Cinnamon Twig Decoction

Cinnamon Twig Decoction

Cinnamomi Ramulus (Gui Zhi) 3 liang (9g), Paeoniae Radix Alba (Shao Yao) 3 liang (9g), Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao) 2 liang (6g), Zingiberis Rhizoma Recens (Sheng Jiang) 3 liang (9g), Jujubae Fructus (Da Zao) 12 pieces (3g)

Gui Zhi Tang is prepared as a decoction. Compliance with the exact instructions for taking this formula is very important to achieve the desired therapeutic effect. It should be taken while it is warm. Following consumption of the warm decoction, the patient needs to additionally consume a bowl of warm rice porridge. The grain qi of the rice enhances the strength of the medicinals and boosts the stomach qi to help expel cold pathogens. Thereafter, the patient should either put on warm clothes or bundle up in a blanket to help induce a light sweat. The reason for this is to avoid further wind invasions and to promote sweating.

Releases the flesh and the exterior, harmonizes ying and wei levels.

Gui Zhi Tang is indicated for externally contracted wind-cold affecting those with an exterior deficiency constitution. The symptoms are aversion to wind, fever, perspiration, headache, congested and noisy nose, and dry retching. The tongue has a white coating, there is no thirst, and the pulse is either superficial and moderate or superficial and weak.

This pattern is caused by externally contracted wind-cold and disharmony between ying and wei qi. The《Treatise on Cold Damage》says “wind attacks the taiyang channel” and “the ying is weak while wei is strong”. The statement “Wei is strong” refers to an external attack by wind-cold that elicits a strong fight from the wei qi against the pathogen. Due to a disturbance of the channels, there is fever, headache, and a superficial pulse. “Ying is weak” refers to the loss of ying yin that occurs due to the insecurity of wei yang. Insecurity of wei qi is an impairment of healthy qi. Fluids leak out as perspiration; thus the symptoms of aversion to wind, and a moderate pulse.

If this formula is indicated for patterns in which there is already sweating, why use Gui Zhi Tang to further induce sweating?

1. Essential pattern differentiation Gui Zhi Tang is the basic formula used to treat external wind-cold invasion in an exterior deficiency pattern. This formula also harmonizes the ying and wei levels as well as yin and yang. This clinical pattern is marked by aversion to wind, fever, perspiration, superficial and moderate pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders, when the patient shows signs of an exterior deficiency wind-cold pattern: common cold, flu, upper respiratory tract infection; and when the patient shows signs of disharmony between ying qi and wei qi: rheumatic arthritis, erythema multiforme, urticaria, cutaneous pruritus, allergic rhinitis, and vomiting in pregnancy. 3. Cautions and contraindications It is not applicable for patients diagnosed with a wind-cold exterior-excess pattern with an absence of perspiration. While taking the formula, the patient should avoid raw, cold, oily or odorous food, alcohol, and meats.

1. Gui Zhi Jia Ge Gen Tang (Cinnamon Twig Decoction Plus Pueraria, 桂枝加葛根湯)