A "strongly warm the center" variation of the classical Lizhong Wan, the same base formula with aconite added to address pronounced "spleen-kidney yang deficiency" patterns.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Finalized in the Song dynasty "Formulary of the Bureau of Medicine" (《太平惠民和剂局方》) as the warming-up of Lizhong Wan with aconite. In Japan, related warming formulas (Ninjin-to / Renshen Tang 人参湯, Shimbu-to / Zhenwu Tang 真武湯) are sold by Tsumura and Kracie as the standard OTC for "cold body, cold belly, loose stools". In Korea it appears as Buja-ijung-hwan (부자이중환) in the Kyungdong hanbang line. The addition of aconite shifts the formula from "tonify the center" to "strongly warm and rescue devastated yang".
From the source text
This page is cultural documentation, not medical advice.
From the source text · 卷五·治痼冷·附子理中丸
Classical text
治脾胃冷弱，心腹绞痛，呕吐泄利，霍乱转筋，体冷微汗，手足厥寒，心下逆满，腹中雷鸣，呕哕不止，饮食不进，及一切沉寒痼冷，并皆治之。
Modern Chinese rendering
本方用于脾胃虚寒所致的心腹绞痛、呕吐泄利、霍乱转筋、体冷微汗、手足厥寒、心下逆满、腹中雷鸣、呕哕不止、饮食不进,以及一切沉寒痼冷之证。这一段方论把附子理中丸定位为"理中丸加附子、温阳散寒"的代表方——理中汤本治中焦虚寒,加附子后专治"沉寒痼冷、脾肾阳虚"之重证,也是"温中祛寒"思路下"温阳散寒"路径的经典条目。
Editorial translation
This formula is used for cold-deficiency of the spleen and stomach: gripping pain in the heart and abdomen, vomiting and diarrhea, cholera with cramp, cold body and faint sweat, reversal cold of the hands and feet, counterflow fullness below the heart, rumbling thunder in the abdomen, unending retching and hiccup, inability to take food or drink, and all manner of deep-seated cold and entrenched cold patterns. This preface positions Fù Zǐ Lǐ Zhōng Wán as the Formulary's representative "Lǐ Zhōng Wán plus aconite, warming yang and dispersing cold" formula — Lǐ Zhōng Tāng itself addresses center-burner cold-deficiency, and the addition of Fù Zǐ specializes it for the severe "deep-seated cold and entrenched cold, spleen-kidney yang-deficiency" pattern — the canonical entry for the "warm the center and dispel cold" approach in its yang-warming and cold-dispersing register.
In tradition
In TCM tradition, associated with the more pronounced form of "spleen-kidney cold and deficiency": cold abdominal pain that prefers warmth and pressure, loose stools or undigested food in the stool, cold limbs, a deep and slow pulse, and a general sense of "cold in the belly". It is the formula most often discussed when Lizhong Wan is felt to be "not warming enough" and the patient has clear cold signs from the waist down.
Formula composition
Monarch2
- Aconite root, processed (Fù Zǐ / 附子)
- Dried ginger (Gān Jiāng / 干姜)
Assistant3
- Ginseng (Rén Shēn / 人参)
- White atractylodes (Bái Zhú / 白术)
- Licorice root, honey-fried (Zhì Gān Cǎo / 炙甘草)
International availability
Japan (Kampo)
- Tsumura & Co.ツムラOTC附子理中湯Bushi-ri-chū-to
Korea (Hanbang)
- Kyungdong경동OTC부자이중탕Buja-ijung-tang
Taiwan & Hong Kong
- 順天堂OTC附子理中丸Fu Zi Li Zhong Wan
Cautions & context
- Aconite (Fù Zǐ / 附子) is a "toxic" herb in Chinese pharmacopoeia, the processed form used in pharmacy is safe at standard doses, but overdose can cause cardiac arrhythmia.
- Not appropriate during fever, active inflammation, or "yin deficiency with fire" patterns in TCM framing, the formula is strongly warming.
