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Chai Hu Gui Zhi Tang柴胡桂枝汤

Bupleurum and Cinnamon Twig Decoction (Bupleurum & Cinnamon Combination)

Harmonizing 和解剂

Ingredients9 herbs

柴Chai Hu柴胡12 g君 ChiefCourses the shao yang and vents the pathogen outward; the largest dose in the formula桂Gui Zhi桂枝4.5 g君 ChiefReleases the muscle layer, frees yang and settles the aching joints黄Huang Qin黄芩4.5 g臣 DeputyClears the heat lodged in the shao yang, paired with Chai Hu白Bai Shao白芍4.5 g臣 DeputyPaired with Gui Zhi to harmonize ying and wei; relaxes cramping pain半Ban Xia半夏6 g臣 DeputyDescends rebellious Stomach qi and stops the nausea人Ren Shen人参4.5 g佐 AssistantSupports the upright qi so the pathogen is not drawn deeper生Sheng Jiang生姜4.5 g佐 AssistantWarms the middle, assists release of the exterior, calms nausea with Ban Xia大Da Zao大枣4 pieces佐 AssistantNourishes and, with ginger, harmonizes ying and wei炙Zhi Gan Cao炙甘草3 g使 EnvoyHarmonizes the two parent formulas into one prescription

Indications

Harmonizes shao yangReleases the exterior, harmonizes ying and weiRegulates the middle and stops nausea

A shao yang pattern with the exterior unresolved: part of the pathogen has moved to the half-exterior half-interior while part still sits at the surface. Releasing alone or harmonizing alone leaves the other half untouched, so the two strategies are combined at half dose.

Clinical Manifestations

  • Lingering low fever with chills and aching joints after a cold
  • Nausea and poor appetite with fullness below the sternum
  • Mild alternating chills and fever
  • Epigastric and flank discomfort with fatigue
  • Recurrent functional abdominal pain, including in children
TongueThin white coating
PulseWiry and floating

Health Categories

Digestive HealthEnergy & FatigueCold & Flu Relief

Modern Applications

Post-viral fatigueLingering low-grade feverFunctional dyspepsiaRecurrent abdominal painInfluenza recovery

Common adjustments

  • Exterior signs fully resolved — move toward Xiao Chai Hu Tang 小柴胡汤 alone
  • Epigastric or abdominal cramping pain prominent — increase Bai Shao 白芍 with Gan Cao 甘草 — the Shao Yao Gan Cao Tang 芍药甘草汤 direction
  • Marked qi deficiency with spontaneous sweating — increase Ren Shen 人参 and use honey-fried Gan Cao
  • Greasy yellow coating, damp-heat in the middle — add Huang Qin 黄芩 weight, or Huo Xiang 藿香 and Pei Lan 佩兰

Contraindications

Not for a fully interior heat pattern with high fever, profuse sweating and great thirst, nor for a pure exterior excess with strong chills and no interior signs. It contains Gui Zhi, so vigorous heat, a bleeding tendency or yin-deficiency heat call for modification, and Ban Xia requires the usual care.

For licensed practitioners’ reference only — not a self-treatment guide.

Pregnancy

Practitioner supervision required in pregnancy — Gui Zhi is traditionally used cautiously during pregnancy and the formula also contains Ban Xia; it should not be self-prescribed.

References

Source Shang Han Lun 《伤寒论》 · Eastern Han

「伤寒六七日，发热微恶寒，支节烦疼，微呕，心下支结，外证未去者，柴胡桂枝汤主之。」
— 《伤寒论》(classical source, public domain)
  1. Classical source (public domain), cited in the source-quote section.
    2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
    3. 《方剂学》（全国中医药行业高等教育规划教材）— pattern analysis cross-checked.

Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.