Traditional Chinese medicine

Introduction

Traditional Chinese medicine has been in use from ancient times. Animal as well as mineral materials have been used as the source of the medicine but the primary source is botanical. Botanical products are used only after some kind of processing, which may include, for example, soaking in vinegar or wine. The World health Organization (WHO) estimates that at least 75% of the world’s population utilizes traditional medicines for healing in addition to curing diseases (Li, Yang, & Zhou, 2007). Traditional Chinese medicine is based on history, experience, culture and belief, and most herbal medicines are complex mixtures of largely unknown chemical composition. The use of herbal medicine in China is highly attributed to one Shen Nong- a paranormal cultivator. Legends saythat Shen Nong trained people on to set up fields as well as plant crops nearly five millennia ago (Yuen & Yung, 2010).

In addition, he  tasted various forms of herbal remedies in addition to trying to comprehend the character as well as effect respective medicines. He was hover cognizant of the fact that someday, he would most likely poison himself but would use plant derivatives for detoxification purposes and therefore enhance survival (Yuen & Yung, 2010). He would then teach people how to use these plants. Herbal medicine professionals within China focus more on the general human status as opposed to explicit germs. It is believed that germs congregate as well as flourish only in undermined body parts (Chen & Chen, 2009). So the true cure for disease is not simply to kill the casual organisms but to counteract conditions that permit disease to invade. This submission will therefore focus as well as analyze the  GuiZhi Tang in regards to herbal formulas employed in China.

Gui Zhi Tang ( Chinese Herbal Formula)

Cinnamon twig formula (GuiZhi Tang) represents the most frequently modified prescriptions in regards to Shang Han Lun (Li D. , 2013). This classical formula, indicated for Wind Cold invasion is simple and effective and has countless variations and associated formulas.It is best used in cases where the protective (wei) qi cannot protect the exterior, and the nutritive (ying) qi cannot nourish and stabilize the interior. When attacked by Wind Cold, the body’s nutritive qi, if left vulnerable by weakened protective qi, is no longer capable of fulfilling its function of containing fluids (Kanherb Company, 2015).

A common presentation is sweating with invasion from wind-cold, where the sweating does not lead to improvement of the condition and renders the patient more sensitive to the environment. It is also common for an individual to feel a natural sensitivity or aversion to drafts, and to experience occasional tenderness, stiffness in the muscle layer and in the neck and shoulders (Kanherb Company, 2015).

The famous Shanghai physician Zhang Yaoqing, cited in Contemporary Explanations of Classical Formulas, sums up the many uses of this formula under twelve headings: harmonization of nutritive and protective qid, Yang deficiency with spontaneous sweating, Running pigleg qi with wheezing, releasing the muscle layer to promote sweating, Insufficiency of ST yang, Deficiency cold pain in the lower abdomen, causing cramping pains, Wind-dampness painful obstruction, Chronic Spleen Wind in children, Deficiency wheezing, Enriching yin and harmonizing yang, Frostbite, Yin-type patterns in external medicine (Li D. , 2013).

In these cases it is inappropriate to use formulas with ephedra or other strongly diaphoretic, warm herbs, or formulas with cold and bitter herbs. In small doses this formula can also be used to address psychological boundary issues seen easily overwhelmed patients who have difficulty holding qi or nourishment. These patients usually have chronic deficiency patterns and progress slowly. Cinnamon Twig Formula gives them some energetic containment, and helps them make effective Therapeutic progress. This formula disperses “Wind Cold Excess” at the rank of protective qi and restores the normal flow of nutritive qi, so that they are harmonized (Kanherb Company, 2015).

Structure of the formula; components.

CinnamoniRamulus (Cassia Twig, Chinese Cinnamon/GuiZhi) 21.4%

Warm and acrid, releases externally-contracted wind-cold from the muscle layer. Enters into ying vessels, reinforces the qi within the vessel walls and expels pathogens from here. It circulates yang qi via the interstitial film where it assists the wei to control pores as well as sweating. The wei qi flows through muscle layers, and as such, guizhi can assist the wei qi to avail warmth to muscles. In this regard, alleviates the inflexibility allied to “taiyang meridian wind strike patterns” (Chen & Chen, 2009).

