Zhi Shi Xie Bai Gui Zhi Tang
Classical TCM Formula Profile
Part of the HJMEDICAL TCM Discovery Center
枳實薤白桂枝湯 · Zhǐ Shí Xiè Bái Guì Zhī Tāng
A classical formula for chest bi from Yang deficiency with phlegm-Qi stagnation and chest oppression.
Read the complete guide →Quick Facts
- Formula Category
- Qi-Regulating Formulas
- Primary Pattern
- Qi Stagnation
- Primary Function
- Unblock Yang, move Qi, dispel phlegm in the chest
- Primary Therapeutic Principle
- Unblock chest Yang, move Qi and resolve phlegm obstruction
- Classical Source
- Shang Han Lun (Zhang Zhongjing, Eastern Han)
- Available as Granules
- Yes
Formula Overview
A classical formula for chest bi from Yang deficiency with phlegm-Qi stagnation and chest oppression.
Therapeutic Principle
Traditionally selected for chest bi from deficient chest Yang with phlegm-Qi stagnation, rather than plum-pit Qi, blood stasis in the chest, or Yang collapse.
Composition: Sovereign, Minister, Assistant, Envoy
Every herb in the formula, grouped by the job it does in the classical hierarchy.
君SovereignTreats the main pattern
枳實Zhi Shi12g
Immature Bitter Orange- lowers qi and breaks up masses
- disperses pi and relieves abdominal fullness
薤白Xie Bai9g
Chinese Garlic- diffuses and promotes chest yang
- moves qi and dissipates masses
臣MinisterReinforces the sovereign
佐/使Assistant & EnvoyTreats accompanying patterns, harmonises the whole
厚樸Hou Po12g
Magnolia Bark- dries dampness and dissolves phlegm
- lowers qi and relieves abdominal fullness
瓜蔞Gua Lou12g
Trichosanthes Fruit- clears up phlegm and dissipates masses and loosens the chest and diaphragm
Classical Composition
- Aurantii Fructus Immaturus (Zhi Shi) 4 pieces (12g)
- Magnoliae Officinalis Cortex (Hou Po) 4 liang (12g)
- Allii Macrostemonis Bulbus (Xie Bai) 0.5 sheng (9g)
- Cinnamomi Ramulus (Gui Zhi) 1 liang (6g)
- Trichosanthis Fructus (Gua Lou) 1 piece (12g)
Dosages follow the classical source and are shown for study, not as a prescription.
Related Conditions
Related Health Topics
Actions
- Unblocks yang and dissipates masses
- dispels phlegm and lowers qi.
Indications
- Zhi Shi Xie Bai Gui Zhi Tang is indicated for chest bi caused by chest yang weakness, phlegm obstruction, and counterflow qi.
- The symptoms are fullness and pain in the chest, chest pain radiating to the back, panting, cough, spitting, shortness of breath, hypochondriac qi counterflowing upward to heart and chest.
Tongue & pulseThe coating is white and greasy, and the pulse is deep, wiry or tight.
Traditional Pathogenesis
Cause & mechanism
- This pattern is caused by chest yang weakness, fluid concentrated into phlegm, binding of qi and phlegm, and yin cold qi counterflow.
- Phlegm is a yin pathogen which tends to obstruct the movement of qi.
- When it collects in the chest, fullness and pain in the chest may occur.
- The pain may radiate between the chest and the back.
- Phlegm obstruction along with lung failing to diffuse and govern descent leads to panting, cough, spitting, and shortness of breath.
- When the chest yang is weak, yin cold qi counterflows and the patient can feel it rising from the hypochondria to attack the heart and chest.
- The root of this pattern is chest yang weakness, while the branches are phlegm obstruction and qi stagnation with counterflow qi.
Treatment strategy
- Therefore, the therapeutic methods are to unblock yang, dissipate masses, dispel phlegm, and lower qi.
How does this formula compare?
Clinical Perspective
Zhi Shi Xie Bai Gui Zhi Tang, Ban Xia Hou Po Tang, Xue Fu Zhu Yu Tang and Si Ni Tang can all address chest oppression. Ban Xia Hou Po Tang moves Qi and phlegm for plum-pit Qi; Xue Fu Zhu Yu Tang invigorates blood in the chest; Si Ni Tang strongly warms Yang collapse. Zhi Shi Xie Bai Gui Zhi Tang unblocks chest Yang and resolves phlegm-Qi for chest bi with Yang deficiency and phlegm obstruction.
Clinical Differentiation
- Zhi Shi Xie Bai Gui Zhi Tang is a commonly used formula for chest bi caused by chest yang weakness, phlegm obstruction, and counterflow qi.
- This clinical pattern is marked by fullness and pain in the chest, hypochondriac counterflow qi rising to attack heart and chest, white, greasy coating, deep, wiry or tight pulse.
Safety notes: This formula is not appropriate for chest bi due to yang deficiency with weak qi.
For educational reference only, based on traditional pattern differentiation — not a substitute for professional advice.
Frequently Asked Questions
What are the actions of Zhi Shi Xie Bai Gui Zhi Tang?
Zhi Shi Xie Bai Gui Zhi Tang has the actions of unblocking chest Yang, dissipating clumps, dispelling Phlegm, and descending rebellious Qi. It is designed for chest Bi (thoracic obstruction) in which Yang is constrained by Phlegm and stagnant Qi.
Which modern diseases is Zhi Shi Xie Bai Gui Zhi Tang suited to?
Modern TCM clinical practice commonly applies it to individuals whose pattern differentiation falls within chest Yang constraint with Phlegm-Qi stagnation, including certain presentations of angina or chest pain, intercostal neuralgia, costochondritis, and chronic respiratory conditions such as bronchitis or COPD with chest fullness, Phlegm, and Qi stagnation.
Is Zhi Shi Xie Bai Gui Zhi Tang suitable for improving chest fullness, pain radiating to the back, and shortness of breath?
For presentations of chest fullness and pain (possibly radiating through to the back), shortness of breath, wheezing or coughing of phlegm, a sensation of Qi surging upward from the flanks to the chest, white greasy tongue coating, and a deep wiry or tight pulse — in those whose pattern differentiation confirms chest Bi due to Phlegm-Qi obstruction with constrained Yang — TCM commonly applies this formula as an adjunct. It cannot replace standard cardiological or medical evaluation of chest pain.
Related Products
Nong's Zhi Shi Xie Bai Gui Zhi Tang (Immature Bitter Orange, Chinese Chive and Cinnamon Twig Decoction) 5:1 Concentrated Granules
Related Articles
Zhi Shi Xie Bai Gui Zhi Tang: Classic TCM Formula for Chest Bi, Pain & Qi Stagnation with Cold
Xue Fu Zhu Yu Tang: Classic TCM Formula for Blood Stasis, Chest Pain & Headache
Ban Xia Hou Po Tang: Classic TCM Formula for Plum-Pit Qi, Throat Discomfort & Qi Stagnation with Phlegm
Si Ni Tang: Classic TCM Formula for Yang Collapse, Cold Extremities & Shock
Browse all classical formulas →
Medical Disclaimer
For general TCM education only — not medical advice. Consult a qualified TCM practitioner or licensed healthcare provider before use, especially if pregnant, nursing, on medication, or managing a chronic condition.