An interpretation of Chai Hu Gui Zhi Gan Jiang Tang

CHGZGJT appears in only one line in the Taiyang chapter: Line 147. It reads: When cold damage has lasted 5 or 6 days, sweating has been promoted and then precipitation (purging) has been used, there is fullness in the chest and rib side and mild bind, inhibited urination, thirst without retching, sweating only from the head, alternating cold and heat, and heart vexation, it means that the disease has not yet resolved, therefore Chai Hu Gui Zhi Gan Jiang Tang governs. So, as Liu Lihong once said to me: in every patient I want to understand the state of Yang. That's the first concern: in this pattern, there has been an outward movement of the Yang, as well as a downward movement of the Yang- both resulting in depletion, and accumulation. In terms of emotion, promotion of sweating is broadly speaking an impulse to the Taiyang and the autonomic nervous system- so a response to fear produces a similar gesture. Purging depletes yang and substance from the earth, so I might think about aspects of the Earth such as: bonding, nourishment, the ability to take in and express minimally egocentric unconditional love. Physically this has moved Dampness from Taiyin to the Rib side- so the substance has moved into the Shaoyang or Wood realm- meaning that at the level of ministerial fire there is a dampening effect. The Wood wants to move up and out expansively and freely- so that which inhibits one's capacity to initiate free expression, or self-expression, or even decisiveness and goal-directed behavior is inhibited by a protective psycho-bio-film comprised of Taiyin damp. The Shaoyang emerges like the Sun rising above the horizon, and it longs for Noon, and ultimately even midnight, and the hour of the wolf (Liver hours). So, most immediately Shaoyang longs for Taiyang expression- so the Gui Zhi component is about the movement in the chest- and in this case the same quality of fullness is present-- and not just fullness but a complex of hot and cold and damp, as the ministerial fire tries again and again to move. Anything that stagnates the ministerial fire will give rise to heat signs, and stagnant heat in the chest (or in the Heart, Taiyang within Yang) gives rise to heart vexation. And there you have it: this is even one of the lines that explicitly mentions vexation. The bottom line is that something from outside has gained purchase internally, and hot and cold have entangled with dampness, and all of it is an attempt to adapt to the conditions. That is, the dampness is trying to protect the system. That could be equally true of being subject to emotional abuse, or a virus, or cold damage proper. And what I have found is that there is often both an internalization of negativity, and a suppression of righteous anger. So I view it as a positive sign if anger appears after administering this formula. And, in cases of Gu-like phenomena, I have also seen clear Shaoyang symptoms arise from giving it. The next step is to clear it from Shaoyang with XCHT, and then CHGZT, and then GZT. So, I might paraphrase Liu Lihong and say I want to know the state of freedom of this patient. I want to promote a state in which a person can express herself free from any compulsion from without, and free from any compulsion within.