Fu Zi Li Zhong Wan — Aconite Pill to Regulate the Middle

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

Overview

Fu Zi Li Zhong Wan — Aconite Pill to Regulate the Middle — is the stronger, deeper-warming version of Li Zhong Wan. By adding Fu Zi (prepared Aconite) — the most powerful Yang-warming herb in the Chinese pharmacopoeia — the formula extends its reach from the Middle Jiao alone to also rescue Kidney Yang. It is reserved for severe Spleen and Stomach Yang deficiency where the cold has penetrated deeply and simple warming of the Middle no longer suffices. It is the formula of choice when there are signs of Kidney Yang failure accompanying the Middle Jiao cold — ice-cold limbs that don’t rewarm, watery diarrhoea with undigested food, severe exhaustion, and pulses that are so deep and weak they are barely palpable. The classical source is the Tai Ping Hui Min He Ji Ju Fang (Imperial Grace Formulary).

TCM pattern

Prescribed for severe Spleen and Stomach Yang deficiency with internal Cold, often combined with Kidney Yang deficiency, characterised by: severe cold pain in the epigastrium and abdomen that is markedly relieved by warmth and pressure; chronic watery diarrhoea with undigested food (the “cock-crow” pre-dawn diarrhoea); vomiting of clear thin fluids; profound aversion to cold; ice-cold limbs that do not rewarm easily; exhaustion and lassitude; pale or dusky-pale complexion; pale, swollen tongue with a moist white coating; and a deep, slow, weak or thready pulse.

Key herbs

1. Fu Zi (prepared Aconitum carmichaelii lateral root) — the principal herb that distinguishes this formula from Li Zhong Wan; powerfully restores Kidney and Spleen Yang, rescues Yang from collapse and warms the entire body
2. Gan Jiang (Zingiber officinale dried rhizome) — warms the Middle Jiao and expels Cold from the Spleen and Stomach; supports Fu Zi and moderates its toxicity
3. Ren Shen (Panax ginseng root) — powerfully tonifies Spleen and Stomach Qi to restore the Middle Jiao’s digestive function
4. Bai Zhu (Atractylodes macrocephala rhizome) — tonifies Spleen Qi and dries Dampness; restores the Spleen’s transforming and transporting function
5. Zhi Gan Cao (honey-fried Glycyrrhiza root) — tonifies Qi, harmonises the formula and moderates the toxicity of Fu Zi

Formula actions

1. Powerfully warms the Middle Jiao
2. Restores Spleen and Kidney Yang
3. Tonifies Spleen and Stomach Qi
4. Disperses internal Cold
5. Rescues Yang from collapse

Conditions treated

1. Severe cold abdominal pain relieved by warmth from Spleen and Stomach Yang deficiency with internal cold
2. Chronic watery diarrhoea with undigested food, including early-morning “cock-crow” diarrhoea from Kidney Yang deficiency
3. Vomiting of clear thin fluids from Cold in the Middle Jiao
4. Ice-cold extremities that do not rewarm from Spleen and Kidney Yang collapse
5. Severe digestive weakness with profound aversion to cold food and drink
6. Chronic gastritis and gastric atony with significant cold pattern
7. Crohn’s disease and ulcerative colitis in flare with cold, watery stools and profound exhaustion
8. IBS-diarrhoea with severe cold-sensitive abdominal pain and post-prandial chills
9. Chronic fatigue from Spleen-Kidney Yang exhaustion
10. Recovery from severe illness, surgery or chemotherapy where Yang has been depleted
11. Post-natal cold abdominal pain and diarrhoea in postnatal women with significant Yang depletion

Cautions

Fu Zi (prepared Aconite) is a powerful herb that must only be prescribed by a qualified Chinese herbalist who knows how to dose and combine it safely. Raw, unprepared Fu Zi is highly toxic; the pharmaceutical-grade preparations supplied by Sun Ten are processed to ensure safety, but the formula is contraindicated in pregnancy, in patients with Yin deficiency or internal Heat, and where there is no clear pattern of Cold and Yang deficiency. Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). Online herbal consultations are available. See the prices page for costs.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide. After a full video consultation, Dr (TCM) Attilio D'Alberto formulates a bespoke herbal prescription and posts your Chinese herbs directly to your door.