At first glance the formula ge gen tang seems strange. Why would anyone add ge gen and ma huang to gui zhi tang?
Ge gen tang
ge gen 12 ma huang 9 gui zhi 6 bai shao 6 sheng jiang 9 da zao 9 zhi gan cao 6
If the wind cold tai yang pattern is unresolved, the pattern can change to yang ming and gives rise to diarrhea, dual tai yang and yang ming.
In tai yang disease with a stretched stiff nape and back, absence of sweating, and aversion to cold, ge gen tang governs.
In tai yang and yang ming combined disease, there will be spontaneous diarrhea, and therefore gegen tang governs.
In tai yang disease, there is no sweating and urination is adversely little, there is qi surging upward to the chest, with clenching of the mouth and inability to speak, there is a desire to develop hard convulsion, and ge gen tang governs.
Ge gen tang is based on a concept found in two formulas that combine ma huang tang and gui zhi tang.
Ma huang tang is used to clear excess cold on the surface in a tai yang cold strike pattern. In this pattern the surface is closed and there is no sweating. The treatment goal is to clear excess cold and this is achieved with warm pungent gui zhi and ma huang. Xing ren assists ma huang in descending the tai yin lung. Zhi gan cao nourishes yin fluids and tonifies tai yin spleen to moisten the lung and anchor pungent gui zhi and ma huang.
In a gui zhi tang pattern there is excess cold but also sweating. In this pattern the surface is open and there is sweating. Warm pungent gui zhi and sheng jiang warm and disperse the cold on the surface. Gui zhi and zhi gan cao tonify heart yang. Gui zhi, bai shao and da zao nourish the jue yin liver blood and the shao yang ministerial fire. Sheng jiang warms the tai yin and raises the nutritive provided by da zao to the surface.
The combination of ma huang tang and gui zhi tang means that the surface is half open and half closed so there we will be tight cold muscles but also sweating.
These two formulas, gui zhi er ma huang yi tang and gui zhi ma huang ge ban tang do just that.
Gui zhi er ma huang yi tang
gui zhi 18 bai shao 18 sheng jiang 18 da zao 18 zhi gan cao 12 ma huang 9 xing ren 12
Nourishes the nutritive better than gui zhi ma huang ge ban tang.
Gui zhi ma huang ge ban tang
gui zhi 9 bai shao 9 sheng jiang 9 da zao 9 zhi gan cao 6 ma huang 9 xing ren 12
Better at clearing excess cold than gui zhi ma huang yi tang.
Back to ge gen tang. It also treats a half open and a half closed surface.
Ge gen, Puerariae radix is sweet tonifying and nourishing of the spleen and lungs. It is is pungent dispersing and sweet nourishing of the tai yang and yang ming channels. Ge gen connects the tai yin to the tai yang and yang ming channels.
Neutral, sweet and pungent it clears yang ming channel congestion and ascends the clear fluids of the sea of water and grain to moisten the hand yang ming channel. It clears the channel stagnation located on the upper back and neck. Combined with bai shao it benefits yin and relieves the convulsions and spasms by relaxing the tendons.
The ma huang is helping with clearing the cold on the surface and in tonifying the heart yang while supporting the tai yin lung in dispersing and descending fluids.
The formula ge gen tang is more nourishing than gui zhi tang and better at clearing cold and stopping diarrhea.
If you want to make gui zhi er ma huang yi tang even more nourishing for the nutritive on the surface and stop diarrhea add ge gen.
If you need to descend and disperse the lungs more add xing ren to ge gen tang.