shanghanlun

Cinnamon Twig Decoction for Nutritive-Defensive Imbalance (lines 53 and 54)

By Fornia ⋅ February 28, 2008 ⋅  Print This Post ⋅ Post a comment

Cinnamon Twig Decoction (桂枝汤) is used not just for Wind Strike Pattern with Deficient Exterior (中风表虚证), but also for non-exterior illnesses. To be more precise, it is useful in treating a pattern of nutritive-defensive imbalance (营卫不和证).

We see examples of this in lines 53 and 54 of Shanghanlun (伤寒论).

病常自汗出者，此为荣气和，荣气和者，外不谐，以卫气不共荣气谐和故尔。以荣行脉中，卫行脉外，复发其汗，荣卫和则愈，宜桂枝汤。 (line 53)

Line 53 means: a person who sweats excessively spontaneously has a problem not with the nutritive qi (荣气), but with the defensive qi (卫气). It is because defensive qi doesn’t hold in that a person begins to perspire. Nutritive qi and defensive qi are interdependent, one coursing in the veins, the other coursing on the outside. When perspiration is induced [using Cinnamon Twig Decoction], the two are in harmony again.

This is like saying that while nutritive qi is all good, defensive qi is weak, and hence you’ve all the good yin-fluids – associated with nutritive qi – leaking out. It then as if sweating it out moderately would balance out the relative excess of nutritive qi (think yin-fluids).

病人藏无他病，时发热自汗出而不愈者，此卫气不和也，先其时发汗则愈，宜桂枝汤。 (line 54)

Line 54 says: If you have a functional perspiration problem where heat effusion and perspiration occur in spurts, it’s (as above) a problem with your defensive qi . Use Cinnamon Decoction in between the sudden spurts of effusion and perspiration.

So Cinnamon Twig Decoction has a prophylactic purpose here – it is to prevent the imbalance of nutritive qi and defensive qi from getting out of hand. You mildly sweat it out before your body does it in way that is considered pathological.

Conclusion:

Put simply, you weaken nutritive qi, taking away it relative excess, hence bringing about a balance between nutritive and defensive qi.

Another POV:

The viewpoint that follows is that of my teacher Zhao Mingfang. He believes – as we said above – that nutritive qi leaks out because defensive qi is not holding in. However, he also avers that you do not weaken nutritive qi when using Cinnamon Twig Decoction. Instead, Cinnamon Twig decoction strengthens both nutritive and defensive. In a nutshell:

• Defensive qi not holding in (卫气不固) causes nutritive qi to leak/spurt out (营阴外泄).
• Nutritive-defensive imbalance (营卫不和) is due to both nutritive and defensive being weak.
• Cinnamon Twig Decoction will strengthen both of them by the action of balancing nutritive and defensive qi (调和营卫).

Which could also mean that…

Cinnamon Twig Decoction (桂枝汤) doesn’t just cause you to perspire and take away that Wind Strike. More than that, it takes away your problem of excessive perspiration by doing something that somehow also causes you to perspire. This something is called 调和营卫, which does not just nurture your depleted nutritive qi (yin-fluids), but also strengthens the root of the problem – weak defensive qi (卫气).

That’s one man’s point of view. Just for anyone to bite on.

Question to ponder:

How does Cinnamon Twig Decoction then differ from Yupingfeng Powder (玉屏风散), which is also known to strengthen your defensive qi (卫气)? Click here for more.

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