【Source】

《Shanghan Lun (Treatise on Cold Damage Disorders)》

 【Ingredients】

Dang-gui (Angelica Sinensis Root), Gui-zhi (Cinnamon Twig), Bai-shao (White Peony Root), Xi-xin (Asarum), (Zhi) Gan-cao (Honey-fried Licorice Root), Mu-tong (Akebia Stem), Da-zao (Jujube)
(7 ingredients)

 【Herb Categories】

<Nourishing Blood>: Bai-shao (White Peony Root), Dang-gui (Angelica Sinensis Root)

<Tonifying Spleen and Middle Jiao>: Gan-cao (Licorice Root), Da-zao (Jujube)

<Pungent-Warm to Release the Exterior>: Gui-zhi (Cinnamon Twig)

<Warming the Interior>: Xi-xin (Asarum)

<Promoting Diuresis and Draining Dampness>: Mu-tong (Akebia Stem)

【Formula Explanation】

From Yifang (Medical Prescriptions): A formula for the Foot Jueyin Liver meridian. Cheng Wuji said: The pulse is the residence of blood; all blood belongs to the heart. To unblock the vessels, one must first tonify the heart and benefit the blood, as bitterness first enters the heart. Dang-gui‘s bitterness helps fortify heart blood. The heart dislikes slackness; quickly consume sour flavors to astringe it. Bai-shao’s sourness astringes heart qi. If the liver is tense, quickly consume sweet flavors to relax it. Da-zao, Gan-cao, and Mu-tong (通草) are used to relax Yin blood. From Shanbu (Revised and Supplemented): This formula is composed of Gui-zhi Tang (Cinnamon Twig Decoction) with Sheng-jiang (Fresh Ginger) removed, Da-zao (Jujube) doubled, and Dang-gui (Angelica Sinensis Root), Mu-tong (Akebia Stem), and Xi-xin (Asarum) added. Given a constitution with blood deficiency, the sweet and warm Dang-gui is used as the principal herb. It enters the Liver meridian and is a vital herb for warming and tonifying Liver blood. Gui-zhi warms and unblocks the meridians, while Bai-shao (White Peony Root) nourishes blood and harmonizes the ying (nutritive qi). The combination of these two has the effect of internally soothing the Jueyin meridian. Used here as assistant herbs, the principal and assistant herbs together form a method of nourishing blood, soothing the liver, and warming the meridians. Xi-xin serves as a deputy herb, unblocking blood vessels and dispelling cold pathogens. Da-zao and Zhi Gan-cao serve as envoy herbs, tonifying Spleen qi and harmonizing the other herbs. Together, all the herbs form a warming, tonifying, and vessel-unblocking agent. From Handian (Han’s Dictionary): This formula removes Sheng-jiang (Fresh Ginger) from Dang-gui Jianzhong Tang (Tangkuei Regulating the Middle Decoction) and additionally adds Mu-tong (Akebia Stem) and Xi-xin (Asarum). Its diuretic and interior-warming effects are very significant.

 【Actions】

Warms the meridians and dispels cold, nourishes blood and unblocks vessels.

 【Indications】

(1) Insufficient Yang Qi with blood deficiency, and external invasion of cold pathogens; cold extremities (Juehan), pale tongue with white coating, a thready pulse that is almost imperceptible or deep and thready. (2) Cold entering the meridians, leading to pain or numbness in the lower back, thighs, legs, and feet. (3) Cold extremities (Juehan), a thready pulse that is almost imperceptible, a generally distended but empty abdomen, and tense rectus abdominis muscles. Yifang: Jueyin cold damage, cold extremities, and a thready pulse that is almost imperceptible (from Shanghan Lun, Jueyin chapter). Shanbu: Indicated for cold extremities and a thready pulse that is almost imperceptible.

 【Therapeutic Scope】

Frostbite, intestinal hernia, sciatica, chronic peritonitis, uterine prolapse, thromboangiitis obliterans, neuropathic pain, dysmenorrhea, gastritis and duodenitis, periarthritis of the shoulder, stubborn urticaria, Raynaud’s disease, cold-damp type psoriasis, primary and secondary infertility. It is also widely used in orthopedics.

 【Contraindications】

This formula is only suitable for cold reversal of the four limbs due to blood deficiency and cold stagnation. It should not be used for cold reversal of the limbs due to other causes.

 【Mnemonics】

(1) ‘Kneeling pain, be careful with morning exercises’ (Gui Tong Zao Cao Yao Dang Xin). This mnemonic helps remember the ingredients: Gui (Gui-zhi – Cinnamon Twig), Tong (Mu-tong – Akebia Stem), Zao (Da-zao – Jujube), Cao (Gan-cao – Licorice Root), Yao (Bai-shao – White Peony Root), Dang (Dang-gui – Angelica Sinensis Root), Xin (Xi-xin – Asarum).#(2) Gui-zhi Tang (Cinnamon Twig Decoction) (Gui-sao san zuo: Gui-zhi, Bai-shao, Da-zao, Gan-cao) with Sheng-jiang (Fresh Ginger) removed and Dang-gui (Angelica Sinensis Root), Xi-xin (Asarum), and Mu-tong (Akebia Stem) added. The phrase ‘Once the heart is unblocked, one must cross the river and return home’ (心通了就要過江歸家) is a phonetic reminder for the added herbs (歸辛通).

 【Pharmacology】

Individual herbs in this formula have effects such as improving blood circulation, inhibiting platelet aggregation, analgesia, sedation, antibacterial and anti-inflammatory effects, detoxification, and antispasmodic effects. It is used for peripheral vascular and neurological diseases, often with modifications (adding or subtracting ingredients) based on the original formula.