2. Guizhi Tang

2. Guizhi Tang

Guizhi 10 grams, Baishao 10 grams, Gancao 6 grams, Shengjiang 6 grams, Dazao 4 pieces—decocted in water and taken orally, usually one dose per day. This formula is effective for mild upper respiratory infections and their sequelae, with its main function being the treatment of post-fever symptoms and complications. Hence the saying, "Guizhi Tang harmonizes Yingwei externally and stabilizes the internal organs." "Shanghan Lun" states: "For Taiyang Zhongfeng, with floating yang and weak yin, floating yang means spontaneous heat, weak yin means spontaneous sweat, feeling chilly, feeling windy, breathing hot air, nasal congestion, dry heaving—Guizhi Tang is the primary choice." This indicates that the main indication for Guizhi Tang is Taiyang Zhongfeng, namely headache, fever, aversion to cold, aversion to wind, sweating, and floating, slow pulse. Terms like "floating yang, weak yin, chilly, windy, breathing hot air, nasal congestion, dry heaving" are merely further descriptions and characterizations of pulse and symptoms. Nasal congestion is a respiratory symptom, while dry heaving is a digestive symptom, indicating that mild respiratory or mild upper digestive symptoms during external pathogenic invasion are also indications for Guizhi Tang. I believe the value of Guizhi Tang lies in its ability to harmonize Yingwei. In traditional Chinese medicine, Yingwei encompasses the autonomic nervous system in modern terms, and the indications for Guizhi Tang largely revolve around such conditions. "Shanghan Lun" states: "For Taiyang disease, if qi rises upward after purging, use Guizhi Tang; otherwise, do not use it." Here, "qi rising upward" refers to upward surging qi, specifically the reverse flow of stomach qi or lung qi. The former manifests as hiccups, vomiting, nausea, etc., while the latter manifests as coughing, wheezing, etc. From a modern medical perspective, both are manifestations of heightened parasympathetic nervous system activity, indicating dysfunction of the autonomic nervous system. "Shanghan Lun" also states: "For Taiyang disease, if the neck and back become stiff and the person sweats profusely and feels windy, use Guizhi Jia Ge Gen Tang." "For asthmatics, use Guizhi Jia Houpu, Xingzi Jia." "For Taiyang disease, if after purging the pulse becomes rapid and the chest feels full, use Guizhi Qu Shaoyao Tang; if slightly chilly, use Guizhi Qu Shaoyao Jia Fuzi Tang." "For Shanghan lasting two or three days, with palpitations and restlessness in the heart, use Xiao Jianzhong Tang." The main symptoms mentioned in these passages—profuse sweating, stiff neck and back, sweating, continuous leakage, feeling windy, difficulty urinating, slight stiffness in the limbs, difficulty bending and stretching, rapid pulse and full chest, slight chill, palpitations and restlessness in the heart—are all closely related to autonomic nervous system dysfunction after fever. Some say that during fever, sympathetic nervous system activity increases, and after fever, autonomic nervous system dysfunction occurs; most of these symptoms fall into this category. I deeply understand that the subtlety of using Guizhi Jia Ge Gen Tang, Guizhi Jia Fuzi Tang, Guizhi Qu Shaoyao Tang, and Guizhi Qu Shaoyao Jia Fuzi Tang lies precisely in addressing these post-fever symptoms. This fully demonstrates the "harmonizing Yingwei" effect of Guizhi Tang's modifications, an aspect that modern medicine often overlooks, and precisely where traditional Chinese medicine excels in treating the aftermath of colds and fevers.

Beyond its "harmonizing Yingwei" effect, what truly deserves attention about Guizhi Tang is its outstanding ability to "stabilize the internal organs." I have gained considerable insight into Guizhi Tang's role in "stabilizing the internal organs," mainly in the following three aspects:

(1) Connective tissue diseases

"Jin Gui Yao Lue" states: "All joints ache, the body feels weak, the legs swell as if detached, dizziness and shortness of breath, warm and

