What is Zhi Gan Cao? Are Sheng Gan Cao and licorice slices the same?
Official Gan Cao is the dried root and rhizome of Glycyrrhiza uralensis, G. inflata or G. glabra. Zhi Gan Cao is sliced licorice stir-fried with refined honey until no longer sticky. The pharmacopoeial name is Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle. Sheng Gan Cao leans toward clearing heat, resolving toxin and transforming phlegm to stop cough. Zhi Gan Cao leans toward tonifying the Spleen, harmonizing the Stomach and boosting qi to restore the pulse. Write Zhi Gan Cao or Mi Zhi Gan Cao; do not treat raw licorice as honey-fried. Do not combine with Hai Zao, Da Ji, Gan Sui or Yuan Hua.
What are the TCM properties and traditional uses of Zhi Gan Cao?
According to the Chinese Pharmacopoeia, Gan Cao is sweet and neutral, enters the Heart, Lung, Spleen and Stomach channels; honey-fried licorice acts to tonify the Spleen and harmonize the Stomach, and boost qi to restore the pulse. It is used for Spleen-Stomach weakness, fatigue, fearful throbbing of the Heart and bound or intermittent pulse. Sweet, it tonifies the middle, eases urgency and harmonizes formulas—but also assists damp and congests qi. Use caution with large or long courses in exuberant damp with fullness, edema and hypertension.
How do you choose raw versus honey-fried Gan Cao?
Clearing heat and toxin, sore throat, sores and phlegm-heat cough more often use Sheng Gan Cao. Spleen-Stomach weakness, fatigue, Heart throbbing and bound pulse more often use Zhi Gan Cao. Both can ease urgency and harmonize; restoring the pulse favors the honey-fried form. Do not treat honey-fried slices as “sweeter snack licorice.” Long large doses can cause edema, raised blood pressure and low potassium.
What is the usual dosage? Can it be drunk daily as a qi-Heart tea?
The pharmacopoeial decoction dose for Gan Cao is 2–10 g (also given as 3–10 g). A practitioner may raise the amount in Zhi Gan Cao Tang. It is not a four-season “honey-fried licorice Heart tea.” Damp fullness, edema and hypertension only grow more congested by sweetness. Bound pulse and palpitations need assessment; it does not replace arrhythmia care.
What are the contraindications? Can it be used in pregnancy?
Use caution or avoid large long courses in exuberant damp with middle fullness and in edema. Use caution in hypertension, hypokalemia and heart failure. Do not combine with Hai Zao, Jing Da Ji, Hong Da Ji, Gan Sui or Yuan Hua (Eighteen Incompatibilities). Small harmonizing amounts in pregnancy formulas are often acceptable; large long courses need a practitioner. Stop if edema, rising blood pressure or weakness appear.
Can Zhi Gan Cao tonify the Spleen, restore the pulse and ease urgency?
It can help Spleen-Stomach qi vacuity and Heart qi insufficiency. Bound or intermittent pulse with Heart throbbing joins ginseng, raw rehmannia, Ass-hide glue, Ophiopogon, cinnamon twig and hemp seed in Zhi Gan Cao Tang (Restore the Pulse Decoction). Spleen vacuity joins Codonopsis, Atractylodes and Poria in Si Jun Zi Tang. Easing urgency joins peony. Sweet-warm, it tonifies the middle and restores the pulse—not a specific for every palpitation, every fatigue or every stomachache. Serious arrhythmia and heart failure are emergencies.
Can Zhi Gan Cao be drunk daily as a qi, Heart-nourishing or harmonizing tea?
Spleen vacuity fatigue and bound-pulse palpitations may enter a short formula; damp fullness and hypertension only grow more swollen with sweetness. “Honey-fried licorice nourishes the Heart” does not replace ECG and electrolyte assessment. Tonifying the Spleen, harmonizing the Stomach and boosting qi to restore the pulse should name Zhi Gan Cao 2–10 g, and avoid Hai Zao and Gan Sui type herbs.
How do you choose among Zhi Gan Cao, Sheng Gan Cao, Da Zao, Huang Qi and Ren Shen?
Honey-fried licorice is sweet, neutral leaning warm: tonifies the Spleen, harmonizes the Stomach and boosts qi to restore the pulse—Heart-Lung-Spleen-Stomach, also easing urgency and harmonizing. Raw licorice is sweet-neutral leaning cool: stronger at clearing heat, resolving toxin and transforming phlegm to stop cough. Jujube is sweet-warm: tonifies the middle, boosts qi, nourishes Blood and calms the spirit. Astragalus is sweet and slightly warm: tonifies qi, raises Yang, secures the exterior and promotes urination. Ginseng is sweet, slightly bitter and slightly warm: greatly tonifies original qi, restores the pulse, secures desertion, generates fluid and calms the spirit. Bound-pulse restoration favors Zhi Gan Cao; heat-toxin sore throat favors Sheng Gan Cao; nourishing Blood favors Da Zao; raising Yang and securing the exterior favor Huang Qi; great vacuity on the verge of desertion favors Ren Shen. They may be paired; damp fullness, edema and the Eighteen Incompatibilities forbid large licorice.
Which herbs is Zhi Gan Cao combined with? What are the representative formulas?
Heart throbbing with bound pulse joins ginseng, raw rehmannia, Ass-hide glue, Ophiopogon, cinnamon twig, hemp seed, ginger and jujube in Zhi Gan Cao Tang. Spleen vacuity joins Codonopsis, Atractylodes and Poria in Si Jun Zi Tang. Write Zhi Gan Cao 2–10 g; do not combine with Hai Zao, Da Ji, Gan Sui or Yuan Hua.
How do you choose and store Zhi Gan Cao?
Choose yellow to deep-yellow slices with a slight sheen, a toasted-honey aroma, a sweet taste and no stickiness. Moldy, burnt-black and syrup-adulterated lots are discarded. Store airy and dry against moths. Buy honey-fried licorice; do not use it long if damp is full; do not replace tonifying the Spleen, harmonizing the Stomach and boosting qi to restore the pulse with raw licorice or an unidentified sweet root by equal weight.