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Unpacking Gui Zhi Tang● Huang Huang’s Notes on Gui Zhi Tang● Case Studies from Renowned Physicians● Gui Zhi Tang for Pregnancy and Postpartum DepressionBy Sharon Weizenbaum

1 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted Gui Zhi Tang Instructions for use Original Text Huang Huang Notes on Gui Zhi Tang Gui Zhi Tang Gui Zhi Tang pattern is made up of three categories of symptoms 6 6 7 9 9 10 Fever 13 Sweating 14 Cardiovascular illness 14 Skin problems 14 Nasal Allergies 15 Vomiting in Pregnancy 15 Modifications 15 Gui Zhi Tang Qin Bo Wei Case 16 From Experience with Classic Formulas from Renowned Physicians 17 Formula Explanation 17 Cases and Discussion 21 Case 1 Ying Wei disharmony 21 Case 2 High Fever 22 Case 3 Spontaneous Sweating 23 Case 4 One sided sweating 25 Case 5 Lack of sweat 26 Case 6 Aversion to Cold 28 Case 7 Early Wind Warmth 29 Case 8 Running Piglet 30 Case 9 Diarrhea 31 Case 10 Extreme Deficiency 31 Case 11 Reversal Pattern Urination related Dizzy Reversal 33 Case 12 Gradually Worsening Esophageal Spasm 35 Case 13 Urticaria 36 Copyright Sharon Weizenbaum 2022

2 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted Case 14 Menstrual itch 37 Case 15 Fever during pregnancy 38 Case 16 Pediatric fright wind 39 Case 17 Pediatric frequent urination 41 Case 18 Corneal viral keratitis dendritic keratitis 42 Case 19 Ablepsia lack of sight 43 Case 20 Crohn s Disease 45 Case 21 Diarrhea 47 Case 22 Diarrhea 47 Case 23 Diarrhea 48 Case 24 Esophageal Spasm 49 Case 25 Common Cold 50 Case 26 Pediatric Persistent Fever 51 Case 27 Low Grade Fever 52 Case 28 Nausea in Pregnancy 53 Dr Xia on Gui Zhi Tang for Postpartum Depression 54 Jie Yu He Ying Tang 54 Formula Name 54 Function 55 Application 55 Formula composition 56 Clinical Application 57 Jin Gui Yao Lue s use of Gui Zhi Tang in Pregnancy 58 Original Text 60 Formula Analysis 61 Discussion 61 Case Examples 64 1 Nausea and vomiting in pregnancy 64 2 Nausea and vomiting in pregnancy 65 3 Cold back in pregnancy 66 Copyright Sharon Weizenbaum 2022

3 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted 4 Reversal surging of the Chong Qi in pregnancy 67 5 Slippery Fetus 69 6 Urinary retention in pregnancy 70 Is Yang Dan Tang Gui Zhi Tang 71 Xiao Yang Dan Tang 71 Jin Gui use of Yang Dan Tang for Postpartum Women 72 Case 1 Postpartum Ying Wei disharmony 72 Case 2 Postpartum Vomiting 74 Case 3 Postpartum Wind Cold with Simultaneous Heat 74 Case 4 Postpartum Sweating 76 Case 5 Postpartum Body Pain 78 Case 6 Post Termination External Contraction 79 Case 7 Postpartum External Contraction 81 Case 8 Postpartum External Contraction 82 Case 9 Postpartum Spontaneous Flow of Breast Milk 83 Case 10 Postpartum Lack of Breast Milk 84 Case 11 Menstrual Related Wind Rash 86 Case 12 Menstrual Itching 87 The gynecological application of Gui Zhi Tang for the stages of a woman s life 88 Unpacking Gui Zhi Tang 94 Introduction to Unpacking Gui Zhi Tang 94 Liu Du Zhou 96 Yu Guo Jun 97 Huang Huang Notes on Gan Cao 98 Gan Cao in Formulas 100 Addendum 102 Notes on Shao Yao 104 Shen Nong Ben Cao Jing 104 Huang Huang Notes 104 Principle Indications Copyright Sharon Weizenbaum 2022 104