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The prescription for vomiting is Gui Zhi Shao Yao Zhi Mu Tang. "The syndrome described in this passage is similar to that of rheumatoid arthritis. The author has long used this formula to treat rheumatoid arthritis with remarkable efficacy. The formula consists of Gui Zhi 10 g, Bai Shao 10 g, Zhi Mu 10 g, Gan Jiang 6 g, Gan Cao 6 g, Fang Feng 12 g, Ma Huang 10 g, Bai Zhu 10 g, Fu Pian 6 g, and other herbs. If Chuan Cao Wu and Cao Wu are each replaced by 15 g (decocted for 1 hour first), the therapeutic effect will be even better. This formula can not only relieve pain and fever in rheumatoid arthritis and improve the patient's overall condition, but also gradually normalize the erythrocyte sedimentation rate; some patients who have long used hormones can gradually reduce their dosage after taking this formula, with very few cases of rebound. Based on the above experience, the author has applied Gui Zhi Shao Yao Zhi Mu Tang with modifications to systemic lupus erythematosus, scleroderma, dermatomyositis, Raynaud's disease, and other connective tissue diseases, all of which have achieved varying degrees of efficacy. In the "Jin Gui Yao Lue," it is written: "On the eighth or ninth day of a cold, when wind-dampness attacks the body, causing pain and discomfort, difficulty turning over, no vomiting or thirst, and a floating, weak, and涩 pulse, Gui Zhi Fu Zi Tang is the main prescription." "If there is sweating, shortness of breath, difficulty urinating, aversion to wind and reluctance to remove clothing, or mild edema, Gan Cao Fu Zi Tang is the main prescription." "For consumptive conditions characterized by urgency, palpitations, nosebleeds, abdominal pain, nocturnal emission, limb soreness, hand and foot heat, dry throat and mouth, Xiao Jian Zhong Tang is the main prescription." "For consumptive conditions with urgency and deficiency, Huang Qi Jian Zhong Tang is the main prescription." "For blood stasis with both yin and yang deficiency, a rapid pulse at the cun position and a tight pulse at the guan and chi positions, accompanied by numbness of the body like wind-stroke, Huang Qi Gui Zhi Wu Wu Tang is the main prescription." The bodily pains, difficulty urinating, sweating, shortness of breath, aversion to wind, reluctance to remove clothing, mild edema, palpitations, nosebleeds, abdominal pain, limb soreness, hand and foot heat, dry throat and mouth, and numbness of the body mentioned in the above passages are all common symptoms of various connective tissue diseases; the formulas used, such as Gui Zhi Fu Zi Tang, are all derived from Gui Zhi Tang through additions, subtractions, and adjustments, and all contain ingredients like Gui Zhi, Bai Shao, Gan Cao, ginger, and jujubes.

