Library

Cinnamon Twig (Guizhi) 3 liang, White Peony Root (Shaoyao) 6 liang, Licorice Root (Gancao) 2 liang, Fresh Ginger (Shengjiang, sliced) 3 liang, Maltose (Jiaoyi) 1 sheng, Jujube (Dazao, split open) 12 pieces.
The above six ingredients are decocted with 7 sheng of water until reduced to 3 sheng. The dregs are removed, and Maltose is added. It is then heated gently over a low fire until dissolved. Take 1 sheng warm each time, three times a day.
Patients prone to vomiting should not use Jianzhong Tang because sweetness may aggravate vomiting.
[Formula Analysis]
This formula is derived from Guizhi Tang (Cinnamon Twig Decoction) by doubling the amount of White Peony Root and adding Maltose. It is named Xiao Jianzhong Tang (Minor Construct the Middle Decoction), implying the modest establishment of Middle Qi (the vital energy of the spleen and stomach). Generally, although Middle Qi is deficient, the exterior syndrome has not yet harmonized, so drastic tonification is avoided. Therefore, Cinnamon Twig is still used to harmonize Ying (Nutritive) and Wei (Defensive) Qi, while doubling White Peony Root and adding Maltose to regulate and establish the Middle Jiao (Middle Burner/Spleen-Stomach system). Unlike Guizhi Tang, it does not require drinking hot millet gruel and covering oneself to induce sweating. Its intent focuses on palpitations and Middle deficiency rather than treating the exterior syndrome of Shanghan (Cold Damage). Once the Middle Jiao is established, Ying and Wei Qi naturally harmonize, body fluids are generated, and the disease resolves through sweating; palpitations and irritability are thereby eliminated. "Vomiting patients should not use it" means that anyone suffering from vomiting should avoid it, as sweetness might exacerbate the vomiting.
In Shanghan (Cold Damage) presenting with Jie Dai Mai (Knotted and Intermittent Pulse) and Xindong Ji (Palpitations), Zhigancao Tang (Roasted Licorice Decoction) is indicated.
[Annotation]
Xindong Ji refers to a sensation of palpitation in the epigastric region, characterized by a trembling, uneasy movement that cannot be self-controlled. If caused by sweating or purging, it is mostly due to deficiency; if not caused by sweating or purging, it is mostly due to heat. Thirst accompanied by difficult urination indicates Fluid Retention (Yin); cold limbs with diarrhea indicate Cold. In this case, the patient suffers from Shanghan with palpitations not caused by sweating or purging, and lacks signs of Fluid Retention, Heat, Cold, or Deficiency. Based solely on the Yin pulse of Jie Dai (knotted and intermittent) and insufficiency, Zhigancao Tang is prescribed because the patient's daily Qi and Blood are weak and unable to withstand the Cold Pathogen, causing the pulse to fail to continue smoothly. At this time, even if the exterior syndrome of Shanghan remains unresolved, it is disregarded; the priority is to tonify the Middle and generate Blood to restore the pulse, with the main method being to promote the circulation of Ying and Wei Qi.
[Collected Annotations]
Cheng Wuji stated: When the pulse beats and stops midway but recovers on its own, it is called Jie (Knotted) pulse; when it does not recover on its own, it is called Dai (Intermittent) pulse. This is due to the deficiency and decline of Qi and Blood, preventing mutual continuity.
Cheng Zhi stated: This establishes a modified method for discussing tonification. Mentioning "Shanghan" implies the pathogenic factor is not yet resolved. The Heart governs Blood; mentioning "Jie Dai pulse and palpitations" indicates Blood deficiency and the discontinuity of True Qi. Therefore, one must vigorously tonify Yin to generate Blood and unblock Yang to dispel Cold. Without Yang, there is no way to hold and control the微弱 Yin. Thus, the formula uses Guizhi Tang minus White Peony Root, soaked in clear wine. This aims to salvage True Qi at the verge of exhaustion and avoid internal Cold when the pulse is weak. Observing Xiao Jianzhong Tang reveals that Shanghan has formulas for tonifying Yang; observing Zhigancao Tang reveals that Shanghan has methods for tonifying Yin.
Cheng Yingmao stated: This discusses pathology via pulse diagnosis. Pathogenic factor stagnation and knotting is called Jie; righteous Qi deficiency and decline is called Dai. Seeing this pulse in Shanghan, combined with palpitations, indicates internal deficiency of True Qi. Hence, Zhigancao Tang is used, primarily to benefit Yin, calm Blood, and harmonize Ying and Wei Qi. Furthermore, he stated: Variations in Taiyang syndrome mostly belong to Yang Exhaustion; variations in Shaoyang syndrome involve Yin Exhaustion, because Shaoyang and Jueyin are interior-exterior pairs, and Ying Yin (Nutritive Yin) is damaged. Using Zhigancao Tang treats by harmonizing Ying to nourish Yin Qi.