A brief note on the following. Much of this information has been taken from ’10 formula families’ by Dr Huang Huang. However, the style of Dr Huang, as is Feng Shi Lun and Hu Xi Xu is very much Pattern = Formula. There is not much mention of Pulses and physiology. Through my graduate mentorship with Sharon Weizenbaum, I would like to introduce further extrapolations on a deeper connection of the formula and pattern with physiology.

Gui Zhi 10g,  Bai Shao 10g,  Gan Cao 6g,  Sheng Jiang 6g,  Da Zao 12g

Traditionally taken with congee (rice porridge), not everyone has the time or convenience to do this. The main idea is to take the strain off the digestive system by not taxing it with hard to digest foods that are greasy or “icy.”

This formula was mentioned in the Shang Han Lun; however, this formula was thought to be previously developed by the master chef Yi Yin in the Shang Dynasty, over 2,500 years ago.

This formula contains the major signs and symptoms of the “Gui Zhi” family: spontaneous/easy sweating, palpitations in the heart or lower abdomen, aversion to wind with:

1. Convulsions or tight/stiff muscles
2. Weakened/overactive nervous system
3. A pulse that is floating, deficient, lax, rapid, or large without force
4. A tongue body that is pale, with a thin, white coat.

In a wind-cold situation, the wind has come in, and the door is not closed properly (pores are open—too weak), so the sweat comes out easily. This is considered an “exterior deficiency.”

In a pharmaceutical sense, Gui Zhi Tang is antipyretic, anti-inflammatory, anti-allergic, analgesic, sedative, and gastric.

Cold and flu:

Shang Han Lun Paragraph 13:

“For Tai Yang illness with headache, fever, sweating, and an aversion to wind, Gui Zhi Tang masters it.”

If we look at Gui Zhi Tang, we see it is made up of two mini-formulas: “Gui Zhi Gan Cao Tang” (Gui Zhi + Gan Cao) and “Shao Yao Gan Cao Tang” (Bai Shao + Gan Cao). GZGT for heart palpitations and SYGCT for cramps.

SHL Clause 64:   “When copious sweating has been promoted and the person’s hands are crossed over the heart and there are palpitations below the heart with a desire for pressure, Cinnamon Twig and Licorice Decoction (guì zhī gān cǎo tāng) governs.”

Caveat! Remember that excessive sweating comes from exercise, saunas and Bikram Yoga as well as herbal medicine!

                                                                                                                                                   
 You Zai-Jing 尤在经 says:

Sweat is the fluid of the heart.  When there is excessive sweating promoted, the heart Yang is emitted as it follows the discharge of fluid.  This causes deficiency of the heart Yang.  When the heart Zang looses the protective guard of the Yang Qi it is then void of any governance.  This is why there are heart palpitations with no rest.  Deficiency likes pressure and there for the patient will cross their hands over their chest area.  This is an attempt to give a bit of peace.  In addition to there being heart palpitations that like pressure, clinically you will also see chest oppression, shortness of breath and a general lack of strength.

Xu Ling-Tai 徐灵胎 says:

When there is mistaken sweating and the patient sweats excessively, since the sweat is the fluid of the heart, this will cause Qi deficiency.  These two flavors restore the Yang and supplement the middle.  This alleviates the Yang deficiency.  If there is an extreme case in which there is shaking and a desire to pound, use True Warrior Decoction (zhēn wǔ tāng).  The light and heavy patterns are not the same and the formulas are very different from each other.  This is the essential meaning.   (伤寒论类方·太阳篇) Courtesy of White Pine Healing Arts Blog

Treatment method: Warm and open through the heart Yang.

Gui Zhi Tang is used to treat conditions such as: cold/flu, fever (40°C), abnormal sweating, autonomic dystonia, myocarditis, high blood pressure, palpitations, tachycardia, Takayasu’s arteritis, insomnia, vivid dreaming, eczema, erythema, urticaria, itching, chilblains, psoriasis, allergies and hay fever.

Variations of Gui Zhi Formula based on GZT

1.2 Gui Zhi Jia Fu Zi Tang

Gui Zhi 10, Bai Shao 10, Sheng Jiang 6, Gan Cao 6, Da Zao 12, Zhi Fu Zi 10.