- Pregnant or breastfeeding people should consult a qualified practitioner before use, aconite has specific contraindications in pregnancy.
- Persistent abdominal pain, especially with fever, blood in the stool, or significant weight loss, requires medical evaluation before any herbal remedy is considered.
Related formulas
Other formulas from this text· "Formulary of the Bureau of Medicine"
Other formulas by this contributor· Imperial Medical Bureau (Song)
Browse by Pattern
Related concerns
Concern · digestion
Digestion
Upper-abdominal heaviness, bloating, sour reflux, loose stools, traveler's stomach, and the aftermath of a meal that was richer, spicier, or larger than usual.
Editorial note
Compiled from "Formulary of the Bureau of Medicine" (1078).
Last reviewed: July 18, 2026
Three layers of evidence
Classical source
≈ 900 years · "Formulary of the Bureau of Medicine" (1078)
Pharmacopoeia indication
"Warm the middle and fortify the spleen. Used for spleen-stomach cold deficiency: cold pain in the epigastrium and abdomen, vomiting, diarrhea, and cold hands and feet."
Modern research status
As of 2026-07-18, a PubMed search using the formula name and the Latin / Korean / Japanese transliterations together with "systematic review" and "meta-analysis" did not identify a dedicated systematic review for this formula. Any clinical evidence that does exist is fragmented across small individual trials or covered in broad herbal-medicine umbrella reviews, which do not allow a per-formula evidence assessment; the absence of a dedicated SR is itself the relevant editorial fact here.
References
References reviewed on July 18, 2026 · PubMed search on 2026-07-18
- 01ClassicalChen Shiwen (陈师文) et al. (eds.), 《太平惠民和剂局方》 (Tài Píng Huì Mín Hé Jì Jú Fāng / Formulary of the Bureau of Medicine), Song dynasty, compiled 1078, vol. 5, the "addressing entrenched cold" (治痼冷) section, the entry for Fù Zǐ Lǐ Zhōng Wán (附子理中丸), the Formulary's representative "Lǐ Zhōng Wán plus aconite, warming yang and dispersing cold" formula for the severe "deep-seated cold and entrenched cold, spleen-kidney yang-deficiency" pattern, the canonical entry for the "warm the center and dispel cold" approach in its yang-warming and cold-dispersing register.
- 02TextbookDuan Fuqin (段富津) et al. (eds.), 《方剂学》 (Fāngjìxué / Science of Formulas), 2nd edition, Shanghai Scientific and Technical Publishers, 2011, the standard modern university-level formula textbook in mainland China, with Fù Zǐ Lǐ Zhōng Wán analysed as the warming-up of Lǐ Zhōng Wán with aconite, the "strongly warm and rescue devastated yang" (回阳救逆) variant of the "tonify the center" formula, indicated for severe spleen-kidney yang-deficiency patterns where Lǐ Zhōng Wán alone is felt to be "not warming enough".
- 03TextbookTsumura & Co. (ツムラ), Ninjin-to (人参湯) and Shimbu-to (真武湯) product documentation, Japan's leading Kampo manufacturer, the standard Japanese Kampo adaptations of the warming-cold formulas in the Fù Zǐ Lǐ Zhōng Wán / Lǐ Zhōng Wán lineage, used for "cold body, cold belly, loose stools" presentations in Japanese Kampo clinical practice, listed in the Japanese Kampo formulary as standard warming formulas.
- 04PharmacopoeiaPharmacopoeia Commission of the PRC, 《中华人民共和国药典》 2020 edition, vol. 1 (Zhōnghuá Rénmín Gònghéguó Yàodiǎn, Pharmacopoeia of the People's Republic of China, 2020 ed., vol. 1), China Medical Science Press, 2020, the official national monograph for Fù Zǐ Lǐ Zhōng Wán, "functional indication" reads "warm the middle and fortify the spleen, used for spleen-stomach cold deficiency causing cold pain in the epigastrium and abdomen, vomiting, diarrhea, and cold hands and feet".