Gui Zhi Tang: A Classic TCM Formula for Cold Relief and More

Gui Zhi Tang, a gem of Traditional Chinese Medicine (TCM), comes from Zhang Zhongjing’s Treatise on Febrile Diseases. This ancient formula, used since before the Han Dynasty, earned the title “first of all prescriptions” for its remarkable ability to restore health.

In times of war, it helped soldiers and refugees regain strength and lift their spirits by warming the body and balancing energy. Today, it remains a versatile remedy for colds, pain, and more.

Gui Zhi Tang

Ingredients of Gui Zhi Tang

Gui Zhi Tang uses just five simple herbs, each with a unique role:

• Cinnamon Twig: Spicy and warm, it promotes sweating, clears cold, and balances the body’s protective and nourishing energies.

• Peony Root: Sour and cool, it nourishes blood, supports yin, and eases pain.

• Roasted Licorice Root: Sweet and mild, it harmonizes the formula and soothes discomfort.

• Ginger: Spicy and warm, it fights cold, warms the stomach, and stops nausea.

• Jujube (Red Date): Sweet and warm, it boosts energy and supports digestion.

Together, these herbs create a balanced formula to relieve symptoms and restore harmony.

Gui Zhi Tang /桂枝湯, 5:1 Concentrated Granules

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Benefits of Gui Zhi Tang

Gui Zhi Tang is best known for treating wind-cold exterior deficiency, where the body’s protective (Wei) and nourishing (Ying) energies are out of sync. Its key effects include:

• Relieving Muscle Pain and Cold Symptoms: It promotes gentle sweating to expel wind and cold, easing headaches, fever, sweating, and chills.

• Balancing Ying and Wei Energies: It restores harmony between the body’s protective and nourishing systems, relieving symptoms like nasal congestion or sensitivity to wind.

• Warming the Body: It boosts yang energy, restoring strength and improving mood.

• Regulating Body Functions: It adjusts body temperature, sweat, blood pressure, immunity, and digestion, helping with issues like constipation or diarrhea caused by poor spleen function.

• Fighting Inflammation and Infection: Modern studies show it has anti-inflammatory, antibacterial, and antiviral effects, plus benefits for blood sugar and heart health.

The herbs work synergistically: cinnamon twig and ginger clear cold, cinnamon twig and peony balance energies, and licorice with jujube strengthens the body’s core.

Conditions It Treats

Gui Zhi Tang is Zhang Zhongjing’s go-to for wind-cold imbalances, but its uses are vast:

• Respiratory Issues: Colds, coughs, nasal congestion, or respiratory inflammation.

• Digestive Problems: Poor appetite, bloating, or indigestion due to weak spleen function.

• Circulatory Health: Heart conditions, irregular heartbeat, or diabetic heart issues.

• Muscle and Joint Pain: Neck strain, shoulder injuries, back sprains, or chronic lumbar pain.

• Nervous System: Insomnia, excessive sleep, or memory issues.

• Women’s Health: Menstrual irregularities, pregnancy discomfort, or postpartum recovery.

• Pediatric Conditions: Anorexia or malnutrition in children.

• Skin Conditions: Eczema or erythema multiforme with white tongue coating and slow pulse, often worse in winter.

• Other Conditions: Allergic rhinitis or general fatigue.

It’s not suitable for skin issues with yellow or greasy tongue coating, rapid pulse, or damp-heat symptoms worse in summer.

Gui Zhi Tang /桂枝湯, 5:1 Concentrated Granules

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Dietary Support

Pairing Gui Zhi Tang with simple recipes can boost its effects:

1. Ginger Date Tea

   • Ingredients: 5 ginger slices, 5 jujubes (red dates).

   • Method: Boil in water, simmer 10 minutes, drink warm.

   • Benefits: Warms the body, boosts energy, and supports digestion.

2. Cinnamon Twig Porridge

   • Ingredients: 5g cinnamon twig, 100g rice.

   • Method: Boil cinnamon twig in water, simmer 10 minutes, strain, cook rice in the liquid to make porridge.

