When you feel “in between”

Sometimes chilly, sometimes overheated, the body a little heavy, the appetite fickle, with discomfort under the ribs and a mood that shifts through the day… In TCM, these signs may be associated with a blocked Shao Yang, the “pivot” that links the exterior and the interior, while the surface of the body has not yet regained its balance. The original text insists on one word, “slight” (微): neither the surface nor the pivot is strongly affected, but both are affected at the same time.

Chai Hu Gui Zhi Tang appeared around 200 AD, at the end of the Eastern Han, in the Shang Han Lun (《伤寒论》) by Zhang Zhongjing (张仲景). Its name is a set of instructions: it combines bupleurum (Chai Hu), the mainstay of Xiao Chai Hu Tang, and cinnamon twig (Gui Zhi), the mainstay of Gui Zhi Tang, two master formulas each taken at half-dose. It is one of the oldest examples of a “combined formula” (合方). In the 20th century, the Beijing physician Liu Duzhou (刘渡舟) broadened its reading: he saw it as a harmoniser of the Liver and Gallbladder as much as of the surface. Our version keeps eight of the nine substances of the original text, without pinellia (Ban Xia).

Two formulas at half-dose

Here Zhang Zhongjing answers a double dead end: releasing only the surface would push the climatic factor inwards, harmonising only the pivot would leave the surface as it is. So he takes both formulas at once. Three pairs carry the construction: bupleurum and skullcap for the Shao Yang, cinnamon twig and peony for the surface, ginger and jujube joining the two. Ginseng supports the whole.

Harmonises the Shao Yang: Bupleurum, the most abundant herb, disperses outwards, while skullcap makes things descend and clears Heat: one lifts, the other tempers, and the pivot moves freely again.

Harmonises the surface and the depths: Cinnamon twig opens and warms outwards, white peony holds and nourishes inwards. Tradition sees this pair as the key to the accord between the surface and the depths.

Supports the body during seasonal transitions: By harmonising the surface and supporting the Upright Qi with ginseng, the formula helps the body regain its balance when the weather changes and Wind-Cold lingers.

Supports the flow of Qi: In Liu Duzhou’s reading, the formula also harmonises the Liver and Gallbladder: bupleurum untangles the Qi that gets blocked under the ribs.