GZT + Zhi Fu Zi 10g – Exterior deficiency cold pattern with internal cold/Yang deficiency

You will find typical GZT patterns with cramping limbs and joint pain, cold abdomen, cold hands and feet, aversion to cold,
copious amounts of clear urine.

Although Zhi Fu Zi is currently a scheduled herb in Australia, we mention it here for use in countries allowed to use it.

• Note, prepared Fu Zi (Zhi Fu Zi) used. First boil for one hour before other ingredients.

Paragraph 20 of the Shang Han Lun states: When a sweating treatment is given to someone with TaiYang disease, but the sweat leaks out continuously and the person has an aversion to wind, urinary difficulty, and a slight tension in the limbs where it is difficult to flex – Gui Zhi Jia Fu Zi Tang masters it.

Zhi Fu Zi is used to improve cardiovascular function, increase blood pressure, regulate microcirculation, strengthen th
e heart, regulate body temperature, gastro-intestinal function and used as an analgesic for pain.

GZJFZT Signs

1. GZT S/S with cold hands, clammy skin, excessive sweating, weak, floating and large pulse, and a pale tongue body
2. Severe joint pain and cramping in the limbs
3. Cold bulging disorders (hernia), abdominal pain, body aches, and cold hands and feet.

Clinical Uses:

Often used with elderly with weak constitutions, cold, body aches, sneezing, joint inflammation, fatigue.

1.3 Xiao Jian Zhong Tang
Gui Zi 6, Bai Shao 15 – 30 (depending on level of abdominal pain), Zhi Gan Cao 6, Sheng Jiang 6, Da Zao 12, Yi Tang 30 = GZT + Yi Tang (maltose/molasses) 30g, Bai Shao increase to 15g, change Gan Cao to Zhi Gan Cao 6g (BS+ZGC = Shao Yao Gan Cao Tang).

1. Chronic abdominal pain with palpitations, feverishness, irritability, weakness and spasmodic constipation (poo the size
   of dry chestnuts).
2. Tender tongue body with sparse coating (soft
   
   http://www.cialisgeneriquefr24.com/

   and shiny = interior deficiency)

Paragraph 100 of SHL states that: When there is an urgency of pain in the abdomen, first use XJZT. 

Jing Gui Yao Lue States: For deficiency due to overwork, chronic intermittent abdominal pai, palpitations, nosebleeds, abdominal pain, dreaming with seminal emission, achy libs, hot hands and feet, dry mouth and throat, XJZT masters it.

Often used in Japan for introverted and nervous school children who get bed wetting, night sweats and stomach pains in the morning.

Modifications of XZJT

1.31 XJZT + Huang Qi = XJZT s/s plus low immune system with a lot of sweating

1.32 XJZT + Dang Gui = Post-partum cramps

1.4 Gui Zhi Jia Da Huang Tang
Gui Zi 10, Bai Shao 20, Gan Cao 6, Da Zao 12, Sheng Jiang 6, Da Huang 6

Interior excess = ‘interior gate is closed’, with exterior deficiency ‘exterior gate open’ (sweating). Da Huang has been called the ‘fierce general that cuts through barriers to force his way in.

GZT presentation plus constipation and abdominal pain. Dislike of abdominal pressure.

1. Fever or subjective feeling of heat, aversion to wind, spontaneous sweating.
2. Constipation, persistent abdominal pain, aversion to pressure on the abdomen, and a thick, dry thick tongue coating.

1.5 Gui Zhi Jia Long Gu Mu Li Tang
Gui Zhi 10, Bai Shao 10, Da Zao 12, Gan Cao 6, Sheng Jiang, Long Gu 20, Mu Li 20

Primarily used with ‘upward gushing’ palpitations and insomnia, nightmares, sweating and night sweats, especially young pale children. Tight lower abdomen, dizziness, hair loss, bed wetting. Mu Li is targeted more towards the abdomen. Pulse: must be floating, full and lacking force- definitely not deep and forceful. Tongue: red and tender.