(2) Cardiovascular Diseases

In the "Shang Han Lun," it is written: "For a cold, if the pulse becomes irregular and the heart palpitates, Zhi Gan Cao Tang is the main prescription." "If, two or three days into a cold, one feels palpitations and restlessness in the heart, Xiao Jian Zhong Tang is the main prescription." As previously mentioned, the composition of Xiao Jian Zhong Tang is no different from Gui Zhi Tang, except that the dose of Bai Shao is doubled. Zhi Gan Cao Tang is also formulated by adding ingredients to Gui Zhi Tang, with the following composition: Gui Zhi 10 g, Gan Cao 6 g, Sheng Jiang 6 g, Da Wei 4 pieces, Dang Shen 10 g, A Jiao 10 g (melted), Mai Dong 10 g, Sheng Di 10 g, Huo Ma Ren 10 g (crushed). This formula is prepared by boiling equal parts of clear wine and water—600 ml total—to obtain 300 ml, then melting the A Jiao and dividing it into three doses to be taken throughout the day. The "palpitations and restlessness" in Xiao Jian Zhong Tang and the "irregular pulse and palpitations" in Zhi Gan Cao Tang are both common symptoms of cardiovascular diseases. The author has achieved satisfactory results treating arrhythmias associated with rheumatic heart disease, coronary heart disease, pulmonary heart disease, and other cardiac conditions using the aforementioned formulas, adding 30 g of Dan Shen and 30 g of Ku Shen, and increasing Mai Dong and Sheng Di to 20 g each for even better effects. In the "Shang Han Lun," it is written: "If, after vomiting or diarrhea, there is reverse fullness below the heart, qi rushing up to the chest, dizziness upon standing, a deep and tight pulse, and the body shaking violently, Fu Ling Gui Zhi Bai Zhu Gan Cao Tang is the main prescription." "If, after sweating profusely during a solar disease, the sweat does not dissipate and the person still has a fever, palpitations, dizziness, and a trembling body, as if about to collapse, Zhen Wu Tang is the main prescription." Both the above-mentioned formulas—Fu Ling Gui Zhi Bai Zhu Gan Cao Tang and Zhen Wu Tang—can be regarded as variations of Gui Zhi Tang: removing Bai Shao and adding Bai Zhu and Fu Ling yields Fu Ling Gui Zhi Bai Zhu Gan Cao Tang; removing Gui Zhi and adding Bai Zhu and Fu Pian yields Zhen Wu Tang. The symptoms described in the texts—such as "reverse fullness below the heart," "qi rushing up to the chest," "dizziness upon standing," "body shaking violently," "palpitations," "dizziness and trembling," and "feeling on the verge of collapse"—are similar to the symptoms of modern medical heart disease and heart failure. The author has long used combinations of Fu Ling Gui Zhi Bai Zhu Gan Cao Tang and Zhen Wu Tang to treat heart failure caused by various cardiac diseases, including rheumatic heart disease, coronary heart disease, high blood pressure, and pulmonary heart disease, with satisfactory results; adding Ren Sheng Mai San (Dang Shen 10 g, Mai Dong 10 g, Wu Wei Zi 3 g) and Coronary Heart No. II (Chi Shao 10 g, Chuan Xiong 10 g, Hong Hua 6 g, Jiang Xiang 10 g, Dan Shen 20 g) further enhances the therapeutic effect.

(3) Gastrointestinal Diseases

In the "Shang Han Lun," it is written: "If, in a solar disease, the doctor mistakenly prescribes purgatives, resulting in abdominal distension and intermittent pain, it is still a solar disease, and Gui Zhi Jia Shao Yao Tang is the main prescription." "If, after acupuncture burns, the needle site becomes cold and develops red nodules, it will inevitably lead to 'ben tun,' with qi rushing up from the lower abdomen to the heart; Gui Zhi Jia Gui Tang is the main prescription for this symptom." "If there is fullness and mild pain below the heart, along with difficulty urinating, Gui Zhi Qu Gui Jia Bai Zhu, Fu Ling Tang is the main prescription." In the "Jin Gui Yao Lue," it is written: "If there is qi stagnation, with a hard mass below the heart, as big as a plate and with edges like a spinning disk, caused by fluid retention, Gui Zhi Qu Shao Yao Jia Ma Xin Fu Zi Tang is the main prescription." The above passages indicate that adjustments to Gui Zhi Tang can treat gastrointestinal pain, bloating, and discomfort. For general pain, increasing the amount of Bai Shao or adding Bai Zhu and Fu Ling can help; for severe pain accompanied by coldness and numbness of the limbs, add Wu Tou; if qi rushes up from the lower abdomen like a 'ben tun' (hyperactive intestinal peristalsis), increase the amount of Gui Zhi (or add cinnamon); if the stomach feels hard like a plate, use Ma Huang Fu Zi Xi Xin Tang. The author often uses these passages as a basis for clinical application, employing adjusted Gui Zhi Tang to treat chronic gastritis (superficial gastritis, atrophic gastritis), gastric and duodenal ulcers, achieving significant therapeutic effects. The formula is Gui Zhi Tang with double the Bai Shao (Gui Zhi 10 g, Bai Shao 20 g, Gan Cao 6 g, Sheng Jiang 6 g, Da Zao 4 pieces), plus 10 g of Dan Shen, 3 g of Mu Xiang, and 3 g of Cao Kou. When the tongue coating is thick and yellow, add 3 g of Huang Lian; when the tongue coating is pale and thin, add 10 g of Bai Zhu and 10 g of Fu Ling; for acid reflux, add 15 g each of Sheng Long and Mu Shi, and 20 g of Wu Zei Gu; for nausea, add 6 g of Sheng Jiang and 6 g of Ban Xia; for hiccups, add 10 g of Xuan Fu Hua and 15 g of Sheng Zhe Shi. Gui Zhi Tang is particularly effective in treating gastric spasms; the author often adds 10 g of Ma Huang, 3 g of Xi Xin, and 6 g of Fu Pian, or 3 g of Chuan Cao Wu and 3 g of Cinnamon, and for those with nausea and vomiting, adds 15 g of Sheng Zhe Shi and 6 g of Ban Xia, often seeing remarkable results in clinical practice. Some patients with autonomic nervous system dysfunction in the gastrointestinal tract, presenting with loss of appetite, fatigue, intestinal rumbling, and loose stools, can be treated with Gui Zhi Tang plus 10 g of Bai Zhu, 10 g of Fu Ling, and 3 g of Cinnamon, with equally good results.

