle of formulation based on proximity or distance. Pathogens in the skin and hair are considered "proximal," so the dosage is made smaller. In Guizhi Tang, Shaoyao assists Guizhi in dispersing pathogens; this is not the same mechanism as in Jianzhong Tang. Pathogens in the heart and abdomen are considered "distal," so the dosage is made larger. In Jianzhong Tang, Shaoyao assists Jiaoyi in building the Spleen; this is also not the same usage as with Guizhi. The *Neijing* states: "When the disease is proximal, whether the formula is odd or even, make the dosage small; when the disease is distal, whether the formula is odd or even, make the dosage large." This refers to that principle.

Jiaoyi (Jun, 1 sheng) Gancao (Chen, 1 liang, prepared by stir-frying) Guizhi (Zuo, 3 liang, bark removed) Shaoyao (Zuo, 6 liang) Dazao (Shi, 12 pieces, split open) Shengjiang (Shi, 3 liang, sliced)

Take the above six ingredients. Add seven sheng of water, boil to obtain three sheng, remove the dregs, add Jiaoyi, and heat gently over a low fire until dissolved. Take one sheng warm, three times daily.

Patients who vomit should not use Jianzhong Tang because of its sweetness.