Hou Po Wen Zhong Tang — Magnolia Warm the Middle Decoction

On this page

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

Overview

Hou Po Wen Zhong Tang — the “Magnolia Warm the Middle Decoction” — is from Li Dong-yuan’s Jin-Yuan Nei Wai Shang Bian Huo Lun. It treats Cold-Damp stagnation in the middle burner, where cold and damp have lodged together producing epigastric or abdominal distention, bloating, cramping pain that improves with warmth, poor appetite and loose stools. The formula uses warming, aromatic and Qi-moving herbs together to disperse the Cold-Damp and restore Spleen function.

I prescribe Hou Po Wen Zhong Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Hou Po Wen Zhong Tang is prescribed for Cold-Damp stagnation in the middle burner:

• Epigastric or abdominal distention, sense of fullness
• Bloating, especially after eating
• Cramping abdominal pain that improves with warmth and pressure
• Poor appetite, loss of taste
• Loose stools, possibly with undigested food
• Cold extremities
• Tongue — pale, white greasy coat
• Pulse — deep, slow, possibly slippery

Key herbs

1. Hou Po — chief; moves middle-burner Qi; resolves Damp; relieves distention
2. Mu Xiang, Cao Dou Kou — aromatically warm and move; resolve Cold-Damp
3. Gan Jiang (or Sheng Jiang) — warms the middle
4. Chen Pi — regulates Qi; dries Damp
5. Fu Ling — drains Damp; supports the Spleen
6. Zhi Gan Cao — harmonises

Formula actions

1. Warms the middle burner
2. Moves Qi; resolves Damp
3. Relieves distention and abdominal pain
4. Restores Spleen function

Conditions treated

1. Functional dyspepsia with Cold-Damp pattern
2. Postprandial bloating and distention
3. IBS with cold-pattern bloating — see IBS
4. SIBO with cold-pattern bloating and distention
5. Gastroparesis with Cold-Damp pattern
6. Chronic gastritis with Cold-Damp pattern
7. Mild Crohn’s with abdominal bloating and cold-pattern

Cautions

Not appropriate for Damp-Heat (foul-smelling stool, yellow coat, burning) or Yin-deficient patterns — the warming and drying herbs aggravate Heat and damage Yin.

Persistent abdominal bloating with weight loss, anaemia, change in bowel habit or pain that wakes at night needs investigation to exclude inflammatory bowel disease, malignancy or coeliac disease.

Always consult a qualified Chinese herbalist registered with the RCHM.

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