Guizhi Jia Fuzi Tang for Treating “Unstoppable Sweating”

Guizhi Jia Fuzi Tang (Cinnamon Twig plus Aconite Decoction) comes from the Shanghan Lun (Treatise on Cold Damage). The original formula is: Guizhi (Cinnamomi Ramus) 3 liang, Shaoyao (Paeoniae Radix) 3 liang, Zhi Gancao (honey-fried Glycyrrhizae Radix) 3 liang, Sheng Jiang (Zingiberis Rhizoma, sliced) 3 liang, Da Zao (Jujubae Fructus, broken) 12 pieces, Fuzi (Aconiti Radix preparata, fired, peeled, broken into eight pieces) one piece. “Take the six herbs, with seven sheng of water, boil down to three sheng, strain, and take one sheng warm.” Guizhi Jia Fuzi Tang treats “Taiyang disease, after promotion of sweating, sweating leaks out unstoppably; the person avers wind, urination is difficult, the limbs are slightly tense and difficult to flex and extend.”

This formula is now generally used as: Guizhi 9 g, Bai Shao (Paeoniae Alba Radix) 9 g, Zhi Gan Cao 9 g, Sheng Jiang 9 g, Da Zao 4 pieces, Pao Fuzi (blast-fried Aconite) 10 g (decoct first for 20–30 minutes), decoct in water; boil three bowls down to one bowl, take once in the morning and once in the evening. When decocting, slice the ginger and break up the jujubes, so they decoct thoroughly. The aconite must be covered with water and decocted first for about half an hour to remove its toxicity.

Guizhi Jia Fuzi Tang has many opportunities for use. Clinically, some patients present with unstoppable sweating—I recently saw a patient whose hand sweat dripped straight down even in the dead of winter. Modern medicine cannot diagnose the cause of this kind of hyperhidrosis, but in TCM there is a corresponding formula to solve these problems.

Of course, TCM treats hyperhidrosis with more than just Guizhi Jia Fuzi Tang; Guizhi Tang, Yu Ping Feng San, Dang Liu Huang Tang, San Ren Tang, and Qin Jiao Bie Jia San can all be used. So in clinical use, one must choose the right formula according to the patient's detailed condition. When TCM selects the right formula to treat such difficult, complicated diseases, it usually achieves the effect of “one dose shows the effect, three doses cure it”—meaning the patient feels marked improvement after one dose and recovers after three.

Which patients is Guizhi Jia Fuzi Tang suitable for? TCM holds that this formula suits patients with “yang collapse”; only when yang is deficient and the wind pathogen does not resolve will sweating be unstoppable. In fact, Guizhi Jia Fuzi Tang is Guizhi Tang plus aconite to warm yang and secure the exterior. Guizhi Tang treats the Taiyang wind-strike pattern of “sweating and aversion to wind”; patients in the Guizhi Jia Fuzi Tang pattern have even more yang deficiency and more severe sweating than those in the Guizhi Tang pattern. “Leaks out unstoppably” describes sweating that cannot be stopped.

The body's fluids are finite; when too much sweat is lost, urination naturally becomes difficult. Some patients also develop the symptoms of “limbs slightly tense and difficult to flex and extend.” Why these symptoms? TCM holds it is because the body's fluids have been lost too greatly to moisten the sinews. Patients who sweat too much, besides “limbs slightly tense and difficult to flex and extend,” may also have cold limbs, bodily weakness, and bodily aching pain.

So the key to using this formula is that the patient must simultaneously have accompanying signs: cold limbs, joint aching pain, spasms and cramps, aversion to cold and wind. As for the pulse, it may be deep or floating and moderate; the tongue generally has a white coating or is watery-slippery with no coating. Guizhi Jia Fuzi Tang is a yang-supporting formula; it treats yang-deficient patients, not yin-deficient or damp-heat patients. Yin-deficient hyperhidrosis should use Qin Jiao Bie Jia San; damp-heat hyperhidrosis should use San Ren Tang. If one does not distinguish carefully and uses the wrong formula, it will certainly be ineffective.

Yu Wuyan once treated a hyperhidrosis patient with yang deficiency. Besides sweating on movement, the patient also had aversion to cold and wind, tight pain at the head and neck, and aching of the lower back and buttocks. Yu Wyan's pattern differentiation judged it a Guizhi Jia Fuzi Tang pattern, so he prescribed one dose; the patient recovered after taking it.

Qin Bowei also once treated a hyperhidrosis patient whose stools had been unformed for more than ten years; besides sweating and aversion to cold, the patient had weak, limp limbs. The pulse was deep, fine, and weak; the tongue coating thin white and watery-slippery. After Elder Qin gave the patient Guizhi Jia Fuzi Tang, the illness resolved after two doses.

Yu Guzhen once used Guizhi Jia Fuzi Tang as an emergency measure for a patient pouring with sweat. The patient had been hospitalized for over two months for chronic osteomyelitis; one afternoon he suddenly developed aversion to cold and headache. After the doctor gave some Western medicine, the patient sweated profusely and unstoppably, averted wind, had urgent urination but no urine, and his limbs convulsed. A TCM consultation was urgently requested. Yu Guzhen prescribed one dose of Guizhi Jia Fuzi Tang; it was immediately prepared and decocted, and after just one dose the patient recovered.

So Guizhi Jia Fuzi Tang is an excellent formula for unstoppable sweating caused by yang deficiency failing to secure the exterior and external invasion of wind. When matched to the right pattern, it produces an immediate effect.