II. Xiao Chai Hu Tang

In the "Shang Han Lun," it is written: "If, five or six days into a cold, one experiences alternating chills and fever, chest and flank discomfort, reluctance to eat, irritability and desire to vomit, or chest discomfort without vomiting, or thirst, or abdominal pain, or flank swelling, or palpitations, or difficulty urinating, or no thirst, with slight fever, or cough, Xiao Chai Hu Tang is the main prescription." The above passage indicates that Xiao Chai Tang is suitable for four main symptoms: "alternating chills and fever, chest and flank discomfort, reluctance to eat," which arise from "five or six days into a cold, with wind attacking the body." It should be noted that when a cold reaches five or six days, it enters the Shaoyang stage, which is half exterior and half interior. The "Shang Han Lun" states: "The illness of Shaoyang is characterized by bitter taste, dry throat, and dizziness." Therefore, throughout history, physicians have considered these four symptoms, along with bitter taste, dry throat, and dizziness, as the basic symptom group for Chai Hu Tang. Long-term practice has proven that these seven symptoms can occur in all chronic or subacute inflammatory diseases. The author has long used Xiao Chai Hu Tang with modifications to treat chronic cholecystitis, chronic pancreatitis, hepatitis, adnexitis, appendicitis, pleurisy, and other conditions, achieving good results. In short, any chronic or subacute inflammation, regardless of the organ involved, can be treated with Xiao Chai Hu Tang through adjustments. In fact, the seven symptoms of Chai Hu are indeed present throughout the course of these diseases. In the author's hometown of Tianshui City, Gansu Province, there was a famous physician named Yu, who was skilled at using Xiao Chai Hu Tang to treat all kinds of illnesses. The author once collected several handwritten prescriptions from him and carefully examined them, finding that all the conditions he treated were chronic inflammations, and all the formulas he used were variations of Xiao Chai Hu Tang. Mr. Yu lived to a ripe old age and passed away 40 years ago, but even today, local middle-aged and elderly people still speak highly of his profound medical skills. The above passage in the "Shang Han Lun" mentions "coughing, abdominal pain, flank swelling, palpitations, difficulty urinating, or slight fever," indicating that Xiao Chai Hu Tang is suitable for chronic or subacute inflammatory conditions affecting the respiratory, digestive, hepatobiliary, and renal systems. It would be more appropriate to rename this syndrome as "Chronic Inflammatory Syndrome," as any chronic or subacute inflammatory disease can be treated with this formula through adjustments. The "Shang Han Lun" also states: "If there is flank pain and fullness, and the face and body turn yellow... use Xiao Chai Hu Tang." "If, four or five days into a cold, one has a fever, aversion to wind, stiff neck, flank fullness, and warm hands and feet with thirst, Xiao Chai Hu Tang is the main prescription." This indicates that Xiao Chai Hu Tang is the primary prescription for treating liver and gallbladder diseases. If Xiao Chai Hu Tang removes Chai Hu and replaces it with dried ginger instead of fresh ginger, it becomes Ban Xia Xie Xin Tang. The "Shang Han Lun" states: "But if there is fullness without pain, it is a痞, and Xiao Chai Hu Tang is not suitable; Ban Xia Xie Xin Tang is recommended." If Ban Xia Xie Xin Tang adds more fresh ginger, it becomes Sheng Jiang Xie Xin Tang. The "Shang Han Lun" states: "If the stomach is upset, there is flank fullness, belching with food odor, fluid in the flanks, and rumbling and diarrhea in the abdomen, Sheng Jiang Xie Xin Tang is the main prescription." If Ban Xia Xie Xin Tang increases the amount