Zuo Jin Wan — Left Metal Pill

On this page

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

Overview

Zuo Jin Wan — Left Metal Pill — is a deceptively simple but highly effective two-herb formula for the pattern of Liver Fire invading the Stomach, causing acid regurgitation, burning epigastric pain and nausea. Created by the Jin-Yuan Dynasty physician Zhu Danxi (1282–1358 CE), the name refers to the Metal phase (Lung/Large Intestine) positioned on the left in the Five Element diagram — the Metal is used to restrain the Wood (Liver) that has generated excess Fire. The formula uses the most intensely bitter and cold herb in TCM (Huang Lian) to drain Liver Fire combined with a very small amount of a warming, descending herb (Wu Zhu Yu) to prevent the cold from causing stagnation and to direct Rebellious Qi downward.

TCM pattern

Prescribed for Liver Fire invading the Stomach with Rebellious Stomach Qi, characterised by: acid regurgitation and heartburn (particularly after emotional upset or stress), burning epigastric pain, belching, nausea and vomiting, bitter taste in the mouth, a red tongue with yellow coating, and a wiry, rapid pulse. The acid regurgitation that worsens with stress or emotional upset is the characteristic distinguishing feature.

Key herbs

1. Huang Lian (Coptis chinensis rhizome) — the principal herb (used in a much larger dose than Wu Zhu Yu); clears Liver and Stomach Fire; dramatically reduces acid production and burning pain
2. Wu Zhu Yu (Evodia rutaecarpa fruit) — a small amount warms the Liver, descends Rebellious Qi and stops vomiting; prevents Huang Lian’s intense Cold from causing Cold stagnation; guides the formula to the Liver channel

Conditions treated

1. Acid reflux and gastro-oesophageal reflux disease (GORD) — the formula’s primary indication; particularly when stress and emotional upset are clear triggers
2. Heartburn from Liver Fire invading the Stomach
3. Nausea and vomiting from Stomach Fire and Rebellious Qi
4. Bitter taste in the mouth from Liver-Gallbladder Heat rising
5. Epigastric burning pain from Stomach Fire
6. Peptic ulcer with Liver Fire pattern — often combined with other formulas for a comprehensive approach
7. Functional dyspepsia with prominent heartburn and stress trigger from Liver overacting on Stomach

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.