David Frierman, LAc: Guìzhī Tāng 桂枝汤 (Cinnamon Twig Decoction) and "Boundary Problems"

Article published at: Nov 13, 2023 Article author: Lily Michaud
Cinnamon Verum botanical illustration
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Here David Frierman, LAc shares a classical Chinese herbal formula that can be used to reassert boundaries that have been violated. 


The most significant Chinese text on how to use herbal medicinal formulas for disease, the Shānghán Zábìng Lùn傷寒雜病論 (Treatise on Cold Damage and Miscellaneous Diseases) was written in the latter Han dynasty by Zhāng Jī 張機 ( [courtesy name]: Zhāng Zhòngjǐng 張仲景). In Chinese Medicine, medicinals are almost never used singly, but in combinations or formulas, and Guizhi Tang is the first and most important formula mentioned in that classicMy mentor, Dr. Guohui Liu, called Guizhi Tang the “number one formula,” and Dr. Heiner Fruehauf calls the Shānghán Zábìng Lùn the “Book of Cinnamon.” There are literally dozens of modifications of this formula for dozens of presentations of various diseases, some of them quite disparate. 

Guizhi Tang is first discussed as a remedy for the initial stage of an external contraction disease (“wàigǎn外感,” that is, a disease caused by external factors and not the result of “internal damage nèishāng 內傷”). In Chinese medical theory, external causes of disease or pathogens, called “evils ( xié)” enter the body through the surface, the skin and hair, and if not eliminated, pathologically progress inward to the organs. At the “surface,” two types of qì yíngqì 營氣 and wèiqì 衛氣 (yīn and yáng respectively) when “harmonized  ” or functioning normally in relationship to each other--yin nourishing yang and yang protecting and motivating yin--“secure” the surface, setting up a physiologic barrier or boundary that prevents evils from invading the body. Thus, when external evils try to invade the body, they first encounter yíngqì and wèiqì, but in the “struggle” that may ensue between the evils and the resistance provided by ying and wei acting as antipathogenic qi (xié zhèng dǒuzhēng 邪正斗爭), ying and wei’s relationship may be compromised resulting in their “disharmony bùhé 不和.” With this “first line of defense” against disease compromised, evils may penetrate further into the body. Guizhi Tang is said to “harmonize ying and wei (tiáohé yíngwèi 調和營衛),” promoting their reintegration thereby enabling them to reestablish the physiologic boundary and resist the evil invasion.  

Guìzhī Tāng and Boundary Problems 

Although harmonization of yin/yang at the surface results in what may be considered a physiologic boundary, in Chinese medicine, “qi” is not limited to material substances or even physiological processes but is also considered consciousness as well as the affects. Therefore, Guizhi Tang can also be used to help reestablish a kind of psychological barrier for those whose emotional boundaries have been assaulted and compromised by emotional and/or physical abuse, by loss of a significant other, or due to other emotional loss. 

In my practice, I like to combine the use of Guizhi Tang with acupuncture that “opens” or accesses the most primordial, internal, and central of the acupuncture channels, the Chōngmài 沖脈. I may also modify Guizhi Tang with a medicinal that resonates with the Chōngmài or center such as Héshǒuwū 何首烏or Rénshēn 人參. (I call this modification “heartbreak soup.”) I feel that if clients can access their core as well as secure their physical and emotional boundaries, they will be enabled to regenerate and reinforce their individuality and emotional strength, facilitation the healing from the psychic distress caused by violation of their boundaries.  

Author, David Frierman, LAc, is an Adjunct Professor at National University of Natural Medicine, Department of Classical Chinese Medicine.


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