Liu Mo Tang (六磨汤) — Six Milled Ingredients Decoction
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Overview
Liu Mo Tang — the “Six Milled Ingredients Decoction” — is from Zheng Zhi Zhun Sheng. The traditional preparation called for the six herbs to be ground (mo, “milled”) immediately before decoction to preserve their aromatic, Qi-moving properties. It treats constipation[11] and abdominal distention from Liver Qi stagnation accompanied by Heat-accumulation in the bowels — a common picture in chronically stressed patients whose constipation flares with anger, frustration or anxiety[4] and is accompanied by belching, sighing and pain that worsens with emotional upset.
I prescribe Liu Mo Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.
TCM pattern
Liu Mo Tang is prescribed for Liver Qi stagnation with Heat accumulation in the bowels:
- Constipation with abdominal distention
- Belching, sighing, hiccups
- Stuffy chest, lateral costal distention
- Symptoms worsen with emotional upset
- Possibly alternating constipation and loose stool
- Bitter taste, dry mouth
- Tongue — thin yellow coat
- Pulse — wiry, possibly slightly rapid
Key herbs
- Mu Xiang (Rx. Aucklandiae, 9g), Wu Yao (Rx. Linderae, 6-9g) — move Qi; relieve stagnation in the middle and lower burners
- Chen Xiang (aquilaria, sustainable cultivated, 3-6g) — moves Qi; descends rebellious Qi
- Bing Lang (Sm. Arecae, 9-12g) — moves Qi; descends accumulation
- Zhi Shi (Fr. Aurantii Immaturus, 6-9g) — breaks Qi stagnation; transforms accumulation
- Da Huang (Rx. et Rz. Rhei, 6g) — purges Heat-accumulation through the bowels
Formula actions
- Moves Qi
- Resolves Qi-stagnation accumulation
- Purges bowel accumulation downward
Conditions treated
- Stress-related constipation with abdominal distention
- IBS[5]-C with prominent bloating and emotional triggers — see IBS
- Functional dyspepsia with constipation
- Constipation in anxiety disorders with marked bloating
- Premenstrual constipation with distention
- Constipation after travel with bloating and Qi stagnation
Cautions
Contains Da Huang — strictly contraindicated in pregnancy.
Use Chen Xiang from sustainable cultivated source — wild aquilaria is endangered. Pharmaceutical-grade granules use cultivated sources.
Not appropriate for cold-deficient or Qi-deficient constipation — use Ji Chuan Jian or Huang Qi Tang instead.
For short to medium-term use; persistent constipation needs investigation to exclude obstruction.
Always consult a qualified Chinese herbalist registered with the RCHM.
Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.
References
[4] Lin Y, Cai S, Wang T, Zhuang T, Huang T, Yu X, et al. Evaluation of the Safety and Efficacy of Xiao Yao San as a Treatment for Anxiety: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2022;2022:1319592. https://doi.org/10.1155/2022/1319592. PMID: 35432568.
[5] Liu Q, Shi Z, Zhang T, Jiang T, Luo X, Su X, Yang Y, Wei W. Efficacy and Safety of Chinese Herbal Medicine Xiao Yao San in Functional Gastrointestinal Disorders: A meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials. Front Pharmacol. 2022 Jan 19;12:821802. https://doi.org/10.3389/fphar.2021.821802. PMID: 35126152.
[11] Lyu Z, Fan Y, Bai Y, Liu T, Zhong LL, Liang HF. Outcome of the efficacy of Chinese herbal medicine for functional constipation: A systematic review and meta-analysis. World J Clin Cases. 2022 May 26;10(15):4856-4877. https://doi.org/10.12998/wjcc.v10.i15.4856. PMID: 35801027.
