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Source: Jīn Guì Yào Lüè 金匮要略

Alternate Chinese names: Guì zhī jiā sháo yào zhī mǔ tāng (桂枝加芍药知母汤 Cinnamon Twig Decoction Plus Peony and Anemarrhena Decoction)

Ingredients

• Fù zǐ (附子 Aconiti Radix Lateralis Praeparata, aconite [accessory root]) (processed) 6–9g
• Guì zhī (桂枝 Cinnamomi Ramulus, cinnamon twig) 6–9g
• Chì sháo (赤芍 Paeoniae Radix Rubra, red peony [root]) 9g
• Zhī mǔ (知母 Anemarrhenae Rhizoma, anemarrhena [root]) 9g
• Fáng fēng (防风 Saposhnikoviae Radix, saposhnikovia) 9g
• Bái zhú (白朮 Atractylodis Macrocephalae Rhizoma, white atractylodes [root]) 9g
• Má huáng (麻黄 Ephedrae Herba, ephedra) 6g
• Gān cǎo (甘草 Glycyrrhizae Radix, licorice [root]) (mix-fried) 6g
• Shēng jiāng (生姜 Zingiberis Rhizoma Recens, fresh ginger) 3–5 slices

Actions: Dispels wind and overcome dampness; clears heat and relieves pain.

Indications: Wind-cold-damp impediment (fēng hán shī bì) with painful joints with swelling associated with palpable heat but without generalized heat effusion. Tongue fur: Yellow, thin, and slimy. Pulse: Rapid.

Method: Decoct with water.

Rationale: Guì zhī, Fáng fēng, and Má huáng dispel wind and overcome dampness. They are acrid, and disperse wind-damp in the exterior. Bái zhú fortifies the spleen and dries dampness. These four agents together address exterior wind-damp and interior dampness. Bái sháo and Zhī mǔ harmonizes yīn and clears heat. Fù zǐ works with Guì zhī, Bái sháo, and Zhī mǔ to free yáng and dispel dampness, thereby moving impediment (bì) and relieving pain. Shēng jiāng helps the Fáng fēng to dispel wind and overcome dampness, while Gān cǎo helps the Fù zǐ to move impediment (bì) and relieve pain. This formula includes both yīn and yáng agents that are mutually complementary in producing the desired effect.

Variations:

• Tension and pain in the joints preventing normal bending and stretching, and relieved by pain: Increase Fù zǐ (附子 Aconiti Radix Lateralis Praeparata, aconite [accessory root]), Má huáng (麻黄 Ephedrae Herba, ephedra), and Guì zhī (桂枝 Cinnamomi Ramulus, cinnamon twig).
• Generalized heaviness, swelling and numbness of the joints exacerbated by dull, wet yīn-type weather: Increase the Bái zhú (白朮 Atractylodis Macrocephalae Rhizoma, white atractylodes [root]) and Fù zǐ (附子 Aconiti Radix Lateralis Praeparata, aconite [accessory root]).
• Palpable heat at the painful area that is worse at night that in the day: Increase the Bái sháo (白芍 Paeoniae Radix Alba, white peony [root]), Zhī mǔ (知母 Anemarrhenae Rhizoma, anemarrhena [root]), and Gān cǎo (甘草 Glycyrrhizae Radix, licorice [root]).

Similar: Guì zhī tāng (桂枝汤 Cinnamon Twig Decoction)

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