【Chinese Name】 |
枳實薤白桂枝湯
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【Phonetic】 |
Zhi Shi Xie Bai Gui Zhi Tang
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【English Name】 |
Immature Bitter Orange, Chinese Chive and Cinnamon Twig Decoction |
【Classification】 |
Qi-regulating formulas |
【Source】 |
《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 |
【Combination】 |
Aurantii Fructus Immaturus (Zhi Shi) 4 pieces (12g), Magnoliae Officinalis Cortex (Hou Po) 4 liang (12g), Allii Macrostemonis Bulbus (Xie Bai) 0.5 sheng (9g), Cinnamomi Ramulus (Gui Zhi) 1 liang (6g), Trichosanthis Fructus (Gua Lou) 1 piece (12g) |
【Method】 |
Decoct zhi shi and hou po in five sheng water and reduce to two sheng then filter the residue. Add the rest of the ingredients and bring it to a boil once again. Divide the decoction into three equal parts. It is to be taken warm three times per day. (Modern administration: It can also be prepared as a decoction.) |
【Action】 |
Unblocks yang and dissipates masses, dispels phlegm and lowers qi. |
【Indication】 |
Zhi Shi Xie Bai Gui Zhi Tang is indicated for chest bi caused by chest yang weakness, phlegm obstruction, and counterflow qi. The symptoms are fullness and pain in the chest, chest pain radiating to the back, panting, cough, spitting, shortness of breath, hypochondriac qi counterflowing upward to heart and chest. The coating is white and greasy, and the pulse is deep, wiry or tight. |
【Pathogenesis】 |
This pattern is caused by chest yang weakness, fluid concentrated into phlegm, binding of qi and phlegm, and yin cold qi counterflow. Phlegm is a yin pathogen which tends to obstruct the movement of qi. When it collects in the chest, fullness and pain in the chest may occur. The pain may radiate between the chest and the back. Phlegm obstruction along with lung failing to diffuse and govern descent leads to panting, cough, spitting, and shortness of breath. When the chest yang is weak, yin cold qi counterflows and the patient can feel it rising from the hypochondria to attack the heart and chest. The root of this pattern is chest yang weakness, while the branches are phlegm obstruction and qi stagnation with counterflow qi. Therefore, the therapeutic methods are to unblock yang, dissipate masses, dispel phlegm, and lower qi. |
【Application】 |
1. Essential pattern differentiation Zhi Shi Xie Bai Gui Zhi Tang is a commonly used formula for chest bi caused by chest yang weakness, phlegm obstruction, and counterflow qi. This clinical pattern is marked by fullness and pain in the chest, hypochondriac counterflow qi rising to attack heart and chest, white, greasy coating, deep, wiry or tight pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders, when the patient shows signs of chest yang weakness, phlegm obstruction, and qi stagnation: angina pectoris, intercostal neuralgia, and non-suppurative costal cartilage inflammation. 3. Cautions and contraindications This formula is not appropriate for chest bi due to yang deficiency with weak qi. |
【Additonal formulae】 |
1. Gua Lou Xie Bai Bai Jiu Tang (Trichosanthes, Chinese Chive and White Wine Decoction 瓜蔞薤白白酒湯) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] Gua lou 1 piece (12g), xie bai 0.5 sheng (12g), white wine 7 sheng (as needed) [Preparation and Administration] Decoct all of the ingredients simultaneously, reduce down to two sheng of the decoction, and drink while it is warm. [Actions] Unblocks yang and dissipates masses, moves qi and dispels phlegm. [Applicable Patterns] Chest bi. Symptoms include: panting, cough, spitting, chest and back pain, shortness of breath, the cun pulse is deep and slow, and guan pulse is tight and rapid. 2. Gua Lou Xie Bai Ban Xia Tang (Trichosanthes, Chinese Chive and Pinellia Decoction 瓜蔞薤白半夏湯) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] Gua lou (smashed) 1 piece (12g), xie bai 3 liang (9g), ban xia half sheng (12g), white wine 1 dou (as needed) [Preparation and Administration] Decoct all of the ingredients simultaneously and reduce to four sheng. Drink one sheng, warm, three times per day. [Actions] Unblock syang and dissipates masses, dispels phlegm and loosens the chest. [Applicable Patterns] Chest bi. Symptoms include: severe phlegm-turbidity chest pain radiating to the back, and unable to lie down flat. |
【Remark】 |
Officinal Magnolia (Magnolia officinalis) is listed as "Endangered" in the International Union for the Conservation of Nature and Natural Resources (IUCN) Red List of Threatened Species. |
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