Gui zhi ren shen tang

Gui zhi ren shen tang

ren shen 9 bai zhu 9  gan jiang 9 zhi gan cao 12 gui zhi 12

When in tai yang disease, the exterior pattern has not yet been eliminated, and precipitation has been used repeatedly, and consequently there is incessant complex diarrhea, a hard glomus below the heart, and both the exterior and the interior are not resolved gui zhi ren shen tang governs.

This is li zhong wan with gui zhi. Li zhong wan is a tai yin pattern and adding gui zhi means it now also treats tai yang exterior wind strike patterns.

The damage to yang qi has impaired the spleen’s transformation function, and the failure to separate the clear from the turbid results in stagnation which obstructs the qi dynamic. The subsequent accumulation of turbid damp in the middle jiao manifests as ‘hard glomus below the heart’ or focal distension in the epigastrium. The failure of the spleen to raise clear yang is reflected in the incessant diarrhea.

The pathogenesis of a gui zhi ren shen tang pattern is a tai yang wind strike pattern and presence of preexisting insufficiency of spleen yang. Thus there is cold in both the exterior and interior. In this pattern there are  symptoms of fever and aversion to cold, hard glomus in the epigastrium, persistent diarrhea, abdominal pain which is eased by warmth and pressure, cold hands and feet, a pale tongue with a white tongue coat, and a pulse that is floating and moderate.

Used for no appetite thirst and palpitations with weak stools.

Ren shen, Ginseng radix is sweet tonifying and nourishing of the spleen, lungs, heart, and kidney. It nourishes yin fluids and therefore is the foremost qi and yin tonic.

The yin fluids from ren shen moderate excessive movement by anchoring yang with yin. It raises the original qi and gathering qi. It strengthens righteous qi and righteous qi is also called true qi and is a combination of original qi and gathering qi. All are dependent on the qi of shao yin and tai yin. Which in turn are dependent on the jue yin and shao yang for the ministerial fire in all three burners.

Often combined with bai zhu to treat excessive dampness due to tai yin deficiency. Ren shen, bai zhu tonify tai yin qi of spleen and lung and strengthen the spleen while bai zhu alone dries and clears dampness to allow normal function to return.

Bai zhu, Atractylodis macrocephalae rhizome is sweet tonifying of the stomach domain and spleen. Bai zhu is bitter draining of excess fluids in the stomach domain, spleen, lungs and bladder.

It tonifies the spleen qi along with the promotion of the spleen’s transforming and transporting actions. It dries the middle burner and tonifies the spleen. It metabolizes fluids and so creates room for healthy new fluids. Bai zhu and ren shen are the representative pair for supporting tai yin qi deficiency and damp accumulation.

Gan jiang, Zingiberis rhizoma, dried is warm (or hot) pungent and astringent. Gan jiang is the main herb to warm the tai yin level and treat excessive dampness by introducing yang ming dryness in tai yin dampness.

Zhi gan cao, Glycyrrhizae radix prep is sweet tonifying and nourishing of all organs but especially the heart.

Zhi gan cao is sweet and mildly warm tonifying and nourishing of yin fluids. It nourishes yin fluids in the tai yin and shao yin. It calms wind in the jue yin.

It balances the pungent gui zhi with its sweet moderation and nourishing. Together gui zhi and zhi gan cao tonify heart yang.

Gui zhi, Cinnamomi cassiae ramulus is pungent sweet and warm dispersing of the imperial and ministerial fire. It warms and tonifies the shao yin and jue yin. In doing so it warms and tonifies the whole body.

Gui zhi is the emperor because it warms the Wood to stir the imperial Fire. It warms the blood which tonifies the heart yang.

Li zhong wan is considered a tai yin level formula but ren shen also tonifies and raises original qi. Gui zhi and ren shen together tonify shao yin.