桂枝汤

3. Common modifications

• With stiffness of the nape and back (project-like rigidity): add Ge Gen (kudzu root) → Gui Zhi Jia Ge Gen Tang (Cinnamon Combination Plus Kudzu).
• With panting and coughing: add Hou Po (magnolia bark) and Xing Ren (apricot kernel) → Gui Zhi Jia Hou Po Xing Zi Tang (Cinnamon Combination Plus Magnolia Bark and Apricot Kernel).
• With yang deficiency and unremitting leaking sweat: add Fu Zi (prepared aconite root) → Gui Zhi Jia Fu Zi Tang (Cinnamon Combination Plus Aconite).
• With acute abdominal pain: double the dose of Bai Shao (white peony root).

4. Cautions and clinical notes

• Contraindications:

o Absolutely contraindicated in externally contracted wind-cold excess exterior patterns (no sweating, floating tight pulse).

o Contraindicated in the early stage of warm-disease (wen bing) with exuberant internal heat.

o While taking this formula, avoid raw and cold foods, glutinous and slippery foods, meat and wheat-flour foods, the five pungent/acrid foods, alcohol and dairy, and foods with strong or foul odors.

5. Granule conversion and dose

• Calculation of the total raw herb weight of the original formula:

o Gui Zhi (cinnamon twig) 9g + Bai Shao (white peony root) 9g + Sheng Jiang (fresh ginger) 9g + Da Zao (Chinese date) 36g + Zhi Gan Cao (honey-fried licorice root) 6g = 69 grams.

• Conversion to 5:1 granules:

o 69 grams of raw herb ÷ 5 = 13.8 grams of granules.

• Recommended dose and method of administration:

o Take one dose daily, divided into three servings, dissolved in warm water, about 5 grams per serving.

o After taking the formula, a small bowl of hot thin rice porridge may be drunk ("sipping hot thin porridge") to assist the strength of the formula and support the source of sweat.

o After taking the formula, cover warmly (add extra clothing or bedding) to induce slight sweating; a light, all-over sweat is ideal — profuse sweating must be strictly avoided.