Herb Formulas Notebook

Zhi Shi Xie Bai Gui Zhi Tang

Unripe Bitter Orange, Chinese Garlic and Cinnamon Twig Decoction


Author: Zhang Zhong-Jing, 張仲景

Year: c. 220

Source: Essentials from the Golden Cabinet (Jin Gui Yao Lue, 金匱要略)


Category: Formulas that Regulate Qi

Pattern: Painful Obstruction of Chest due to clumping of Qi and Phlegm from chest Yang deficiency

Key Symptoms: Fullness and pain in the chest or a stabbing pain that radiates from chest to back, wheezing, coughing, shortness of breath.
Secondary Symptoms: Focal distention in the chest that feels like a flow of Qi proceeding from the flanks to the area around the heart.

Tongue: White greasy coating
Pulse: Submerged, wiry or tight


Ingredients

Gua Lou 12g
Xie Bai 9g
Zhi Shi 12g
Hou Po 12g
Gui Zhi 3g


Preparation: Decoction. The source text advises boiling zhi Shi and Hou Po with 5 cups of water until 2 remain, removing the dregs and adding the other three ingredients before boiling again for a short time. At present all five ingredients are usually added together.


Actions: Unblocks the Yang, dissipates clumps, expels Phlegm, directs Qi downwards

Contraindications: Chest pain due to Lung consumption or Phlegm-Heat. Should not be used long term.



Notes:
One liang is taken as 3g in modern sources but in Eastern Han times it was equivalent to 13.875g. This means that the dosages in classical formulae could have been more than 4x what is given today making them far higher than recommended safe dosages today but prompts consideration of what an effective dose may be (He, 2013).



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