Paeoniae Radix, Alba (Chinese Peony, White / Bai Shao) 21.4%

Benefits the yin and contains the weak nutritive qi. Together with GuiZhi, simultaneously enhance the ability of the protective qi to dispel pathogenic influences while strengthening the nutritive qi. It is sour, protects the ying in addition to contracting body vessels. The contraction and expansion of the ying level by baishao and guizhi respectively, leade to a cancellation of respective actions presented by both. Instead the two act in concert to fortify the ying, eject pathogens, as well as revitalize the wei (Brand, 2007). The result of this synergy is harmonization of the ying and wei. By constraining the ying and contracting the vessels, baishao checks additional outflow of fluids from ying into tissues. The implication here is that sweat emmitted by guizhi is restricted to already accumulated fluids within the interstitial layer. Moreover, it perneates muscle layers where it assuages the rigidity allied to “wind-cold patterns” (Monda & Heuertz, 2009).

ZingiberisRhizomaRecens (Ginger, fresh / Sheng Jiang) 21.4%

Helps GuiZhi releases the exterior while also treating the nausea and vomiting by warming the middle and directing qi downward. Together with Da Zao, it works to complement the nutritive aspect of ying in addition to the defensive wei levels (Brand, 2007).

JujubaeFructus (Jujube Date, red / Hong Zao, Da zao) 21.4%

It aids the sour deputy nourish and harmonize the nutritive value of qi as well as the blood. Combined with sheng jiang, it benefits the middle qi, which rises to regulate the nutritive and protective qi.  It also assists baishao in harmonizing the ying level. In addition, it collaborates with sheng jiang as well as zhigancao to maintain the transformational as well as transportation functions in regards to the spleen and middle burner harmony (Li D. , 2013).

Glycyrrhizae Radix Preparata (Chinese Licorice Root, Honey-fried / ZhiGan Cao) 14.4%

This formula harmonizes the actions of the other ingredients, combining with GuiZhi and Sheng Jiang to transform the yang aspects of the condition with Bai Shao and Da Zao to transform the Yin. “Glycyrrhizae Radix Preparata” also directs the formula all through the 12 primary meridians, while guizhi assists circulation within vessels, directs collaterals. This amalgamation  spreads the formula’s balancing effects within the interior as well as exterior body sections (Monda & Heuertz, 2009).

Chinese cinnamon twig, the chief herb in this formula, supplements Yang and releases externally contracted Wind Cold from the muscle layer, and strengthens the regulatory function of nutritive qi. It is combined with White peony root to support protective qi in dispelling exterior invasions and to strengthen nutritive qi. Ginger rhizome further assists Chinese cinnamon twig in releasing the exterior, by warming the middle and directing qi downward. Red jujube fruit nourishes and harmonizes the nutritive qi and blood. Honey fried Chinese licorice and rhizome harmonizes the actions of the other herbs and assists Chinese cinnamon twig and Ginger rhizome in transforming the Yang aspects of the pattern, and White peony and red jujube fruit in transforming the yin (Kanherb Company, 2015).

“Cinnamon Twig Formula” represents a archetypal prescription for balancing the defensive qi as well as  qi (nutritive). From a clinical standpoint, this encompasses an assortment of applications, including but not limited to; common colds, skin allergies, different respiratory conditions, incapability to control body temperature, and early phases of “wind-cold-damp bi syndrome” (Li, Yang, & Zhou, 2007). During the “Tang Dynasty”, a Chinese physician and alchemist,-“Sun Si Miao”, recommended “Cinnamon Twig formula” as a  least recognized prescription and thus the most undervalued formula in regards to standard formulary (Monda & Heuertz, 2009). When a formula claims many seemingly disparate applications, it may suggest to  clinicians it is too wide in terms of effectiveness in explicit treatments. Such a drug is most likely considered a pedestal prescription requiring alterations prior generating any clinical outcomes (Company, 2015).