The type of ‘upward gushing’ is quite noticeable in this formula type; there is a sense of panic, being jumpy and hard to calm down, light sleep or insomnia or many nightmares with night sweats.

This is also specifically applicable to men who have persistent seminal emission and cold tip of the penis, dizziness and hair loss and throbbing below the navel.

1. Chest and abdominal pulsation or throbbing, jumpiness, spontaneous sweating or night sweats, insomnia with excessive dreaming.
2. A large, floating, and force-less pulse, and a tender and red tongue body with a sparse coating.

The key to using this formula is in the pulse and tongue. The pulse must be floating, full, and lacking force. If it is deep and thin, deep and excessive, or large and forceful, it is without exception not the pulse for this formula.

1.6 Dang Gui Si Ni Tang
Gui Zi 10, Bai Shao 15, Gan Cao 10, Da Zao 20, Dang Gui 10, Xi Xin 6, Tong Cao 6

Cold, painful extremities and headache. Frost bite fingers. Pulse: thin Tongue: pale. Pain that is worse on exposure to cold or menses.

Dang Gui: Sedates pain, tonifies blood, reduce pain, strengthen constitution, moisten intestines.

Xi Xin: Scatters cold and stops pain. Treats cough with ascendant qi, headache, cramping spasms of the joints, wind-damp, it
also 1. Promotes sweating and scatters cold: treats cold damage with a lack of sweating, fever, and a sunken pulse. 2. Stop pain: treats headaches from external wind-cold invasion, with body aches and toothache. 3. Warm the lungs and dispel phlegm: treats wind-cold type coughing and wheezing with copious phlegm.

Tong Cao: (literal English translation is ‘unblocking herb’) Unblocks and uncloggs, gently moves blood.

The type of pain this formula treats is from ‘cold deficiency’. It often appears where there is nerve or blood vessel pathology or reduced circulation of blood.

SHL Paragraph 351: For those with cold hands and feet that have extreme cold and a pulse that is so thin that it is on the point of exhaustion, DGSNT masters it.

1. Hands and feet are extremely cold, numb, and painful, even to the point of turning blue.
2. Thin pulse (from blood vessel contraction, not heart deficiency)
3. Abdominal pain, headache, or back, foot, or leg pain
4. Pale tongue with a white coating

Common conditions: Raynaud’s, sciatica, tooth pain, dysmenorrhea, frostbite and headaches when worsened by cold.

1.7 Wen Jing Tang
Gui Zhi 10, Bai Shao 10 Gan Cao 6, Sheng Jiang 6, Dang Gui 10, Ren Shen 10, E Jiao 10, Mu Dan Pi 10, Wu Zhu Yu 3, Chuan Xiong 6, Ban Xia 6-12, Mai Dong 10-24.

Here we introduce Chuan Xiong, combined with Dang Gui and Bai Shao which regulates the menses.

However, before we go straight into listing all the things that WJT does for women alone, I want to state that formulas are not discriminatory and WJT is also great for men if the picture matches the patient.

So what are we looking for?

1. The key is dryness of mucous membranes – especially dry mouth and skin.
2. Then you are looking at blood stasis – clotted
   periods in women and dark veins on the ankles in men.
3. Also, ‘knotted pulse’ which will feel like the ‘rhythm’ of the pulse is not in a constant beat ( dum, DUM, duuum, dum, dumm), with high/low amplitude, but not skipped beats like ZCGT (Dum, Dum, Dum …, Dum, …., …, …, Dum, Dum). 
4. Then we can feel the abdomen and it is often cold, sometimes cold legs and warm head, or hot hands/feet at times, other times cold hands/feet.
5. The body stature will generally look skinny and dry, think Twiggy and David Bowie rather than Steven Fry or Nigella Lawson – less voluptuousness.
6. The buttocks will also often feel cold.
7. The tongue is often blue/purplish and the face lacks luminescence, brightness and is a little dusky.
8. Hot and Dry symptoms: Burning palms, flushed cheeks, hot flashes, itching, poor healing of sores, digestive disorders, depression, insomnia.