4 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted The principle indication for Bai Shao is pain 104 Spasms of the foot 105 Abdominal pain 105 Formulas 106 Addendum 107 Notes on Rou Gui 108 Curious Uses for Rou Gui 110 Formulas that include Rou Gui 112 1 Gui Fu Tang 112 2 Kan Li Dan 112 3 Da Hui Yang Yin 112 4 Gui Fu Li Zhong Tang 113 5 Yang Ba Wei Di Huang Wan 114 Shao Yao Gan Cao Tang 114 Original Clause 115 From Cases of Renowned Physicians 115 Formula Explanation 115 Cases 116 Case 1 Restless Legs 116 Case 2 Hiccup 117 Case 3 Priapism 118 Case 4 Anal Fissure 119 Case 5 Constipation 120 Case 6 Tooth grinding 121 Other Cases from various texts 122 Case 7 Stomach pain 122 Case 8 Lower calf pain Charlie horse 123 Case 9 Yin contraction syndrome 125 From Liu Han Tang s A Record of Clinical Experience using Classical Formulas For Nerve Disorders Copyright Sharon Weizenbaum 2022 126 126

5 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted For Digestive Disorders 126 For the Vascular System 127 For the Endocrine System Disorders 127 For Urinary and Reproductive Disorders 127 For Gynecological Disorders 128 Other disorders 128 From Walking Along the River By Yu Guo Jun 129 Spastic Cough 129 Constipation 129 Kidney Stone Pain 131 Post Herpatic Neuralgia 131 Gan Cao Gan Jiang Tang 132 Original text Clause 29 132 Formula explanation 133 Cases 133 Case 1 Nose bleed 133 Case 2 vomiting blood 135 Case 3 Taxation Lin 137 Case 4 bed wetting 139 Case 5 diarrhea 140 Case 6 Lung Atrophy 142 Case 7 Dispersion Thirst 143 Case 8 Dizziness 144 Case 9 Stomach Duct Pain 145 Gui Zhi Gan Cao Tang 146 Formula Explanation 147 Cases 147 Case One Heart Palpitations and Pain 147 Case 2 Dizziness 148 Case 3 Insanity 149 Copyright Sharon Weizenbaum 2022

6 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted Case 4 Deafness 151 Case 5 Flustered with Fright Palpitations 152 Other Cases 153 Gui Zhi Tang Gui Zhi 3 liang 9 gm Shao Yao 3 liang 9 gm Zhi Gan Cao 2 liang 6 gm Sheng Jiang 3 liang 9 gm Da Zao 12 dates 3 dates Feng says 20 gm Instructions for use Break the first three ingredients into pieces add to the rest of the ingredients in a pot and decoct in 7 Sheng of water Reduce to 3 Sheng and strain Take 1 Sheng at a moderate temperature followed by 1 Sheng of hot thin gruel to reinforce the effect of the decoction Cover the body with a blanket for a time until the whole body is damp from light sweat One cannot allow the sweat to flow like water since the disease will not be dispelled If one dose causes sweating and the disease is diminished stop taking the doses One need not finish the whole packet If sweating is absent take another dose according to the previous method If sweating is again absent reduce the time between doses finishing three doses in half a day If the disease is severe take it throughout the whole day and continually observe the patient After finishing one packet if the disease signs are still showing take it again If sweating is absent one can take up to 2 3 packets Copyright Sharon Weizenbaum 2022

7 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted Avoid raw cold sticky slimy foods and meat noodles the five pungents alcohol milk products and foods with smell funny or are spoiled Original Text 12 In Tai Yang Zhong Feng the Yang floats and the Yin is flaccid When Yang floats there is spontaneous fever and when Yin is flaccid there is sweating The patient huddles up due to their aversion to cold and they have aversion to wind as if their body has been splashed with cold water gentle fever as if their body is covered with feathers sneezing or hoarse breathing in the nose and dry retching Gui Zhi Tang governs 13 In Tai Yang disease when there is headache fever sweating and aversion to wind Gui Zhi Tang governs 15 In Tai Yang disease after being purged the patient feels Qi surging one may use Gui Zhi Tang according to the methods mentioned previously If Qi surging is absent Gui Zhi Tang cannot be prescribed 24 After taking the first dose of Gui Zhi Tang Tai Yang disease is still not resolved and rather there is vexation The recovery can be brought about by first needling Feng Chi and then Feng Fu and then continuing Gui Zhi Tang 25 Profuse sweating occurs after taking Gui Zhi Tang If the pulses are flooding and big use Gui Zhi Tang the same way If the patient presents with malaria like symptoms and signs which take place twice a day the disease would be resolved after sweating Gui Zhi Er Ma Huang Yi Tang is indicated 53 The disease with frequent spontaneous sweating indicates that the Ying Qi is in harmony When the Ying Qi is harmonious yet the exterior is not in harmony then they are not harmonious with each other Since Ying qi circulates toward the vessels while the Wei circulates toward the outside recovery will be achieved with harmonizing the Ying and Wei through sweating Gui Zhi Tang governs Copyright Sharon Weizenbaum 2022