Almost all applications for “Cinnamon Twig Formula” can be justified by its vital actions in regards to harmonizing ying as well as wei. The ying as well as wei compounds represent the ideal internal-external relationship in the body. They are thus inextricable one cannot achieve meaningful results in the absence of the other. Although their inter-dependence is multifaceted, the important nature of their relationship is that one (wei) rules the outward directional movement and their destinations. On the other hand, ying directs inwards movements in respect to nourishing body tissues along with cells (Monda & Heuertz, 2009). Health cannot be maintained unless they are in harmony. Likewise, life cannot be sustained without either of them (Yuen & Yung, 2010).

Most “Cinnamon Twig Formula” uses are explained its inherent aptitude to normalize interstitial fluids levels and invigorating movement through them. Cinnamon twig invigorates blood flow in addition to dilating blood vessels (Li, 2013). This aids in the removal of harmful pathogens from blood to the interstices. However, the pungent nature of the cinnamon formula also revitalizes the flow of Wei in regards to eliminating pathogens (Yuen & Yung, 2010). White peonyon the other hand nourishes ying as well as strengthens the same within vessels. The dual action of invigoration outside the vessels and the consolidation within the vessels help in the restoration between wei and ying (Monda & Heuertz, 2009).

Debatably, the mainly adaptive and extensively tailored formula in regards to Shang Han Lun, with respect to “Cinnamon Twig Formula” applications have increased over the years culminating in contemporary applications especially in treating different skin illnesses (Chen & Chen, 2009). Moreover, no modification is required in the treatment of severe cases of “cold-type eczema” or most forms of urticarial conditions (Brand, 2007).

Psycho-Emotional issues usually fall under the general category of boundary issues that can be addressed through such this formula. Patients usually have an unceasing insufficiency patterns underlined by compromised capacity to keep the exterior out or contain the interior within in regards to psycho-emotional concerns (Brand, 2007). For instance, in particular patterns of Attention Deficit Hyperactivity Disorder (ADHD) is a relevant exemplar where individuals  exhibit the classic symptoms of ying as well as wei imbalances like poor heart regulation, sweating, constipation with clear urine, or frequent colds, this chronic overstimulation from the outside can be corrected with “Cinnamon Twig Formula”. A recent study using Cinnamon Twig Formula to treat ADHD in children aged between 2 and 13 years, indicated 93% amelioration rates after undergoing therapy for three weeks (Flaws, 2003). The formula was somewhat altered with daily dosages of each herb being reduced by one third except baishao, which was increased by a third. Most had showed symptoms of ADHD for periods spanning from 5 to 40 years (Flaws, 2003).

Another condition that the “Cinnamon Twig Formula” can treat is Postpartum Colds and Flu. Absence of reciprocated guideline between ying as well as wei is observed after childbirth, after a serious illness in patients underlined by feeble health constitution. In such instances, there might be no outwardly contracted “wind-cold” but presence of sweating, aversion to wind and fever can be noticed. Postpartum essentially means blood is undersupplied as a result of  loss during the birthing process. Channels and collaterals are open and vulnerable. Loss of blood and qi is great. The deficiency of qi and blood compromises the wei and ring harmony, making it easy for the mother to have a wind-strike. “Cinnamon Twig Formula” is prescribed with a view to treat any wind-strikes, and also provide a protective mechanism. It thus represents the effective approach in this regard due to its ability to provide uterine warmth (Chen & Chen, 2009).

Shang Han Lunlists avils more alterations to  “Cinnamon Twig Formul” compared to other base formulas (Flaws, 2003). some of the modifications made to the formula over the ages include the following.  Astragalus Formula (Huang Qi Jian Zhong Tang) which is  a modification of “Cinnamon Twig Formula focusing on the on complementing spleen qi. Secondly “barley malt sugar” (yi tang), astragalus (buang qi), and white atractylodes (baizhu) are added to the formula to acquire the desired effect (Li, Yang, & Zhou, 2007).

Another modification is Bupleurum and Cinnamon Formula (Chai Hu GuiZhi Tang); it is a combination of Cinnamon Twig Formula and “Minor Bupleurum Formula” (Xiao Chai Hu Tang). The formulas are malgamated to a great effect of treating Taiyang and shayang stages of exterior invasion. The Minor Bupleurum addresses shaoyang symptoms realted to conditions such as joint crackling and pain, epigastric pain and fullness in the chest while Cinnamon Twig Formula addresses taiyang symptoms such as fever and chills (Li, Yang, & Zhou, 2007).

