Xiao Jian Zhong Tang — Minor Construct the Middle Decoction

On this page

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

Overview

Xiao Jian Zhong Tang — Minor Construct the Middle Decoction — is one of the most elegant and clinically important formulas from Zhang Zhongjing’s Shang Han Lun for rebuilding and warming the Middle Jiao when it has become depleted and cold. Its name reflects its function: “construct the middle” — to rebuild and tonify the Spleen and Stomach when they are weakened by deficiency Cold. The formula’s principal ingredient, Yi Tang (maltose/barley malt sugar), is a food-medicine that warms, tonifies and moderates, giving the formula a particularly gentle and nourishing character. Xiao Jian Zhong Tang is used for the pattern where both Yin (Blood) and Yang (Qi/warmth) are deficient in the Middle Jiao, producing a complex presentation of pain, fatigue and both hot and cold signs.

TCM pattern

Prescribed for Middle Jiao deficiency Cold with Spleen and Stomach Qi and Blood deficiency, characterised by: intermittent, cramping abdominal pain that is relieved by warmth and pressure and by eating, fatigue, palpitations, irritability (from the Blood deficiency component), a pale tongue, and a thin, wiry or moderate pulse. The coexistence of cold abdominal pain with irritability and palpitations reflects the simultaneous Yang and Yin deficiency.

Key herbs

1. Yi Tang (Saccharum granorum / maltose) — the principal herb; warms and tonifies the Middle Jiao, moderates the formula and alleviates pain; a classic food-medicine
2. Gui Zhi (Cinnamomum cassia twigs) — warms the channels and Middle Jiao, assists Yang and invigorates circulation
3. Bai Shao (Paeonia lactiflora root) — nourishes Blood and Yin, softens the Liver and alleviates cramping pain (used in a large dose)
4. Zhi Gan Cao (honey-fried Glycyrrhiza root) — tonifies Qi, harmonises and alleviates pain
5. Sheng Jiang (fresh Zingiber officinale rhizome) — warms the Middle and assists Gui Zhi
6. Da Zao (Ziziphus jujuba fruit) — nourishes Blood and Spleen Qi; harmonises

Conditions treated

1. IBS with cold abdominal pain relieved by warmth, pressure and eating — the formula’s primary modern indication
2. Peptic ulcer disease with cold, cramping pain from Middle Jiao deficiency Cold
3. Chronic fatigue with poor digestion and cold abdomen from Spleen and Stomach deficiency
4. Palpitations and anxiety from Blood deficiency coexisting with Middle Jiao Cold
5. Children’s abdominal pain from Spleen and Stomach deficiency Cold — the formula is gentle enough for children
6. Convalescence from prolonged illness where the Middle Jiao needs gentle rebuilding

Cautions

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.