of Gan Cao, it becomes Gan Cao Xie Xin Tang. The "Shang Han Lun" states: "If there is flank fullness and fullness, with dry vomiting and restlessness... Gan Cao Xie Xin Tang is the main prescription." The above-mentioned three Xie Xin Tangs—Ban Xia Xie Xin Tang, Sheng Jiang Xie Xin Tang, and Gan Cao Xie Xin Tang—are all variations of Xiao Chai Hu Tang, and the main symptoms they address never deviate from "flank fullness." According to the author's experience, these three formulas are extremely effective in treating chronic gastritis (superficial and atrophic gastritis), demonstrating that Xiao Chai Hu Tang with adjustments is one of the main prescriptions for treating gastric diseases. The "Shang Han Lun" also states: "If, eight or nine days into a cold, one undergoes purgation, with chest fullness, agitation, difficulty urinating, delirium, and the whole body feeling heavy and unable to turn over, Chai Hu Jia Long Gu Mu Shi Tang is the main prescription." The author has had a particularly deep experience with this passage, finding that Chai Hu Jia Long Gu Mu Shi Tang is highly effective in treating early-stage coronary heart disease, various cardiovascular diseases, and conditions characterized by chest tightness, difficulty urinating, and overall heaviness. For coronary heart disease, add blood-circulating and stasis-resolving herbs such as Chi Shao, Chuan Xiong, Hong Hua, Jiang Xiang, Dan Shen, Han San Qi, and water leech powder; for high blood pressure, add Huai Niu Xi, Sheng Zhe Shi, Sheng Bai Shao, Sheng Gui Ban, Sheng Di, and Huang Lian; for rheumatic heart disease, add Fu Pian, Bai Zhu, Fu Ling, and Gan Jiang; for arrhythmias, add Ku Shen, Dan Shen, Sheng Di, Mai Dong, and A Jiao. The original formula for Chai Hu Jia Long Gu Mu Shi Tang is: Chai Hu, Huang Qin, Dang Shen, Ban Xia, Gan Cao, Sheng Jiang, Da Zao, Sheng Long and Mu Shi, Gui Zhi, Fu Ling, Da Huang, and Qian Dan. Qian Dan is a lead compound refined from black lead; although it can calm the mind and soothe the spirit when taken internally, it is toxic and can cause vomiting and stomach upset, so recent recommendations suggest replacing it with Sheng Zhe Shi. Given that many passages related to Xiao Chai Hu Tang mention "difficulty urinating" or "cough," there have been numerous reports of using this formula to treat acute and chronic nephritis and urinary tract infections; there are also reports of using this formula to treat bronchial and pulmonary infections. The author believes that Xiao Chai Hu Tang combined with Long Dan Cao, Shan Zhi Zi, Che Qian Zi, and Mu Tong is the best formula for treating urinary tract infections, with significant effects on acute nephritis and hematuria. In summary, the clinical application of Xiao Chai Hu Tang can cover inflammatory lesions in the heart, gallbladder, liver, stomach, kidneys, lungs, bladder, and other organs of the human body.

III. Bai Hu Tang and Cheng Qi Tang

In the "Shang Han Lun," the Yangming syndrome in the Six Meridians Differentiation is divided into meridian symptoms and腑symptoms. The main prescription for meridian symptoms is Bai Hu Tang, while the main prescription for腑symptoms is Cheng Qi Tang. Based on more than 40 years of clinical experience and insights, the author believes that the so-called Yangming syndrome is a syndrome of acute heat, with meridian symptoms mainly characterized by high fever and腑symptoms mainly characterized by visceral lesions. The former includes various acute infectious diseases, influenza, heatstroke, and other acute infections during their high-fever phase; the latter includes various acute abdominal conditions such as acute cholecystitis, cholelithiasis, acute pancreatitis, acute intestinal obstruction, acute appendicitis, acute toxic dysentery, and acute pulmonary infection.