Gui Zhi Ren Shen Tang is a variation of Li Zhong Wan with the addition of Gui Zhi.
Gui Zhi Ren Shen Tang:
Ren Shen 9, Bai Zhu 9, Gan Jiang 9, Zhi Gan Cao 12, Gui Zhi 12
Li Zhong Wan:
Ren Shen 9, Bai Zhu 9, Gan Jiang 9, Zhi Gan Cao 9
To comprehend the rationale for adding Gui Zhi to Li Zhong Wan, it is beneficial to examine the disease triggers mentioned in the Treatise on Cold Damage.
In Tai Yang disease, where the exterior pattern remains unresolved and precipitation has been used excessively, resulting in persistent complex diarrhea, a hard glomus below the heart, and unresolved exterior and interior conditions, Gui Zhi Ren Shen Tang is indicated.
Tai Yang disease involves surface cold, and repeated precipitation draws the cold inward, creating a Tai Yin pattern with cold present both externally and internally.
The inclusion of Gui Zhi addresses the Tai Yang surface and fortifies the body’s Yang Qi.
Damage to Yang Qi impairs the spleen’s transformation function, leading to stagnation that hinders the Qi dynamic. This results in turbid damp accumulation in the middle jiao, presenting as a ‘hard glomus below the heart’ or focal distension in the epigastrium. The spleen’s inability to elevate clear Yang manifests as incessant diarrhea.
The pathogenesis of Gui Zhi Ren Shen Tang pattern is a Tai Yang wind strike with pre-existing spleen Yang deficiency, characterized by cold affecting both the exterior and interior. Symptoms include fever, aversion to cold, hard glomus in the epigastrium, continuous diarrhea, abdominal pain relieved by warmth and pressure, cold extremities, a pale tongue with a white coating, and a floating, moderate pulse.
Gui Zhi is a Tai Yang herb that warms the surface and the Tai Yang bladder.
Gui zhi is a Tai yang herb that warms the surface and the Tai yang bladder.
It is a Shao yin herb warm the Imperial fire, which in turn warms the Ministerial fire. The combination of Gui zhi and zhi gan cao creates the formula Gui zhi gan cao tang, which addresses both a deficiency of Yang qi and Yin fluids. It strengthens and nourishes the Heart Yang, with zhi gan cao facilitating the transformation of Yang through its Earthly energy.
Gan jiang and bai zhu work together to warm and dry excess fluids within, thus warming and drying the Earth element.
Ren shen boosts the spleen qi, elevating it to the chest to enable the Heart and Lungs to distribute clear qi throughout the body, and also enhances the Original qi of the kidneys, supporting the circulation of Ministerial fire.