Formula Database

Gui Zhi Tang

(Cinnamon Twig Decoction)

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Source: Discussion of Cold Damage (c. 220)
Author: Zhang Ji (Zhong-Jing)

Category: Formulas that Release the Exterior

Pattern: Taiyang stage Wind-Cold or Wind attack with Exterior deficiency, imbalance of Ying and Wei Qi

Key Symptoms: Aversion to drafts (including intolerance of open windows and needing to wear a scarf or protective clothing), sweating at any time of day or night (may be spontaneous or triggered by activity, stress or wind), fever or other heat symptoms
Secondary Symptoms: Headache, stiff neck, nasal obstruction, aching and pain in the extremities (especially arms and shoulders), dry heaves, flushing, constipation

Tongue: May have white coating but not always
Pulse: Floating and either lax or frail
Abdomen: Tension in rectus abdominis

Gui Zhi 9g
Bai Shao 9g
Zhi Gan Cao 6g
Sheng Jiang 4sl
Da Zao 3-4pc

Preparation: Decoction.

Actions: Releases pathogens from the muscle layer, regulates Ying and Wei

Contraindications: Exterior Cold and interior Heat, or internal Dampness

This is one of the principle formulae of the Shang Han Lun and therefore of Chinese medicine as a whole. Several variations are described in the source text with a few of the most notable being:

Gui Zhi Jia Gui Tang: Increase Gui Zhi to 15g for Taiyang symptoms with Running Piglet disorder (recurrent attacks of an upward surging sensation from the abdomen to the chest) caused by excessive sweating depleting the Yang Qi of the chest making it unable to control the ascent of Yang from the lower to upper Jiao.

Gui Zhi Jia Shao Yao Tang: Double the dosage of Shao Yao for a Taiyang stage disorder with abdominal fullness and occasional pain. This is due to using purgatives which have allowed the Taiyang stage disease to advance to Taiyin. By adding 30g of Yi Tang (Maltose) to this formula the focus shifts entirely to Taiyin and becomes Xiao Jian Zhong Tang for middle Jiao deficiency with spamodic abdominal pain and reduced appetite without signs of Taiyang disease.

Gui Zhi Qu Shao Yao Tang: Remove Shao Yao for a Taiyang disorder with irregular pulse and feeling of fullness in the chest due to improper use of purgatives injuring the Qi of the chest. The removal of Shao Yao removes the astringent quality making the formula push the pathogen out more strongly.

Gui Zhi Jia Hou Po Xing Zi Tang: Add Hou Po and Xing Ren for a Gui Zhi Tang presentation with wheezing, either from improper treatment or a previous constitutional pattern.

Gui Zhi Jia Fu Zi Tang: Add Zhi Fu Zi for a Taiyang condition with incessant sweating and painful obstruction due to over-induction of sweating damaging the Yang of the Exterior without releasing the pathogen which is now stuck in the channels.

Gui Zhi Jia Ge Gen Tang: Add Ge Gen for a Gui Zhi Tang presentation with stiff upper back and neck.

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.