8 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted 54 Patients whose Zang organs have no other illness periodically have fever and spontaneous sweating without recovery This means that the defensive Qi is not harmonious The recovery will be brought about by the promotion of sweating prior to the onset of fever and spontaneous sweating Gui Zhi Tang is appropriate 57 Cold damage has been resolved by sweating However after half a day there is vexation again and floating rapid pulses so one might promote sweating again Gui Zhi Tang governs 95 In Yang disease when there is fever and sweating it is caused by weakness of the Ying Qi and unreasonable strength of Wei Qi In order to eliminate pathological wind Gui Zhi Tang governs 234 In Yang Ming illness when there is a slow pulse profuse sweating and slight aversion to cold these symptoms indicate that the exterior syndrome has not resolved Sweating can be promoted and Gui Zhi Tang may be appropriate 276 In Tai Yin illness when there is a floating pulse the promotion of sweating can be employed and Gui Zhi Tang is appropriate 387 When vomiting and diarrhea have stopped but mild pain continues one should consider relieving the exterior condition Gui Zhi Tang is indicated to slightly harmonize the exterior Jin Gui Yao Lue 21 Postpartum wind persisting over 10 days with mild headache aversion to cold occasional heat sensations oppression below the heart dry retching sweating despite its long duration the Yang Dan Tang pattern persists Jin Gui Yao Lue Among women with normal pulses that appear slightly weak at the Yin position along with thirst inability to eat an absence of chills or fever this indicates a disease of pregnancy Gui Zhi Tang governs As a rule this pattern should appear within sixty days of conception However with reverse treatment Copyright Sharon Weizenbaum 2022

9 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted vomiting and diarrhea will appear within another month In this case there will be termination Huang Huang Notes on Gui Zhi Tang1 The uses of Gui Zhi Tang are quite broad It is one of the first formulas one must learn and know To understand Gui Zhi Tang one must understand the flavors of the herbs Gui Zhi is a dry twig primarily from Guan Dong and Guan Xi It has a special fragrance and is sweet and pungent hot The uses of Gui Zhi are quite broad Of the 113 formulas in the Shang Han Lun 44 include Gui Zhi Clinically Gui Zhi is used for disease patterns such as fever sweating body pain multiple joint pain headache abdominal pain diarrhea cold limbs dizziness with dry heat nocturnal emission palpitations knotted pulse panting shortness of breath edema blood stasis and spirit disorders Gui Zhi Tang Gui Zhi Tang is the first formula mentioned in the Shang Han Lun It is said that it was invented by an high official in the Shang Dynasty In the past high officials were great chefs They summarized their experience in utilizing the pharmacopeia and they use cooking technology to create many kinds of soup formulas Gui Zhi Tang was a useful pungent and fragrant formula as well as a regulating formula We don t know how many years this formula has been used nor how many people have used it At any rate it is a classic formula that has had a long history of experience It is a crowning formula in Chinese medicine and there is not a study of medicine that does not include it Gui Zhi and the Gui Zhi Tang pattern are the same Gui Zhi Tang has a particularly large scope of use There has been a struggle throughout Chinese people s history between this scope of use and diseases There are not any diseases nor any one symptom nor any western medical science disease concept to compare the use of Gui Zhi Tang with The 1 From lecture notes translated by Sharon Weizenbaum for a 2008 course with Huang Huang at White Pine Institute Amherst MA 01002 Copyright Sharon Weizenbaum 2022

