Zhi Shi Xie Bai Gui Zhi Tang枳实薤白桂枝汤

Immature Bitter Orange, Chinese Chive and Cinnamon Twig Decoction

Regulating Qi 理气剂Promote the Movement of Qi 行气

Ingredients5 herbs

HerbDosageRoleWhat it does in this formula

枳Zhi Shi枳实Aurantii Fructus Immaturus12g臣 DeputyBreaks the knot downward and clears fullness under the heart 厚Hou Po厚朴Magnoliae Officinalis Cortex12g臣 DeputyDries damp, transforms phlegm and relieves distention 薤Xie Bai薤白Allii Macrostemonis Bulbus9g君 ChiefUnblocks the yang, scatters cold and dissolves the knot 桂Gui Zhi桂枝Cinnamomi Ramulus6g佐 AssistantWarms and frees the yang, and settles qi surging upward 瓜Gua Lou瓜蒌捣Trichosanthis Fructus12g君 ChiefSweeps phlegm out of the chest and opens the obstruction

Indications

Unblocks the yang and disperses knotted qiTransforms phlegm and directs qi downwardTurns back qi surging up toward the chest

Chest painful obstructionfrom devitalized chest yang with phlegm and qi knotted together. Yang no longer spreads through the chest, turbid yin rises into the space it has vacated, and qi from the lower burner pushes up behind it.

Clinical Manifestations

Fullness and pain in the chest, sometimes radiating to the back
Wheezing, cough with sputum, shortness of breath
A sensation of qi rushing up from below the ribs into the chest
Chest oppression that worsens on lying flat
Cold, damp weather aggravating chest tightness

TongueWhite greasy coating

PulseDeep and wiry, or tight

Health Categories

Respiratory HealthHeart & Circulation

Modern Applications

Angina pectoris Coronary heart disease Chest tightness Chronic bronchitis Non-cardiac chest pain

Common adjustments

Cold predominant, marked chest coldness — add Gan Jiang 干姜 and Rou Gui 肉桂
Phlegm thick and copious — add Zhi Ban Xia 制半夏 and Chen Pi 陈皮
Fixed stabbing pain suggesting blood stasis — add Dan Shen 丹参 and Chuan Xiong 川芎
Marked qi deficiency with fatigue — add Ren Shen 人参 or Huang Qi 黄芪

Contraindications

Chest pain can be cardiac. New, severe, crushing or spreading chest pain, or chest pain with sweating, breathlessness or collapse, is a medical emergency and needs urgent conventional assessment — herbal treatment does not substitute for it. Within TCM practice the formula is also unsuited to chest oppression from heat or yin deficiency, where warming and drying make matters worse.

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

Pregnancy

Generally avoided in pregnancy. Zhi Shi and Hou Po break qi downward and Gui Zhi is warm and unblocking; if the pattern genuinely calls for it, only a practitioner should decide, and chest pain in pregnancy warrants conventional assessment first.

Related Formulas

References

Source Jin Gui Yao Lue 《金匮要略》 · Eastern Han

「胸痹心中痞，留气结在胸，胸满，胁下逆抢心，枳实薤白桂枝汤主之。」
— 《金匮要略》(classical source, public domain)

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.