Gui Zhi Tang — Cinnamon Twig Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

What is Gui Zhi Tang?

Gui Zhi Tang (“Cinnamon Twig Decoction”) is the first formula in Zhang Zhong Jing’s Shang Han Lun (c. 220 CE) and is considered by many as the most important formula in the entire Chinese pharmacopoeia. It is the foundational formula of the entire Shang Han Lun tradition and the model for an enormous number of subsequent formula variations. Its elegance lies in its dual action: it both releases the Exterior in Wind-Cold invasion AND tonifies and harmonises the Ying and Wei levels — making it suitable for the “weak Tai Yang” pattern where there is Wind-Cold attacking a constitutionally Wei-Qi-deficient patient.

Gui Zhi Tang TCM pattern

Prescribed for Wind-Cold attacking the Exterior in a patient with Wei Qi deficiency, characterised by: fever and aversion to wind, sweating that does not relieve the fever, headache, stiff neck, dry retching, a thin white tongue coat, and a floating, slow or moderate pulse. The key distinction from Ma Huang Tang patterns is the presence of sweating — this indicates that the Wei Qi is too weak to close the pores against the pathogen.

Key herbs

1. Gui Zhi (cinnamon twig) — 9 g; releases the Exterior; warms and unblocks the channels
2. Bai Shao (white peony root) — 9 g; nourishes Yin and restrains Wei Qi leakage
3. Sheng Jiang (fresh ginger) — 9 g; releases the Exterior, warms the Stomach
4. Da Zao (jujube) — 4 pieces; tonifies the Spleen and harmonises
5. Zhi Gan Cao (honey-fried liquorice) — 6 g; harmonises and supplements Qi

The Gui Zhi / Bai Shao pair is the defining feature — it harmonises the Ying (nutritive) and Wei (defensive) levels, releasing the Exterior while preserving fluid.

Formula actions

1. Releases the Exterior and expels Wind-Cold
2. Harmonises the Ying and Wei
3. Strengthens the Spleen and Stomach (through Sheng Jiang, Da Zao, Zhi Gan Cao)

Conditions treated

1. Common cold and influenza with sweating, aversion to wind and weak immunity
2. Constitutional Wei Qi deficiency with recurrent colds
3. Mild fevers in elderly or postpartum patients
4. Spontaneous daytime sweating from Wei Qi deficiency
5. As the base for many variations (Gui Zhi Jia Long Gu Mu Li Tang, Xiao Jian Zhong Tang, etc.)

Cautions

Contraindicated in Wind-Cold patterns without sweating (use Ma Huang Tang) and in Wind-Heat patterns (use Yin Qiao San). Take with thin rice porridge after dosing to assist the formula. Always consult a qualified Chinese herbalist registered with the RCHM. Online herbal consultations are available.