10 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted concepts related to Gui Zhi Tang are purely Chinese medical concepts In those days the Shang Han Lun author Zhang Zhong Jing called it Gui Zhi Tang Pattern This book continues to use the same method of naming this Gui Zhi Tang will be the formula to use for Gui Zhi Tang pattern regardless of the disease Chinese medicine has a saying which is according to the pattern determine the treatment This saying points to the principle of coordinating the formula with the pattern Chinese medicine looks to see if the formula and pattern correspond and does not pay attention to what kind of disease the patient complains of This is because the disease name does not have a definite pattern and relatively fixed It is the essence of traditional Chinese medicine to know how to cope with a constantly changing situation The clinical use of Gui Zhi Tang reflects this principle Gui Zhi Tang pattern is made up of three categories of symptoms 1 Spontaneous sweating fear of wind fever or awareness of a heat feeling 2 Upward surging feeling palpitations muscles and flesh are spastic and tense 3 Pulse is floating or weak or moderate or fast or large without strength Tongue is pale red or dark pale with thin white moss Spontaneous sweating refers to spontaneous sweating even when the environment is not hot nor has the patient taken drugs to induce sweat Fearing wind refers to wind and cold allergy When the patient is in a warm room or adds more clothes this is resolved Fever can refer to the body temperature going up or to the subjective feeling of heat by the patient Of the above three types of symptoms if only one manifests you cannot say it is a Gui Zhi Tang pattern But if all three manifest at the same time the correspondence to the Gui Zhi Tang pattern is very significant The symptoms in number 2 above all relate to neurotic weakness of sexual function A feeling of up surging includes dizziness feeling feverish red face insomnia lots of dreams Copyright Sharon Weizenbaum 2022

11 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted and an up surging feeling in the Chest and abdomen There may be throbbing in the navel area and the muscles are spastic and tight with spastic type stomach and intestinal pain The rectus abdominus are tight and the muscles of the four limbs are spastic and painful The pulse floating refers to feeling the pulse beat clearly with just a light touch Clinically you will see this in thin patients The Gui Zhi Tang pulse pattern is not just floating though It is often simultaneously moderate or moderate and fast or weak so that when you press it there is little or no strength Sometime you might see a weak fast pulse From a Chinese medical perspective Gui Zhi Tang pattern is the manifestation of a typical exterior deficiency pattern There is a relationship between the exterior and interior and there is a relationship between excess and deficiency Exterior and interior refer to the location of the illness When the disease is in the outer form of the body this is considered the Biao The outer form includes the sweat glands the skin the subcutaneous tissue the joints and upper respiratory tract Symptoms of fever fear of wind and cold not sweating or sweating profusely body pain floating pulse and thin tongue moss are all symptoms of the pathology being located on the exterior When the disease is located in the interior there are pathological changes in the digestion the heart blood vessels the internal secretions the blood and the central nervous system Symptoms such as constipation diarrhea listlessness or agitation body heat with thirst or cold limbs with fear of cold deep pulse thick tongue moss etc are all symptoms of illness located in the interior Gui Zhi Tang pattern is an exterior pattern Excess and deficiency refer to the strength of the illness In other words we must analyze the strength of the body s resistance and ability to balance and regulate In regard to the whole body deficiency refers to Qi deficiency in which the body s resistance is low and the physiological function has decreased Excess refers to the evil Qi flourishing and the strength of the disease toxin is flourishing and the strength of the body s resistance is strong Yet this is only part of the story With deficiency there is a weak hollowness which allows the secretions to go out and restraint to be insufficient With excess there is Copyright Sharon Weizenbaum 2022

12 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted substantiality with an excess of ability to restrain so there are not enough secretions going out This is similar to the saying that if the great gate is open the people can go in and out by themselves This is how it is with deficiency When the great door is shot tightly the wind blows but cannot enter and the people cannot leave This is how it is with excess We can see from this that the person s body has many such gates such as the po gate cardiac gate or anus Under normal physiological conditions these gates are sometimes open and sometimes closed When there is illness the opening and closing may lose its regulation or a gate may become steadily closed or steadily open Being open is a state of deficiency and being closed is a state of excess If the Po gate is consistently open then there will be lots of sweating constant sweating or spontaneous sweating This is deficiency on the exterior When the Po gate is closed there is no sweat aversion to cold dry skin and this is excess on the exterior If the anus is open then there will be diarrhea that is watery and clear and prolapsed anus This is interior deficiency If the anus is closed then there will be constipation or stool only every few days and abdominal pain that resists touch This is excess on the interior Gui Zhi Tang pattern includes aversion to wind sweating and fever and is therefore an exterior deficiency pattern Analyzed from a single substance pharmodyamics perspective as well as from a clinical practice perspective Gui Zhi Tang has the following applications It is a febrifuge an anti allergen anti inflammatory analgesic sedative and stomach stimulant In particular Gui Zhi Tang has been shown to not have a single part of the body it treats On the contrary it regulates the nervous system the vascular system and the immune system and all of these relate to the whole body function Chinese medicine talks about regulating the Ying and the Wei In terms of Ying it nourishes the Yin Qi of the minute essences of the whole body In terms of the Wei it is the body s protection and Yang Qi When Ying and Wei are harmonized the body is strong and healthy and it is not easy to get sick and sweating occurs in a normal way The opposite of this manifests with spontaneous sweating night sweating aversion to wind fear of cold susceptibility to getting colds and other illnesses We can see that the two Qi Ying and Wei are equivalent to the body s Copyright Sharon Weizenbaum 2022

