Zhi Zi Dou Chi Tang

Zhi Zi Dou Chi Tang

From "Shang Han Lun"

[Composition] Zhi Zi 9 grams (fourteen pieces), Dan Dou Chi 9 grams (four合)

[Usage] First, decoct the Zhi Zi, extract the juice, then add the Dou Chi, and continue decocting to remove the residue, serving warm.

[Indications] Residual heat that has not yet been cleared.

[Indications] High fever with chest fullness, a feeling of discomfort in the heart, restlessness and insomnia, even recurring sleep disturbances, and a red tongue with a slightly yellow coating.

[Functions] Clear heat and relieve frustration.

[Formula Explanation] Residual heat often disturbs the heart and chest, leading to high fever and chest fullness; residual heat often results from long-term heat, depleting true yin and damaging the mind, leading to feelings of discomfort in the heart, restlessness and insomnia, even recurring sleep disturbances. In this formula, Zhi Zi and Dou Chi both have the effect of clearing heat and relieving frustration. This formula treats heat as the root cause, and frustration as the symptom; Zhi Zi’s bitter coldness primarily clears heat, while Dou Chi’s sweet coldness first relieves frustration—thus Zhi Zi serves as the primary herb, and Dou Chi as a supporting herb. Together, these two herbs treat heat and frustration simultaneously, complementing each other.

[Clinical Additions and Subtractions]

① Add Zhigan Cao, creating Zhi Zi Zhigan Cao Dou Chi Tang (from "Shang Han Lun"), used to treat heart discomfort and also associated with little breath.

② Add fresh ginger, creating Zhi Zi Fresh Ginger Dou Chi Tang (from "Shang Han Lun"), used to treat heart discomfort and vomiting.

③ Add Zhi Shi, using clear water to decoct, creating Zhi Shi Zhi Zi Tang (from "Shang Han Lun"), used to treat patients recovering from heat illness; if the condition is due to food-related issues, add Da Huang to clear heat and eliminate accumulation.

[Reference Materials] ① "After sweating and vomiting, if one experiences restlessness and difficulty sleeping, and the symptoms are severe, it is often accompanied by recurring sleep disturbances, a feeling of fullness and discomfort in the chest, and a desire to vomit. The Zhi Zi Chishi Decoction is indicated for such cases; if one experiences only slight shortness of breath, the Zhi Zi Gan Cao Chishi Decoction is recommended; if one experiences nausea, the Zhi Zi Sheng Jiang Chishi Decoction is suitable." (Shang Han Lun)

② Zheng × suffered from epigastric pain. After treatment, the pain did not subside but instead worsened, accompanied by constipation and abdominal distension, a feeling of fullness and discomfort in the chest, a sense of fullness and discomfort, a desire to vomit, difficulty sleeping due to tossing and turning, poor appetite, and fatigue. After seven or eight days, his pulse was found to be deep, wiry, and slippery, his tongue was yellow and greasy with a cloudy coating, and his condition was assessed as being primarily due to retained food. Initially, only herbs that could aid digestion and promote bowel movements were sufficient to achieve recovery; however, after several days of delay, this condition had progressed to a state where food was trapped in the stomach, leading to deficiency. While tonifying the body was certainly necessary, using laxatives was also inappropriate. Therefore, in response to the symptoms of fullness and discomfort in the chest, as well as the desire to vomit, the physician prescribed the Zhi Zi Sheng Jiang Chishi Decoction: 3 qian of raw Zhi Zi, 3 qian of fresh ginger, and 5 qian of fragrant chive. The medicine was administered in two doses, warm, and after completing the entire dose, all symptoms had subsided. Last night, he slept soundly, and this morning he had a bowel movement, with some food able to be consumed. (Huai Ya Analysis of Shang Han Lun)

[Commentary]

① According to Shang Han Lun, those with loose stools should not take this formula, as loose stools often indicate deficiency-cold in the spleen and stomach; the bitter and cold nature of Zhi Zi can easily damage the spleen and stomach.

② This formula can be used for neurasthenia, vegetative nervous system disorders, chronic cholecystitis, coronary heart disease, gastrointestinal diseases, and other conditions.

II. Clearing the Heart and Cooling the Blood

When heat enters the heart and blood, this method is employed when symptoms include feverish heat, thirst, confusion, delirium, faint red rashes, vomiting, nosebleeds, bloody stools, a red and dark tongue with little coating, and a fine, rapid pulse.