• If there is fullness in the epigastrium and the right guan pulse (indicating yang ming excess) and red tongue tip, you can add Huang Lian.
• If there is no fullness in the epigastrium and the the right guan is even fuller and stronger with irritability, a red tipped tongue; add Shi Gao
• If there is pre-menstrual water amassment and fluid retention, you can integrate Dang Gui Shao Yao San, by adding to the formula: Bai Zhu, Fu Ling and Ze Xie.
• This is not a ‘Yin Deficiency’ heat formula. The heat is caused by blood stasis leading to dry heat. This pattern is for deficient cold in the chong and ren, leading to blood stasis.

Wen Jing Tang is primarily a moistening formula, secondarily a warming formula. It is used in the clinic primarily for irregular menses or amenorrhea, especially with or a history of dark blood clots. As a beauty formula for women- as this treats dryness of the skin it has the ability to moisten the skin, plump up the breasts and moisten vaginal dryness. The warming nature of the formula treats the dryness of winter, the cold freezes the water reserves and our skin becomes dry and hair brittle. It is also used as a fertility formula to increase ovarian function and boost a low basal body temperature.

Gan Jiang or Sheng Jiang? Gan Jiang is better to warm the interior and stop diarrhea, Sheng Jiang is more warming plus diuretic.

What about large fleshy women that don’t appear to be a typical thin gui zhi type pattern? One example case example from Sharon Wizenbaum in The Lantern– Patient with dry symptoms of dry lips, feet and vagina, and cracked fingertips. Dr Huang assured that the key sign of dry finger tips and lips were key signs.

——————————————————————————————————————————————

1.8 Zhi Gan Cao Tang
Gui Zhi 10, Zhi Gan Cao 10, Sheng Jiang 6, Da Zao 15, Ren Shen 6, Sheng Di 12, Mai Dong 10, Huo Ma Ren 10, E Jiao 10.

Fatigue, dizziness, insomnia, constipation. Cold damage with an irregular pulse and palpitations. Exhaustion from overwork,
sweating with a stuffy chest. Pulse: slow with dropped beats. Tongue: No coating.

Shang Han Lun Paragraph 177: For cold damage with an irregular pulse and Heart-disturbing palpitations, ZGCT masters it.

This formula is often considered for Gui Zhi constitution patients with cardiovascular disease, mainly arrhythmia with and irregular pulse with dropped beats.

This is an important ‘Yin Tonic’ and is the basis of many yin tonic formulas. Simply stated, yin deficiency means an insufficiency of the substances that have form; yang deficiency is a diminishment of the formless functional capacity. The bones and flesh of the physical body are considered to be formed and substantial.  Thus, when there is yin deficiency, these become emaciated, withered, shriveled, and smaller. Yang deficiency is when there is diminishement, weakness, and inhibition of the body’s physiological functions. 

Specific Signs:

1. A pulse that is deficient, without force, and irregular

2. Emaciation with a drawn and wan complexion, a sparse or nonexistent tongue coating.

3. Fatigue, obvious palpitations with a feeling of throbbing in the chest and/or abdomen, deficiency irritability, dizziness, excessive dreaming or insomnia, and constipation.

1.9 Ling Gui Zhu Gan Tang

Gui Zhi 10-15, Fu Ling 15-30g, Bai Zhu 10-30g, Gan Cao 3

Main signs are dizziness, palpitations, sloshing sounds in the stomach, coldness in the middle of the back, a cough with copious thin, clear sputum, fullness and discomfort in the chest and costal regions, urinary difficulty, and a swollen tongue with a slippery coating, often with teeth marks.

Manifesting symptoms:

Head: ‘Puffy face’, facial water spots, ENT, Face disorders, clogged up ears, puffy under the eyes (yes it’s a water sign, not necessarily kidney deficiency).

Heart: Palpitations, oppressed sensation in the chest, shortness of breath

Lung: Cough and wheeze.

Constipation: This is a really interesting one. Not always do we see edema and poor urination (earth is swamped by water and needs draining and percolating – fu ling/bai zhu) in this pattern Sometimes there is frequent urination (earth can’t hold water thus leaks and needs strengthening – bai zhu). In this case many doctors such as Feng Shi Lun, Mazin Al Khafaji, will use high doses of Bai Zhu (30g) to treat spleen deficiency constipation. Bring the water in the earth where it needs to be.