13 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted balancing and defensive systems They serve an extremely important function in relation to keeping the body healthy Now we can see that the function of Gui Zhi Tang to harmonize and regulate the Ying and the Wei is very important too Therefore Gui Zhi Tang is considered a regulating formula and it s application in every department is extensive Fever The Shang Han Lun recorded in writing the following In Tai Yang illness there is headache fever sweating fear of wind and Gui Zhi Tang is the principle formula What one sees as a Gui Zhi Tang pattern in the clinic is feverish type illness Whether the fever is from an infectious non infectuous or is a long term fever from an unknown cause whether it is a low grade or high grade fever If there is a Gui Zhi Tang presentation you can use this formula The well known doctor from the past Yue Mei Zhong treated a 14 year old girl with fever she had had for over half a year Her temperature would go up to 40 C She had taken many formulas without any effect She had a fever with aversion to wind with sweating sometimes Her pulse was floating and moderate She had thirst but didn t drink a lot Her stool and urination were regular and the tongue was pale and yellowish He used Gui Zhi Tang and after 3 packages was cured A Dr Lin saw 68 cases of fever of unkown origin 5 cases used antibiotics and anti fever drugs without effect He used Gui Zhi Tang and there was a cure Sweating Abnormal sweating is a common symptom in the Gui Zhi Tang presentation It says in the Shang Han Lun that the patient is without disease in the Zang and there is unresolved fever with spontaneous sweat use Gui Zhi Tang Gui Zhi Tang can treat spontaneous sweat night sweats or localized sweating such as sweating from the head or yellow sweat It is effective for autonomic nervous system disorders and neurasthenia Copyright Sharon Weizenbaum 2022

14 Unpacking Gui Zhi Tang Translated and Compiled by Sharon Weizenbaum except where noted Cardiovascular illness The Gui Zhi Tang pattern often manifests in cardiovascular illness such as myocarditis hypertensive myocardial illness with palpitations paroxsysmal tachycardia and absence of pulse There are many types of treatment methods for these illnesses so it is important to pay attention to the distinguishing charactaristics when choosing Gui Zhi Tang In addition to the aroused heart symptoms you many also see such symptoms as spontaneous sweat aversion to wind poor sleep and many dreams with a dark pale tongue In my own experience the patient s body type will also be a Gui Zhi body type Use it with caution for patients who are red and plump or yellow and pulmp Skin problems The Gui Zhi Tang pattern also often manifests with skin issues during the course of the illness A Dr gu treated many types of erythema eczema urticaria puritis winter skin inflammation chilblain and tinnea As long as the tongue has a thin white moss and the pulse is floating moderate or floating and slippery you can use this formula and it will be effective I have similar experience but in addition to the choices for the appropriate pattern above of tongue and pulse I also look to see if the body type is thin with a white complexion if the patient catches cold and sweats easily when they encounter wind and cold There are many types of skin illness and the pathology is complex In clinical practice Gui Zhi Tang is usually with added flavors or combined with other formulas Nasal Allergies It is written in the Shang Han Lun that the Gui Zhi Tang pattern includes a symptom named nasal ming ringing sound Clinical what is seen is aversion to wind spontaneous sweating with the patient having sensitive type body Many of these patients have allergic typ nasal inflammation or allergic asthma I use Gui Zhi Tang and add Xi Xin or Fu Zi to treat this pattern when there is clear nasal mucous or watery phlegm with good effect There is a report using this formula with Ting Li Zi and Chan Tui to treat 20 cases Copyright Sharon Weizenbaum 2022

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