Weight loss is not merely about calorie counting. In Traditional Chinese Medicine (TCM), obesity is often closely related to the accumulation of "dampness-phlegm" and dysfunctional transportation and transformation by the spleen and stomach. The "Zhi Zhu Tang" formula recorded by the Medical Sage Zhang Zhongjing in the Synopsis of the Golden Chamber uses only two medicinal herbs: Zhi Shi (Immature Bitter Orange) and Bai Zhu (White Atractylodes). It aims to eliminate the dampness-phlegm and excess flesh in the abdomen described as "hardness below the heart, large as a plate," fundamentally regulating body constitution to achieve healthy weight loss. This article details the principle, applicable population, and specific effects of this formula.

1. The Four Common Habitual Roots of Modern Weight Gain

• Frequent Late Nights: Not sleeping deeply during the Zi hour (11 PM-1 AM) damages Yin and consumes Qi, leading to deficient internal fire, increased appetite, and slowed metabolism.

• Poor Diet: Overloading the spleen and stomach, impairing their transformative function, turns food into dampness-phlegm waste that accumulates in the body.

• Lack of Exercise: Slow blood and Qi circulation allows dampness-phlegm to stagnate in the meridians, congealing into fat.

• High Stress: Liver Qi stagnation overacts on the spleen (Earth), causing spleen deficiency that generates dampness, creating a vicious cycle of Qi stagnation, blood stasis, and phlegm congelation.

2. The Ancient Formula "Zhi Zhu Tang": The Weight-Loss Wisdom of Simultaneous Unblocking and Tonifying

This formula is designed for the characteristics of "the obese often have dampness-phlegm" and "the obese often have Qi deficiency." With only two herbs, it addresses both the "outflow" and "inflow," treating both the symptoms and root cause.

• Zhi Shi (Immature Bitter Orange): Acts as the "path-opening vanguard."

  • Action: Widens the chest and directs Qi downward, promotes digestion and relieves stagnation. It can unblock the nine orifices, forcefully expelling and eliminating fullness in the chest, abdomen, and flanks, as well as accumulated dampness-phlegm-fluid retention through bowel movements or passing gas.

  • Targets: Obesity accompanied by difficult bowel movements, constipation, or hard abdominal fullness. Its core action is to resolve the "outflow" of dampness-phlegm.

• Bai Zhu (White Atractylodes): Plays the role of the "logistics commander."

  • Action: Strengthens the spleen, supplements Qi, dries dampness, and transforms phlegm. It can both tonify the Qi deficiency common in the obese and enhance the spleen and stomach's transformative function, cutting off the source of dampness-phlegm generation.

  • Targets: Spleen deficiency with fatigue, heavy dampness, and excessive phlegm. Its core action is to cut off the "inflow" of dampness-phlegm.

3. Formula Analysis and Ingenious Combination

The pairing of these two herbs achieves simultaneous purgation and tonification, descending and ascending:

• Zhi Shi (Purgative, Descending) unblocks and guides stagnation, providing an outlet for pathogenic factors.

• Bai Zhu (Tonifying, Ascending) strengthens the spleen and boosts Qi, supporting righteous Qi.
  Thus, it eliminates existing dampness-phlegm and excess flesh while enhancing the body's ability to metabolize dampness, restoring the ascending-descending pivotal function of the spleen and stomach, thereby achieving healthy weight loss that is less prone to rebound.

4. Usage and Notes

• Method: Steep or decoct the two herbs in proportion (often referring to the original formula's ratio of Zhi Shi to Bai Zhu) in water as a tea substitute.

• Duration: Effectiveness varies by constitution; it is recommended to observe and adjust over a one-month cycle.

• Key Point: This formula is for constitutional regulation. It must be combined with correcting poor lifestyle habits (e.g., staying up late, prolonged sitting, dietary irregularities) for optimal results.

Zhang Zhongjing's Zhi Zhu Tang offers a TCM perspective on weight loss starting from "dampness-phlegm" and the "spleen and stomach." It is not only a method to remove excess flesh but also a wisdom for health preservation that restores the body's clarity, free flow, and balanc