Here we add Fu Ling, which is traditionally used to treat dizziness and palpitations.

1. Epigastric pulsation, an upward-rushing feeling in the chest, or dizziness.
2. Abdomen that is soft and weak, while there is fullness in the chest and costal regions, and a gurgling or sloshing sounds
   in the stomach.
3. Urinary difficulty (inhibited urination – heart fire is unable to descend to hibernate in the kidneys) and a tendency toward edema or urinary frequency.
4. Fat tongue, usually pale
5. Often thirst with no desire to drink. ‘When the water qi does not transform, the fluids do not spread so there is thirst’ (there is no steaming up) however there is no desire to drink as there is ample fluids, just not in the right place.

SHL Paragraph 67: For cold-damage after either inducing vomiting or purging with a feeling of rebellion and fullness below the heart, the qi ascends to gush into the chest, so there is dizziness after getting up, and the pulse is sinking and tight. Inducing sweating disrupts the channels, so there is trembling and shaking of the body. LGZGT masters it.

Dr Liu used LGZGT + Qian Cao 6, Hong Hua 10g, extensively for coronary heart disease (Palpitations + sweating + irregular pulse) for

• Recurrent ventricular extrasystoles
• Rheumatic heart disease
• Pulmonary heart disease
• Atrial fibrillation
• Bradycardia

Treatment principle. Based basically on Heart and Spleen Yang deficiency, we are warming the Yang qi to transform fluids.

1.10 Gui Zhi Fu Ling Wan

Gui Zhi 6-10, Fu Ling 10, Mu Dan Pi 6-10, Bai/Chi Shao 6-15, Tao Ren 6-10

Invigorating blood and removing stasis. Use in the Jiang Gui Yao Lue as a gynecology formula that dispels masses.

1. Pain in a fixed location
2. Bleeding of blackish purple blood that congeals easily
3. Restlessness, irritability, and even mania
4. Dark purple tongue body and a dark, lusterless complexion

Pressure pain with masses in the lower abdomen, especially on either side of the navel, is a characteristic sign of blood stasis.

In practice this formula is often modified to include otehr herbs such as chai hu, tu bie chong, hong hua and niu xi.

1.11 Zhi Shi Xie Bai Gui Zhi Tang

Gui Zhi 6-10, Zhi Shi 6-10, Hou Po 6-10, Xie Bai 10-15, Gua Lou 10-12

Regulating qi and dispersing clumps.

In practice this formula is principally used for chest obstruction (emphysema, angina, intercostal neuralgia, stomach ache) with chest and back pain, swollen and full hypochondria, and constipation.

Jing Gui Yao Lue: Chest obstruction, obstructed qi that knots up in the chest and creates fullness, qi from below the ribs that rebels upward and strikes against the heart, ZSXBGZT masters it.

1. Stuffiness and pain affecting the chest and upper back; epigastric focal distention with fullness.
2. Constipation or dry stool that is difficult to pass
3. A thick, greasy, and dry tongue coating with a tongue body that is dark and may have stasis spots.

*If the tongue coating is wet, the tongue body flabby and pale, the stool is watery or dry at the beginning of the bowel movement, but soft at the end, this is not the right formula- use Gan Jiang based formula like Ren Shen Tang etc.

1.12 Gui Zhi Shao Yao Zhi Mu Tang

Gui Zhi 6-12, Bai Shao 6-15, Gan Cao 3-6, Sheng Jiang 5-12, Bai Zhu 6-10, Ma Huang 5-10, Zhi Mu 6-10, Fang Feng 6-10, Fu Zi 6-10

Facial edema, swollen feet, joint pain, aversion to wind, dizziness and shortness of breath.

1. Severe joint pain accompanied by swelling
2. Aversion to wind with feverishness; there may be sweating or only slight sweating
3. Dark yellow complexion or facial edema, along with swollen and edematous feet.

There are other variations of formula with Gui Zhi Tang as it’s base such as Chai Hu Gui Zhi Tang, Ma Huang Tang and Ge Gen Tang, however we will cover these formulas under their Respective chief herbs such as Chai Hu and Ma Huang.