   • Benefits: Promotes sweating, relieves cold symptoms, and balances energies.

3. Peony Soup

   • Ingredients: 10g peony root, 5g roasted licorice.

   • Method: Boil in water, simmer 10 minutes, drink warm.

   • Benefits: Nourishes blood and eases pain.

Precautions

Gui Zhi Tang is powerful but not for everyone:

• Avoid it if you have a cold with no sweat, internal heat, irritability, thirst, or a rapid pulse.

• Skip raw, cold, greasy, meaty, alcoholic, or strong-smelling foods during treatment.

• After taking it, eat hot porridge or drink warm water, then cover up to encourage light sweating.

• Consult a TCM practitioner if you have chronic conditions or are pregnant.

Conclusion

Gui Zhi Tang is a cornerstone of TCM, blending ancient wisdom with modern benefits. From fighting colds to easing joint pain and supporting digestion, its simple herbs pack a powerful punch.

By pairing it with warming foods like ginger tea or cinnamon porridge, you can enhance its effects and feel better faster. Always consult a TCM expert to ensure it’s right for you, and let this timeless formula bring balance and vitality to your life.

Chinese Name	桂枝湯
Phonetic	Gui Zhi Tang
English Name	Cinnamon Twig Decoction
Classification	Exterior-releasing formulas
Source	《Treatise on Cold Damage》Shang Han Lun《傷寒論》
Combination	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)
Method	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.
Action	Releases the flesh and the exterior, harmonizes ying and wei levels.
Indication	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.
Pathogenesis	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.
Clarification	If this formula is indicated for patterns in which there is already sweating, why use Gui Zhi Tang to further induce sweating? In the Gui Zhi Tang pattern, body fluids leak out of the body as sweat. This happens because an external attack of wind-cold results in the insecurity of wei yang and damages ying yin. Therefore, if one does not eliminate the external pathogen, ying and wei will lack harmony, and the sweating will not stop. Although Gui Zhi Tang is said to induce sweating while releasing pathogens from the flesh and exterior, it also regulates the ying and wei levels. Once the external pathogens are released, the surface will become secure. When ying and wei are harmonious the fluids will not leak out. Therefore, when Gui Zhi Tang is used as directed, after it induces a light sweat over the entire body, the sweating described in the original pattern automatically stops. The sweat that results from an external wind-cold with exterior deficiency pattern is referred to as a “pathological sweat”, while the sweat induced by Gui Zhi Tang is referred to as “medicinal sweat”. The distinction of the two is that pathological sweating often comes with chills, aversion to wind, and headache, while medicinal sweating often comes with warmth and slight sweating over the entire body, which is followed by recovery.
Application	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.
Additonal formulae	1. Gui Zhi Jia Ge Gen Tang (Cinnamon Twig Decoction Plus Pueraria, 桂枝加葛根湯) [Source]《Treatise on Cold Damage》Shang Han Lun《傷寒論》 [Ingredients] Gui Zhi Tang add ge gen 4 liang (12g) [Preparation and Administration] Prepare it as a decoction. Add 1 dou of water to decoct ge gen until 80% water remain. The decoction should be taken warm and the patient should bundle up with an extra layer to induce a mild sweat. [Actions] Releases pathogens from the muscles and skin, ascends fluids to comfort the sinews. [Applicable Patterns] Presentation of a Gui Zhi Tang pattern with a stiff neck and back. 2. Gui Zhi Jia Hou Po Xing Zi Tang (Cinnamon Twig Decoction Plus Magnolia and Apricot, 桂枝加厚朴杏子湯) [Source]《Treatise on Cold Damage》Shang Han Lun《傷寒論》 [Ingredients] Gui Zhi Tang add hou po 2 liang (6g) and xing ren 50 pieces (6g) [Preparation and Administration] Prepare it as a decoction. The decoction should be taken warm and the patient should bundle up with an extra layer to induce a mild sweat. [Actions] Releases pathogens from the muscles and skin, descends qi to relieve shortness of breath. [Applicable Patterns] Presentation of a Gui Zhi Tang pattern with slight labored breathing.

Gui Zhi Tang