【Source】

Shang Han Lun, Golden Cabinet

【Composition】

Cinnamon Twig, White Peony Root, (Honey-fried) Licorice, Jujube, Fresh Ginger

(5)

【Classification】

【Blood Nourishing】: White Peony Root

【Spleen and Middle Jiao Tonifying】: Licorice, Jujube

【Acrid-Warm Exterior Releasing】: Three Assistants: Licorice, Ginger, Jujube, Cinnamon Twig, Fresh Ginger

【Formula Explanation】

Yi Fang: Foot Taiyang Herbs. (1) Zhang Zhongjing emphasized sweating to release the exterior, but a light approach to relax the muscles. In cases of wind stroke, profuse sweating is not advisable, as it can reverse the movement of Qi and Blood. Thus, even if there is an exterior evil, it should only be gently released. Therefore, Gui Zhi Tang is used for mild regulation. (2) The classics state: When wind prevails, regulate with acrid coolness, assisted by bitterness and sweetness. Sweetness softens, and sourness astringes. (3) Cinnamon Twig: Acrid and sweet, disperses and releases Yin, thus being Yang. (4) The ministering herb is White Peony Root with its sour astringency, assisted by the sweet and neutral Licorice, preventing the leakage of Yin Qi. (5) Ginger: Acrid and warm, capable of dispersing. Jujube: Sweet and warm, capable of harmonizing. These are not solely for external release, but also for circulating the spleen’s bodily fluids and harmonizing the Ying and Wei. (6) Ma Huang Tang is solely for exterior release, thus it does not use ginger and jujube, allowing fluids to flow freely. Shan Bu: The name Gui Zhi Tang is derived from its principal herb, Cinnamon Twig. Cinnamon Twig is acrid and warm; its acridity disperses evils, and its warmth supports Yang and the Wei. White Peony Root is sour and cold; its sourness astringes sweat, and its coldness enters Yin and benefits the Ying. Cinnamon Twig as the monarch and White Peony Root as the minister means that within the dispersing action, there is an intention to astringe sweat. White Peony Root as the minister and Cinnamon Twig as the monarch mean that within the solidifying of the exterior, there is a path for mild sweating. Fresh Ginger’s acridity assists Cinnamon Twig in releasing the muscles and exterior. Jujube’s sweetness assists White Peony Root in harmonizing the Ying and interior. Licorice, being sweet and neutral, has the ability to pacify the interior and expel the exterior. It is used to harmonize the Middle Jiao, thereby harmonizing the exterior and interior, and also harmonizing all the herbs. With the complementary actions of Cinnamon Twig and White Peony Root, and the supportive relationship of Ginger and Jujube, and borrowing the harmonizing effect of Licorice on Yang (exterior) and Yin (interior), Qi (Wei) and Blood (Ying), they work together without conflict, achieving harmony through the combination of hardness and softness. The crucial essence lies in drinking warm thin gruel immediately after taking the decoction to aid the medicinal power. This is because when the Qi of grains is abundant internally, it not only facilitates the production of sweat but also prevents the retention of pathogenic factors and blocks the entry of future evils. It is also clever to drink it warm and induce mild sweating after about an hour, which teaches the method of mild sweating. Excessive sweating, like flowing water, will not eradicate the illness, thus cautioning against excessive sweating. Han Dian: The principal herbs of this formula, Cinnamon Twig and Fresh Ginger, both have stimulating effects, capable of promoting blood circulation, warming the body, and strengthening the functions of various organs. White Peony Root has a calming effect, adjusting the action of Cinnamon Twig. In combination with Licorice, it can alleviate abnormal tension and treat pain. Jujube and Licorice both treat urgency and have strengthening effects. They, along with Fresh Ginger, are also used to improve taste.

【Functions】

Releases muscles and disperses the exterior, harmonizes Ying and Wei, solidifies the exterior and disperses evils, nourishes Yin and harmonizes Yang.

【Indications】

Exterior-contracted wind-cold with exterior deficiency syndrome, Taiyang disease, presenting with fever, headache, sweating, aversion to wind, nasal sound, dry heaving, no thirst, thin white tongue coating, and floating and moderate pulse. Miscellaneous diseases, post-illness, pregnancy, postpartum, etc., showing intermittent fever, spontaneous sweating, mild aversion to wind, due to disharmony of Ying and Wei. Yi Fang: (1) Treats Taiyang wind stroke, floating Yang and weak Yin, fever, headache, spontaneous sweating, aversion to wind and cold, nasal sound, dry heaving. (2) Also treats Yangming disease with a slow pulse, profuse sweating, and mild aversion to cold, indicating that the exterior has not been resolved, and sweating can be induced (Shang Han Lun, Yangming Chapter). Shan Bu: Wind-cold attacking the exterior, with a floating and weak pulse, spontaneous sweating, headache, fever, aversion to wind and cold, nasal sound, dry heaving, and other symptoms. Also used for miscellaneous diseases with spontaneous sweating, night sweats, deficiency, and deficient malaria. Contraindicated if the pulse is floating and tight, and there is no sweating, or in drinkers of alcohol with wind-cold and sweating.

