Poria-cocos mushrooms (Fu Ling) Cinnamon twigs (Gui Zhi) Atractylodes rhizomes (Bai Zhu) Liquorice (Gan Cao)

Ling Gui Zhu Gan Tang

Chinese: 苓桂术甘汤

Pinyin: Líng Guì Zhù Gān Tāng

Other names: Poria Cinnamon Twig Atractylodes and Licorice Decoction

Number of ingredients: 4 herbs

Formula category: Formulas that warm and transform water and Dampness

Conditions for which it may be prescribed: AsthmaPleurisyPertussis and nineteen other conditions

  1. Warms and transforms Phlegm-Fluids
  2. Strengthens the Spleen
  3. Resolves Dampness

Contraindications: Contraindicated for Phlegm-Fluids due to Damp Heat or patterns characterized by... Contraindicated for Phlegm-Fluids due to Damp Heat or patterns characterized by Yin Deficiency and hyperactive Liver Yang, because this formula is acrid and warming. see more

Source date: 220 AD

Source book: Discussion of Cold Damage

Ling Gui Zhu Gan Tang is a 4-ingredient Chinese Medicine formula with Poria-Cocos Mushrooms (Fu Ling) as a principal ingredient.

Invented in 220 AD, it belongs to the category of formulas that warm and transform water and Dampness. Its main actions are: 1) warms and transforms Phlegm-Fluids and 2) strengthens the Spleen.

In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.

In this case Ling Gui Zhu Gan Tang is used by TCM practitioners to fight patterns like Phlegm or Phlegm-Fluids in the hypochondrium. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as morning sickness, meniere's disease or basilar insufficiency for instance.

On this page, after a detailed description of each of the four ingredients in Ling Gui Zhu Gan Tang, we review the patterns and conditions that Ling Gui Zhu Gan Tang helps treat.

The four ingredients in Ling Gui Zhu Gan Tang

Fu Ling is a king ingredient in Ling Gui Zhu Gan Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Poria-Cocos Mushrooms (Fu Ling)

Part used: Dried sclerotium

Nature: Neutral

Taste(s): Sweet

Meridian affinity: SpleenHeartKidneyLung

Category: Herbs that drain Dampness

Fu Ling strengthens the Spleen and release Dampness. It thereby transforms Phlegm-Fluids by addressing the root of this disorder which is the malfunction of metabolism of Body Fluids.  The combination of Fu Ling and Gui Zhi (Cinnamon twigs) is a delicate way of dealing with mucus and Phlegm accumulation due to cold. One increases the Body Fluids circulation, while the other warms the Qi flow.

Learn more about Poria-Cocos Mushrooms (Fu Ling)

Gui Zhi is a deputy ingredient in Ling Gui Zhu Gan Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

2. Cinnamon Twigs (Gui Zhi)

Part used: Dried young branches

Nature: Warm

Taste(s): PungentSweet

Meridian affinity: SpleenHeartLung

Category: Warm/Acrid herbs that release the Exterior

Gui Zhi warms the Yang and improves Qi's ability to transform the thin mucus and Phlegm. It also directs the rebellious Qi downward.  Its combination with Fu Ling (Poria-cocos mushroom) is a delicate way of dealing with mucus and Phlegm accumulation due to cold. Fu Ling increases the Body Fluids circulation, while Gui Zhi warms the Qi flow.

Learn more about Cinnamon Twigs (Gui Zhi)

Bai Zhu is an assistant ingredient in Ling Gui Zhu Gan Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

3. Atractylodes Rhizomes (Bai Zhu)

Part used: Dried rhizome

Nature: Warm

Taste(s): BitterSweet

Meridian affinity: SpleenStomach

Category: Tonic herbs for Qi Deficiency

Bai Zhu strengthens the transforming and transporting functions of the Spleen and dries Dampness. Together with Gui Zhi (Cinnamon twigs), it tonifies the Spleen Yang more strongly so that the excessive Dampness is resolved more easily.

Learn more about Atractylodes Rhizomes (Bai Zhu)

Gan Cao is an envoy ingredient in Ling Gui Zhu Gan Tang. This means that it directs the formula towards certain area of the body and/or harmonizes the actions of other ingredients.

4. Liquorice (Gan Cao)

Part used: Dried root and rhizome

Nature: Neutral

Taste(s): Sweet

Meridian affinity: SpleenStomachHeartLung

Category: Tonic herbs for Qi Deficiency

Gan Cao strengthen the Qi of the Middle Burner. It has a slight
tendency to cause Stagnation, but it can be effectively counteracted by Fu Ling (Poria-cocos mushroom)Gui Zhi (Cinnamon twigs), when combined with Gan Cao, transforms its sweetness into Yang through its own acrid and moving nature.

Learn more about Liquorice (Gan Cao)

Conditions and patterns for which Ling Gui Zhu Gan Tang may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Ling Gui Zhu Gan Tang is used by TCM practitioners to treat two different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Morning sickness Meniere's disease Basilar insufficiency Coronary heart disease Hypertension Hypotension Cor pulmonare Mitral valve prolapse Myocarditis Pericardial effusion Gastroptosis Peptic ulcers Chronic gastritis Functional stomach disorders Bronchitis Asthma Pertussis Pleurisy Cataracts Viral conjunctivitis Optic nerve atrophy Central serous retinopathy

Again it wouldn't be correct to say "Ling Gui Zhu Gan Tang treats morning sickness" for instance. Rather, Ling Gui Zhu Gan Tang is used to treat patterns that are sometimes the root cause behind morning sickness.

Now let's look at the two patterns commonly treated with Ling Gui Zhu Gan Tang.

Body Fluids (Jin Ye) is one of Chinese Medicine's vital subtances. Learn more about Body Fluids in Chinese Medicine

Phlegm

Ling Gui Zhu Gan Tang is sometimes prescribed by TCM practitioners to treat Phlegm. This pattern leads to symptoms such as chest pressure, nausea, dizziness and feeling of heaviness. Patients with Phlegm typically exhibit slippery (Hua) or wiry (Xian) pulses as well as a tongue with sticky coating, thick coating.

Phlegm has a great importance in Chinese Medicine as it is both a condition in and of itself as well as a cause for other diseases.

The main cause for the formation of Phlegm is Spleen Deficiency since the Spleen rules the transformation and transportation of Body Fluids. If this function is... read more about Phlegm

Body Fluids (Jin Ye) is one of Chinese Medicine's vital subtances. Learn more about Body Fluids in Chinese Medicine

Phlegm-Fluids in the hypochondrium

Pulse type(s): Deep (Chen), Wiry (Xian)

Tongue coating: Sticky coating

Tongue color: Pale

Tongue shape: Swollen

Symptoms: Coughing Palpitations Shortness of breath Dizziness or vertigo A feeling of distension of the hypochondrium Hypochondrial pain that is worse on coughing and breathing

Ling Gui Zhu Gan Tang is sometimes prescribed by TCM practitioners to treat Phlegm-Fluids in the hypochondrium. This pattern leads to symptoms such as hypochondrial pain that is worse on coughing and breathing, a feeling of distension of the hypochondrium, shortness of breath and coughing. Patients with Phlegm-Fluids in the hypochondrium typically exhibit deep (Chen) or wiry (Xian) pulses as well as a pale tongue with sticky coating.

When Phlegm-Fluids (a type of Phlegm characterized by white, very watery and thin mucus) clogs up the chest and hypochondriac regions, the Qi rebels, producing cough and shortness of breath.

Obstruction of the flow of Qi also produces chest and hypochondriac pain that, in severe cases, may extend... read more about Phlegm-Fluids in the hypochondrium

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