Cinnamon D Formula (GuiZhiJia Long Gu Mu Li Tang) is modified form of “ Cinnamon Twig Formula”in which sheng jiang (unsullied ginger) is replaced with dried ginger (ganjiang); “Dragon bone” (long gu) as well as oyster shell (mu li) are introduced in the altered product with a view of enhancing harmonization in the heart as well as kidney during the drugs action (Li, Yang, & Zhou, 2007). Instead of focusing on  wei and ying, these alterations consider the composition of the formula with respect to explicit organs (Li, 2013).

Xiao Jian Zhong Tang (Minor Centre-Fortifying Decoction): the profound nature of Guizhi tang is readily apparent because of the dramatic change in indications achieved by subtle modifications, in this case the simple addition of Yi Tang (Maltosum). While GuiZhi tang is a formula for external contraction, Xiao Jian Zhong Tang is a major formula for internal medicine. Xiao Jian Zhong Tang is a representative formula for deficiency cold patterns of abdominal pain, among other indications. Yi Tang is a sweet medicinal which supplements the center and relaxes tension. This action of relaxing tension only appears in three common items in the Chinese material medica: Yi Tang, Bai Shao, and Gan Cao. The three of them are used in this modification, which accounts for its profound ability to treat cramping pain in deficiency patterns (Brand, 2007).

The formula is acrid and sweet-characteristics that reinforce heat and sweet flavors thereby reinforcing dampness. In this regard, there is a general caution against the application of of “Cinnamon Twig Formula” in interior damp-heat conditions. Guizhi Tang is also inappropriate for patients with exuberant interior heat as well as in greater yang disease that has been erroneously treated with purging and no exterior signs remain present. The formula should also be used with caution during the summer or hot weather (Li , 2013).

To treat variations of wind-cold with GuiZhi Tang, the oulined modifications must be considered:

• For marked insufficiency of protective qi with prominent aversion to cold, increase the quantity of GuiZhi and Gan Cao, or rather add Fu Zi.
• For profuse sweating and a thin pulse from weakness of construction, increase the dose of Bai shao and Gancao.
• For incessant leaking sweat in cases of relatively severe protective qi deficiency, add Huang qi (Astaragali Radix) as well as Bai Zhu.
• For marked nasal congestion with sneezing add Fang Feng and Xin Yi Hua.
• For a swollen, heavy sensation in the head indicating the presence of heat that prevents the yang from directing downward; add Ju Hua and Chan Tui.
• For severe headache, add Bai shao, chi shao, and Gao Ben (Li D , 2013).

Conclusion

This submission has focus as well as analyzed the  GuiZhi Tang in regards to herbal formulas employed in china. It has documeted differe formulas as well as various applications coupled with relevant modifications aimed at improving the health outcomes. A critical finding from the exercise reveals that whenever a dissonance in regards to protective as well as the nutritive ability of qi arises the “Cinnamon Twig formula” is the most effective approach to restoring that equilibrium.

References

Brand, E. (2007). Formula combinations; legendary herbs (first ed.). Legendary Herbs.

Chen, J., & Chen, T. (2009). Chinese Herbal formulas and applications. Art of Medicine , 2 (1), 11-23.

Flaws, B. (2003). Chinese Medical Update. Blue Poppy Press.

Kanherb Company. (2015). Kan traditions formula guide (sixth ed.). los Angeles, California: Kanherb Company.

Li, C. G., Yang, L., & Zhou, S.-F. (2007). Herb and Drug interactions. Australian Journal of Acupuncture and Chinese Medicine , 2 (1), 17-21.

Li, D. (2013). Herbal formulas. Routledge: London.

Monda, S. J., & Heuertz, S. J. (2009). Clinical Guide to Commonly Used Chinese Herbal formula (fifth ed.). Herbal Medicine press.

Yuen, J. W., & Yung, J. Y. (2010). Traditional Chinese Herbal Medicine. School of nursing, Hong Kong Polytechnic University.