【Indications】

Various types of common cold, influenza, fever, spontaneous sweating, and various internal miscellaneous diseases. Neuralgia, headache, cold abdominal pain, weak constitution, morning sickness during pregnancy, and other conditions.

【Contraindications】

(1) Avoid raw and cold, sticky, greasy, meat and flour products, pungent five spices, alcohol, dairy, and foul-smelling substances. (2) If the pulse is floating and tight, and there is fever with no sweating, it should not be administered. (3) In cases of alcohol drinkers with illness, Gui Zhi Tang should not be used. (4) Contraindicated in the early stage of warm diseases with fever but no aversion to cold, profuse sweating and thirst, or internal damp-heat. (5) After taking the decoction, drink warm thin gruel and cover with a blanket to induce mild sweating; do not induce profuse sweating.

【Mnemonic】

(1) Gui Sao San Zuo: Noble herbs + three assistants Licorice, Ginger, Jujube. (2) Use noble herbs to stir-fry ginger and jujube (Cinnamon Twig, White Peony Root, Licorice, Ginger, Jujube).

【Additions and Subtractions】

Shan Bu: (1) Double the White Peony Root and Fresh Ginger, and add Ginseng. This is Gui Zhi Xin Jia Tang, used to treat exterior deficiency cold of the Ying system, and limb pain. (2) Double the White Peony Root and add Maltose. This is Xiao Jian Zhong Tang, used to treat interior deficiency palpitations and abdominal cramps. (3) Add Astragalus. This is Huang Qi Jian Zhong Tang, used to treat deficiency, deficiency heat, spontaneous sweating, and night sweats. Han Dian: Gui Zhi Jia Shao Yao Tang involves doubling the White Peony Root in Gui Zhi Tang. Gui Zhi Tang is a treatment for Taiyang disease, while this formula treats Taiyin disease. Adding Rhubarb for cases where Gui Zhi Tang is indicated but there is a tendency for constipation. Adding Kudzu Root is indicated for Gui Zhi Tang symptoms with tension in the neck and back. Adding Astragalus is for skin that contains water, lacks elasticity, and has symptoms such as night sweats and numbness. Adding Aconite is for Taiyang disease with coexisting Shaoyin syndrome. Bai Zhu or Bai Zhu and Fu Ling can be added for conditions such as neuralgia, rheumatism, cold abdominal pain, hemiplegia, and infantile paralysis. (1) For exterior deficiency with blocked Taiyang channel Qi and stiffness in the neck and back, use Gui Zhi Tang with Kudzu Root added, which is Gui Zhi Jia Ge Gen Tang (Shang Han Lun). It releases muscles, expels wind, raises bodily fluids, and relaxes the meridians. It primarily treats Taiyang disease, with stiffness in the neck and back, and paradoxical sweating while feeling aversion to wind. (2) For lung failing to descend, with cough and asthma, add Magnolia Bark and Apricot Kernel to this formula, making it Gui Zhi Jia Hou Po Xing Ren Tang. It harmonizes Ying and Wei, descends rebellious Qi, and calms asthma. It treats asthma attacks presenting with Gui Zhi Tang symptoms, or mild asthma after the exterior of Taiyang disease has been purged. (3) For Yang deficiency, add Aconite to Gui Zhi Tang, making it Gui Zhi Jia Fu Zi Tang. It harmonizes Ying and Wei, solidifies the exterior and supports Yang, addressing both the exterior and interior. It treats Taiyang disease with excessive sweating leading to persistent sweating, aversion to wind, difficult urination, and slight spasms and difficulty in bending the limbs. (4) For body pain, discomfort, and difficulty in turning, remove White Peony Root and add Aconite, making it Gui Zhi Jia Fu Zi Tang (Shang Han Lun). It disperses wind, eliminates dampness, supports Yang, and dispels cold. It treats wind-dampness externally attacking and lingering in the superficial layer, causing body spasms, discomfort, and difficulty in turning, with no thirst, and a floating and astringent pulse. (5) For deficiency of both Yin and Yang, add Dragon Bone and Oyster Shell to this formula, making it Gui Zhi Jia Long Gu Mu Li Tang. It treats deficiency of essence and blood, Yin and Yang deficiency, nocturnal emission in men, dream intercourse in women, abdominal fullness and tension, cold at the base of the penis, dizziness, hair loss, extremely deficient and thready pulse, and pale tongue with thin white coating.

【Pharmacology】

Induces sweating and reduces fever, anti-inflammatory and analgesic, antiviral, regulates intestinal and immune function, with certain effects on respiration and myocardial blood flow. It has the effect of promoting blood circulation, warming the body, and strengthening the function of various organs.